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FOX HILL BLK 1 LT 1
Fox Hill Block 1 Lot 1 #051-073-19 Municipality of Anchorage • -. Development Services Department Building Safety Division On -She Water & Wastewater Program, 4700 South Bragaw St. ' P.O. Box 196650 Anchorage, AK 99519-6650 www.G.anchorage.ak.us(907)343-7904 Page 1 or 3 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number. SWO60199 PID Number. 051-073-19 Nome: WILLIAM SCHNABEL Wastewater System: ❑ New ■ Upgrade Adore": 21615 WOODCLIFF DRIVE a CHUGIAK, AK 99567 ABSORPTION FIELD Phone: No. of Bedrooms: (907) 786-1912 3 ODeep Trench Cl Shollow Trench DBed DMound ■Other LEGAL DESCRIPTION Sall """° 2.0 Tq o.w can `"°'SEE DWC. cm/s, rL n Block: Lot: Subdivision: 1 1 FOX HILL oeplh to POO eettem fern 010 page: Growl Mplh be pipe: SEE DWG. rt. 0.56 n Township: — Range: — Section: — i• ease eka w "g greae: cnwel Imglh: SEE DWG. rL 34 n Wa WELL: ❑ New ❑ Upgrade w . .khn: 10 Na nkr Of ..� u. * tM.eea .a.. 4 2.5 ckwwfiookon Pr k A.8.4 7olq ow - co Ta Total okaerption sea: n FL POO m0l~. n 340 So. rL D 3034/ F-810/ SCH 40 PVC Dr . eea: slake water LsW: kwto .. GEG, Ltd. Cote kul 77�13-14/2006 FX ww: Pa set Ae C.&V Neght Akww CrwM: �M n rL TANK SEPARATION DISTANCES aseptic OHolding OS.T.E.P. OOther io Septic Absorption Lift Holdingbkc/Prhw4 kO141IOCu"" eeo�K Ccw-Ay in e From Tank Field Station Tonk seer Unee al« a. OG NwrWer of aa,npw"."t. Well — 100'+ — — 25'+ Surface Water _ 100'+ — — — LIFT STATION Lot Line — 10'+ — — — sir' k' seep * &wna xkev Foundation _ 10'+ _ _ _ " &M p1''P7 aI & °° " °"'" q; Curtain Drain — 25'+ _ _ _ Pu & 6w • V" k"p"60ne P wwwd ar. Remarks: *THIS IS A BOTTOMLESS ISF THAT WAS BENCH MARK REBUILT. Lawban one Drecnptipn: BOTTOM OF SIDING NEAR POINT "B" Meun'ea El..wtb": 100.00 Inspections performed by: GEG , Ltd. Dates: 1st 7/13/2006 ENGINEERS UALoo�o 2nd 7/14/2006 o OF DO ..... • 9S�oo0 3rd 7/14/2006 • Development Services Department P P Approval 4. Reviewed and approved by: Date: ..... ..... .. OQ f A. Go ness� p .J E— c►�00 Reviewed and approved by: 0 Date: 2 06 Ldp°"proresslan°� R«.. ��oofes f'ERMffNUMBER: AS DRAWING PARCEL ID NUMBER: SWO SW060199 051-073-19 1 1 I / I �I I i MTI 71.35 150.10 MT2 94.98 76.70 FV1 98.17 80.55 96.17 78.93 RFV4 94.42 77.66 92.98 76.60 EXISTING ISF REBUILT 2' HIGHER IN ELEVATION THAN EXISTING BED. APPROXIMATE LOCATION OF CURTAIN DRAIN ., :if�•• .s i •A• 1 / GLACIER ROAD -- - - - - EXISTING 550 GALLON FAT ALBERT LIFT STATION I, •t 'W r xm� r:..A A n 1 1 1 1 1 I 1 I I ��,•. -- o F.."'..... •q°ups GARNESS ENGINEERING GROUP, Ltd. CONSULTANTSA GENERAL CONTRACTORS Jnl cnoa nn, wrt .• ••. .•••• ••••••.••• 101• NM'lMrlt Wf N!0) . 111.Y( (p7)1/)y1i � /M (IO)J3M-])N . YmLIL �w.Mwrp'w�y�,_ PREPARED FOR: PHONE NUMBER: PAGE NUMBER: •• .... WILLIAM SCHNABEL 786-1912 2 OF 3QQ If GO ness.. LEGAL DESCRIPTION: DRAWN BY: QO r• ' • CE— AFD FOX HILL SUBDIVISION; LOT 1, BLOCK 1, C.J.G. p 71,v. gad TYPE OF WORK: DATE: p�OedPfolaasioA°oma AS -BUILT DRAWING OF SEPTIC SYSTEM UPGRADE 7/182006 ��D0000�o PERMIT 1 NUMBER: ASDRAWING 17I1rG P05NUMBER: SWO SW060199 0 CEL ID N-19 NOTE: THE DISTRIBUTION LINE IS 3/4- PVC WITH 1/4 INCH HOLES AND ORFICE SHIELDS SPACED 4 FEET ON CENTER. (7 HOLES PER LATERAL/28 HOLES TOTAL) FABRIC 1ae,,.� \ �. + s� f�+�Y ,\G'.,•s- .Y1):..�ni 1F rw �� " \SIM �!` ii V: � :A�. ` •r�`/�+' •.ar. TOP OF SAND_ !1.i,.a`•ti 94.35 (AVG) ::i::.•4 �..r-:..rt?7br „'ti Lrr.ISF SANO:. ^'*.•+.l•. `'�'Ia R -..ori =r ;,- OR -i bl.o d(... wy4, t�i�JJ' ��4VYM 2VlMYy/y< , v%,� .C>..• :., rr.+a>.�.: .,: w _. <{r yr .'.. 1' 1T4 .r.• -n - .sail ,: ly'hc•dY�l,.v TOP OF EXISTING INERT OF PIPE~v .. i ��.Sf i.�r �� aj17'ir " 1^��• r: J`v •�-�n •. ,vim%I.LS1.i 4t 1\•Mi f.�\.! •{1rS : 'il.��h 4R1 , SAND .92.40 . 94.91 (AVG.) .4\.lyi•. _` .�.±+ :...-r•. c ,.1 _`ti,:;..,,, 1 10' WIDE -BOTTOM OF EXCAVATION . 92.09 (AVG.) EXCAVATION LIMITED TO THE REMOVAL OF ALL CONTAMINATED MATERIAL GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS 6 GENERAL CONTRACTORS �.� �• • • • • • I =I L NOM OMq WO[ 101 ' MIOW4S, M K!0> � AO[ (M>)S))y1T . IN jY0>).110-ilN . Y0511C w�.Ow�.InrYer PREPARED FOR: PHONE NUMBER: PAGE NUMBER: `1 WILLIAM SCHNABEL 786-1912 3 OF 3 Q s -.J t ey rnesS: LEGAL DESCRIPTION: DRAWN BY: CE -79$3 FOX HILL SUBDIVISION: LOT 1. BLOCK 1. C.J.G. �Q e�e''!%rZcyp,p.�i>'�tgv0� TYPE OF WORK: DATE: �40O4pf�OOOoo PROFILE AS—BUILT OF ISF REBUILD 7/18/2006 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 6 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SWO60199 Legal Description: FOX HILL BLK 1 LT 1 Design Engineer: 0855 GARNESS ENGINEERING GROUF Owner Name: WILLIAM SCHNABEL Owner Address: 21615 WOODCLIFF DRIVE CHUGIAK , AK 99567-0000 oVV Date Issued: Jul 12, 2006 Expiration Date: Jul 12, 2007 Parcel ID: 051-073-19 Site Address: 021615 WOODCLIFF DR Lot Size: 39999 SO. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: Q✓ Disposal Field E✓ Septic Tank ❑ Holding Tank ❑ Privy El 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 catling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. DURING EXCAVATION ENGINEER NEEDS TO DETERMINE WHY EXISTING I.D.S.F. FAILED AND SUBMIT ENGINEERING STATEMENT WITH WASTEWATER INSPECTION REPORT. ANY DESIGN CHANGES DUE TO EXCAVATION NEED TO BE SUBMITTED TO ONSITE WATER WASTEWATER PROGRAM PRIOR TO CONSTRUCTION. Received By: Issued By: Date: Or Date: Z db Municipality of Anchorage Development Services Department Building Safety Division On -Site Water& Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us Rul:;w . (907)343-7904 �f rte• ON-SITE RUSH SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 1)J/ -6_q3– / 4/ Property owner(s) WILLIAM SCHNABEL Day phone 786-1912 Site address Legal description (Sub'd, Block & Lot ) FOX HILL: LOT 1. BLOCK 1 Legal description (Township, Section & Range) N/A Lot Size 999 —Acre Sq.Ft. THIS APPLICATION IS FOR ( ®all that apply): Absorption Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Zip Code 99567 Number of Bedrooms 3 THIS APPLICATION IS AN: Initial ❑ Upgrade Renewal ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and Is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. 30 •a'D )eilo5 Permit/Rush Fees:A JO "rI I %5 Waiver Fees: Date of Payment:_ -71/ 1 a� Receipt Number: 14Z7 34 (Rw. 11/05) Date of Payment: Receipt Number: GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS July 11, 2006 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, Ak 99519-6650 (907)343-7904 Ref: Proposed Septic System Upgrade for Foxhill Subdivision; Lot 1, Block 1, To whom it may concern: The existing 3 bedroom house is served by a private well and septic system. The ISF is currently in the state of failure and needs to be upgraded. We are proposing to rebuild the ISF. Comments regarding the design are summarized as follows: 1. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications. 2. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system. 3. TOPOGRAPHY: There are no slope concerns. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any gAestions, please contact us at 337-6179. Thank you for your assistance. M.S. NOTE. Attached is a site plan drawing, a design drawing, one soil log, which are all part of the design package for this septic system. (Contact G.E.G. Ltd. for 7 page construction specification letter.) 3701 E. Tudor Road, Suite 101 ' Anchorage, AK 99507 Ph: (907) 337-6179' Fax: (907) 338-3246 • Website: gamessengineering.com LOT 4. BLOCK 1 FOXHILL SUBDIVISION 0 \ 0O \\ LOT 3. BLOCK 1 FOXHILL SUBDIVISION LOT 8. BLOCK 2 7%HILL SUBDIVISION 7't / 1 / 1 T—LOT—T— LOT 9. BLOCK 2 FOXHILL SUBDIVISION LOT 2. BLOCK 1 FOXHILL SUBDIVISION ----------i \ ---------/— I \ / \ / BF GLACIER ROAD T13N, R1W. SEC 4. LOT 23 (NO CONCERN) TING SEPTIC SYSTEM I I I L -------------- r- - - - - - - - - - - - - - ------------- r-------------- I I I LOT 3, BLOCK 1 KIMPTON SUBDMSION I I I I CZPW ARPAD LOT 7, BLOCK 1 KIMPTON SUBDIVISION I / \ I I I GARNESS ENGINEERING GROUP, Ltd. p 17,` CONSULTANTS d GENERAL CONTRACTORS �.... .•• .•• ••• •••...... �ror [ nAn fvw. fort +or rAr for 32" PREPARED FOR: PHONE NUMBER: PAGE NUMBER: e... •• •• ••••••........... WILLIAM SCHNABEL 1 OF 3 0 y ey . C rness. LEGAL DESCRIPTION: DRAWN BY: O� v CE— 3 FFG FOX HILL•, LOT 1. BLOCK 1 DATE: B.F.M. TYPE OF WORK: 4^ Opro Tesslol, oma Q SITE PLAN 7/5/2006 Inw. �rwl HOUSE L____—_—_ I I AREAL I LLL T15N. R1W. SEC 4. LOT 22 F— I (WELL ON FAST SIDE OF LOT) GARNESS ENGINEERING GROUP, Ltd. p 17,` CONSULTANTS d GENERAL CONTRACTORS �.... .•• .•• ••• •••...... �ror [ nAn fvw. fort +or rAr for 32" PREPARED FOR: PHONE NUMBER: PAGE NUMBER: e... •• •• ••••••........... WILLIAM SCHNABEL 1 OF 3 0 y ey . C rness. LEGAL DESCRIPTION: DRAWN BY: O� v CE— 3 FFG FOX HILL•, LOT 1. BLOCK 1 DATE: B.F.M. TYPE OF WORK: 4^ Opro Tesslol, oma Q SITE PLAN 7/5/2006 Inw. �rwl NUMBER OF BEDROOMS:SMAXIMUM DEPTH TO BE LETTER THAT PERTAINS TO THIS DESIGN. TO OBTAIN A COPY OF THE LETTER GALLONS PER DAY (CPD): 450 LIMITED BY THE REMOVAL OF CONTACT GEG. BY PROCEEDING FORWARD PERCOLATION RATE/S: 30 MIN./INCH ALL CONTAMINATED MATERIA(. WITH THIS INSTALLATION, THE ENGINEER, PROPOSED ISF APPLICATION RATE: 2.0 i 1 WELL DRILLER, CONTRACTOR AND MINIMUM DRAINFIELD SO.FT.: 225— •\ PROPERTY OWNER AGREE THAT THEY HAVE READ THESE SPECIFICATIONS AND DRAINFIELD DESIGN: \ AGREE TO ACCEPT THE TERMS AND MAXIMUM DEPTH:sSEE NOTE \ \ CONDITIONS OUTLINED. WIDTH: 10 FEET LENGTH:30 FEET M.OA APPROVED LSF SAND FILTER: 2.5' EFFECTIVE: 0.5 FEET EXISTING ISF TO \ \ \ REDUCTION FACTOR: N/A BE REBUILT ACTUAL SO.FT.: 300 i i WT 1 i� 1 i Q J1 " / / `— -- EXISTING GALLONTANK EXISTING 550 EP GALLONWITH TC SEPTIC TANK I UFT STATEN / / / / / \� O ; �� •, i ;: `.'i EXISTING 3 •t :.I: L.; A: �: BEDROOM _— — 1. :..... ... •�.. HOUSE O I�:; I..i ��•�N I GLACIER ROAD GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS L Tuts so.o. fort I01 . me mwL r Mws• . MCK (ssTW.-sIn . ru (wrAls-42" . s - ....,.n....ryn.wpeww PREPARED FOR: WILLIAM SCHNABEL FOX HILL: LOT 1. BLOCK 1 .TYPE OF WORK: DESIGN FOR SEPTIC SYSTEM UPGRADE (na.. 91M) 2 OF 3 uQ y I ey�� wness. DRAWN Li Y: oo C % 53 B.F.M. ,O(p••'�cq FLUSHING VALVES (WITH PROTECTIVE COVERS) (EXTEND ABOVE GRADE) - EXISTING AIR 3/4' DIA SCH. 40 PVC LATERALS (HOLES, SHIELDS, AND FLUSHING VALVES PER ORIGINAL DESIGN) 7L______ -,T o ----------------------- 10' o � - 4' DIAMETER MONITORING TUBE NORTH 6' OF OLD ISF TO BE ABANDONED IN PUCE EXCAVATION WILL BE LIMITED TO THE REMOVAL OF ALL CONTAMINATED ISF SAND. TOP OF SAND SHALL BE AT 6' WASHED PEA GRAVEL WITH ORIGINAL ELEVATION OR HIGHER 3/4' DA SCH. 40 LATERALS AT MID STRATUM r PVC LATERALS FABRIC 2- 1 - 10' WIDE I GARNESS ENGINEERING GROUP, Ltd. H CONSULTANTSd GENERAL CONTRACTORS Q•••••• ..... ............. ]101 C 111008 b0. T 101 • Y6°OMGC m H001 . ,1CN[ (1p w?1 lT • rm (90IX1)lat4 VlHSO[. m.,s�lw,wgYwyy,py.n PREPARED FOR: PHONE NUMBER; PAGE NUMBER: V ..... ............ WILLIAM SCHNASEL 3 OF 3 OQ f A. orness:' LEGAL DESCRIPTION: DRAWN BY: FOX HILL; LOT 1, BLOCK 1 B.F.M. Q ° CE -3 7/j/•�Ob' �o�� TYPE OF WORK: OA7E DETAIL oOOO4as Ao 0\ DRAWING FOR SEPTIC SYSTEM UPGRADE 7/7/2006 Municipality of Anchorage / Development Services Department :y: :d7 Building Safety Division On-Site Water and Wastewater Program, 4700 S. Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page I Dt3 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM ANDIOR WELL INSPECTION REPORT PermitNumber: 50 PID Number: 0 1 -0 % N e9;//4 6hervl Sclincibel Wastewater System: ❑New E] Upgrade Po9 aal 16 [Mr te,d 09522 ABSORPTION FIELD Pra,.. 1 f N�.ro.r a Rwoa.. / o D.w T,« o swb'. T,« 08.a a Mwm ZLW LEGAL DESCRIPTION Sd RabeDepen �P n r Ran aipna ids' as.0 `SCt 3,'9 Fl Bl :k: I La sW6viwap . I Dead, b P" Wta, Ran «pial pals- Grant dean DensaM1 P' o r/ 1• FI. 3" Ian 014 eIFt. Tow p Ranee sedan Feadded.pp wp-slgr .: Gana LoVh 3 . FI. V i1. Well: El New C3 Upgrade Gn vndpl. I NumRwakrs: Dla«ae tfal'aeen I., FILill'Fl GTe„swl"Il (Pnvae. A B. C1 Taa Daps: Cased b' P� Taal 0,0"M «ea' 3 60 P mabnal D30 t X *;'4 � e FI Ft' NO. Oat A+'• Slalpwa«Level: 12F d in Dal. lnelabd 5-:j5_130 FI w. c a YN SM a: avna /IepH /Nave Gant TANK GPM FI. FL SEPARATION DISTANCES $1 Septic ❑ Holding ❑ S.T.E.P. ❑ Other. Lift Holding PubEUPrival ma, lI w« Prcml Capaaly 1�r�WI From Station Tank Sewer Line e S IG 5 16 1 — a5+ �««w9.8 PEweFsla+,p. ISepticgAbsorption } LIFT STATION La ler 55-0 ca �em� s7�C5 Fandalan 10' 1 S ^ I (�1 � •P.mP ai IwN w. !7l •Plmp or I.va n Nqn w«« rr« « it h qg im Damn D,an /vooe Pury Wla 8 Lbda Ebclrral Fapedan. part Cy tw R.marRa ->''- I-or L'-rNt wAivKK R7clud�rlto, BENCH MARK Lerslan and DevrFnm- p Td( in Irrl0.c s[-a7a TArK '40C.) hO M 0 Is Assa,ItA E Ian �1p is .J JHS / '4_ d geGq o.,. t 4 O I Yl V IOD FL Enq Di: A/�11 f 17034 Egle River Loop Road, No 20d S Inspections Dates: 1 5 a �! -oa i t ,h performed by: — tA,a:+l,�sn "" 2s � v ..�ROBERT Development Services Department Approval G CO E-8011 Reviewed and approved by: GtJ, �or/ Date: 6 -/ 0 - 0++� f! " • ;, C'v= IRv, hall 11� J!'•-. Lrot...ti PERMIT NO. SW020019 PACE 2 OF 3 Municipalit of Anchorage DEPARTMENT OF HEATH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Ataska 99519-6650 • Telephone 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LECAL LOT 1, BLOCK 1, FOXHILL S/D P.I.D. NO. 051-073-19 PERMIT NO. SW02001 9 PACE 3 OF 3 Municipalit of Anchorage DEPARTMENT OF HEATH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 1, BLOCK 1, FOXHILL S/D P.I.D. NO. 051-073-19 FINAL GRADE 96.6' 9 96.0' 5.8' INSULATION ELECTRICAL CONDUIT 92.7' NEW 1300 GAL. 1)." DISCNARCE PIPE POLY. TANK h: 92.5' _ r 1 550 GALLON FAT ALBERT WITH PUMP ASSEt.(BL FINAL GRADE MTI MT1=95.1' ORIGINAL GRADE ,INSULATION v. ru CRAM U..' n,reeJ Ih' ue uxe �LND DIST. LINE=92.6' MT1=92.4' BOTTOM OF SAND=90.4' N. T. S. GROUNDWATER AT 86.4' ^r, C�}+- L.;•,�L� 141 78.9' B.O.H. �; J. i.��� /• .. _ r �+, ROBERT C COWAN I�Q i� CE -8001 fJl\�w 1,, j>:Zi►-a����' A C FCO — 21.0 9.0 ST1 21.5 14.0 — ST2 21.5 17.0 — MT 25.0 15.0 — MH 22.5 22.0 — FV1 87.5 78.5 — FV4 89.5 81.5 — MT1 88.5 81.0 — JU -10-2002 1331 S&S ENGIWEP,ING 7,2M2 907 694 1211 P.02 P.1 C N77?A OC7-/,OMG I work Petfbffmd @ request of TWEED Excavating do Construction 17034 Eagle River Loop Rd, Suite 202 E491c Rlver. Alaska 99577 behalfot whom it may concern; S&S elechW installation of the lift station at lot 1, block I — Foxbill, located in Peters Creek, Alaska was >nmd by a licensed electrician, in accordamc with the cunew national electric code. Of Perjury. I calif}• the above h6rmation to be true and eoneeL ALASKA ELECTRIC. LLC to L. Brown, Presidemowner Tweed Excavating & Consintctnon Fr7e P.O. B=876370, Wmdlk Alaska 99687 Office (907) 37-T-38931 Cdl232-8687/Fax 373-3890 TOTAL P.02 MUNICIPALITY OFANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade 1 ST T N SOBc 7- -1-12 41a Z .1-1241aZ 2. ° — 1-: oap..m. Date Issued: Feb 05, 2002 Expiration Date: Feb 05, 2003 Permit Number: SW020019 Parcel ID: 051-073-19 Legal Description: FOX HILL BLK 1 LT 1 Design Engineer: 0003 S & S Engineering Site Address: 021615 WOODCLIFF DR Owner Name: Henry Bruneau Lot Size: 39999 SQ. FT. Owner Address: PO BOX 672048 Total Bedrooms: 3 Permit Bedrooms: 3 CHUGIAK . AK 99567-2048 This permit is for the construction of: ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified In Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: -;L,/S"/ 0-:L- I9- Date: Municipality of Anchorage -1 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.enchorage.ak.us (907) 343-7904 Parcel I.D. ON-SITE SEWER/WELL PERMIT APPLICA1 FOR A SINGLE FAMILY DWELLING IDSI — b7 -S—/ 1 Fermi Property owners) tfCnY y ty-& ne oit. Mailing address (1) Q4•i>or 67aD4.5J Mailing address (2) 6A N A;ct k+ A Legal description (Lot, Block & Sub'd.) Lot Legal description (Section, Township & Range) T Lot Size 01000 Acre Sq.Ft. 3a,RR°I THIS APPLICATION IS FOR: Needed By: IZ:Do Requested By: io"Sc'-� Zip Code Number of Bedrooms 3 r � • Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade ($ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. / S & S ENGINEERING Y / _ 17034 Eagle River Loop Road, No. 204 (Signature of property owner or authorized agent) Permit Fees: q 00• J Waiver Fees: Date of Payment: a' /'Y /� Date of Payment: Receipt Number: a f S 3 7 9 Receipt Number: (Rev. 12/00) S& IEALTNAMHORITY APPROVALS SEWERS WATER MANE%TENSIONS SEWERS WATER NSPECRON ENGMERNGSTUOIES ANOREPOMS WEUNSPECRON A FLOW TEST SITE PIANS ROAD OESION SOILTEST PERCOLATION TEST STAL CTLRUL S MECNAMAL INSPECTIONS ONSITE WASTEWATER MPOSALSYSTEM DES" ROBERT C. COWAN, P.E. CMLENGINEEFIS (907)694-2979 FAX(907)694.1211 February 1, 2001 MUNICIPALITY OF ANCHORAGE Development Services Department P.O. Box 196650 Anchorage, AK 99519 REFERENCE: Lot 1, Block 1, Fox'hill S/D It is requested that you issue a permit to install a pressurized septic system (Intermittent Dosing Sand Filter) to serve the existing 3 bedroom house on the referenced property. A test hole was excavated and a percolation test performed. The approximate location of the test hole is located on the attached site plan. At the time of excavation on 1/18/02, no water was found. After monitoring ground water for seven days water was found at 7.5 feet. We do not anticipate any adverse effects on neighboring wells, septic systems, reserve areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent properties. If you require additional information, please contact us. Sincerely, ,412-4 Robert C. Cowan, P.E. RCC/bjj Enclosure n 17034 NOM EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER, ALASKA 99577 1" = 40' DESIGN SITE-PLAN 71 9' O not W— O xy r In o x� ppm eaG� =• G7mmrnlip ►S7 ��� W > tlu rn ^� N a to o \ D . CA L4 Ln d c > \mo 5 I y > I v o II m O I o II N II p v NDN •- rrl I Ln -U o Nv O O I �o o F -'ii D rh�y.y r �' Ln RO mm n m I r 0 /� Dad CCC "`iii ri s u �j50d Y w LO ^ " o. u m I i, av x O Z I o/ •; 00 03 N N X03 o .7 I a l l a000 `�, A I xmx X Oz 'm=! v n V'X OMWO I 'Oz O r " nOyy r N {JI Om x A I iyz �> - I T O\��_ O� ^'V) Ory O — ' O K O sF0 e I >m C) x X iN O r' O C VN r'r TI NIV 11!(17 y n o N ,Lz N- n z NIV21 D <yC m n O > =Om oma• s un r Z 0 o_ o O ti 20' DRAINAGE EASEMENT N. T. S. DESIGN PROFILE :o^�9F0 1 11 8 N = / `:nom / i m o o ^�, �s>z �N rn ;ml rl m � -T.I�_—.[IJ� .h.. �I— I-1 iioe r W o .� A-r1=1 I11-11� ga o 0 e 0. N C O '!� Ln O W z 0 F= m C'% g ✓ \ N o .� -Lu.e�.a-W- m J e -['11:--Li-III-53 rll- -lil� � � •-.; Ili-D 3 O II NII 7 L N r .Le l N N -0 O , all �J —il J R Ln70 ^-m ;,o v. CD e IP- p 5u ME m I 0s > d - N � � r 7-LLI o ^ Wh pa' N A 8 j: �IITWIj�sj�'y6o3 € E IOW ��o @ a ,•, Jc tLjLiliWi • o a y�l,A W" IJ �i� fl }1 • } W A � Ali F 1 � s•r i" Municipality of Anchorage Development Services Department Building Safety Division yRa On -Site Water and Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www. d. anchoraae.ak.us (907) 343-7904 Soils Log - Percolation Test Performed For: ^f'7Q t i N 44 Date Legal Description: 7- /U 8- D .0 9- le / 10- to it- 12- 13 - t -12-13- -'0 74- �i 15- C M ownship, Range, Section: WAS GROUND WATER ENCOUNTERED? S IF YES. AT WHAT DEPTH? L Depth to Water After -7 ♦ D i} P Monitoring? E Date: e;I J/ /01 y, ROBERT C. COWAN i I c� CE -8801 f��•, DeA (Feet) Or MYTTIFFTEAM M, I. 2- -3-o EM 3 -o r. 5_ F 6-./O 7- /U 8- D .0 9- le / 10- to it- 12- 13 - t -12-13- -'0 74- �i 15- C M ownship, Range, Section: WAS GROUND WATER ENCOUNTERED? S IF YES. AT WHAT DEPTH? L Depth to Water After -7 ♦ D i} P Monitoring? E Date: e;I J/ /01 y, ROBERT C. COWAN i I c� CE -8801 f��•, PERCOLATION RATE� jn wteskxh) PERC HOLE DIAMETER COCOMMENTS�h TEST RUN BETWEEN FT AND FT ,1 PERFORMED BY: I� I ���}Tt}'� r��� /{-u-i -1 CERTIFY THAT THIS TEST AS PERFORATED IN ACCOR ANCE WITH ALLSTATE AND MI INICIPAI 11DELINES IN EFFECT ON THIS DATE. DATE: i, �/ /O :I-. MYTTIFFTEAM M, EM WROM Imm� -_A F i� PERCOLATION RATE� jn wteskxh) PERC HOLE DIAMETER COCOMMENTS�h TEST RUN BETWEEN FT AND FT ,1 PERFORMED BY: I� I ���}Tt}'� r��� /{-u-i -1 CERTIFY THAT THIS TEST AS PERFORATED IN ACCOR ANCE WITH ALLSTATE AND MI INICIPAI 11DELINES IN EFFECT ON THIS DATE. DATE: i, �/ /O :I-. S&S ROBERT C. COWAN, P.E. CML ENGINEERS (907)694.2979 FAX(907)694-1211 INTERMITTANT DOSING SAND FILTER SPECIFICATIONS W-WHARHORTV APPROVALS Lot 1, Block 1, Foxhill Subdivision February 1, 2001 GENERAL STATEMENT OF WORK SEM4RSWATER MWEXTENSK" The work and plans covered by these specifications consist of furnishing all labor, materials, tools, transportation, and equipment necessary to complete an Intermittent Dosing Sand Filter system as described herein and on the attached drawings. SEWER&WATER ►svEcraH All work under this project shall comply with current Municipality of Anchorage (MOA) Regulations. ENOINEElIMS1UMS AT)KF RS 3 Bedroom House 450 GPD Use 10' x 36' Bottomless Sand Filter and absorption area (360 S.F. required) Sand filter to be constructed on accepting soil with all organics removed. (bottomless only.) WEUNSPECTION t FLOW TEST SITE INVESTIGATION SITEPL" The Contractor must carefully examine the project documents, have full knowledge thereof, have investigated the site, and be satisfied with the conditions affecting the work. Conditions include, but are not limited to those bearing upon transportation, disposal, handling and storage of materials, availability of labor, water, electric power, roads, and MAODEMN uncertainties of weather, physical conditions at the site including all underground utilities, the conformation and condition of the ground, the character of equipment and facilities needed preliminary to and during prosecution of the work. The Contractor must be satisfied SOIETEST with the character, quality and quantity of surface and subsurface materials or obstacles to be encountered. Any failure by the Contractor to become acquainted with the available information will not relieve him/her from responsibility of performing the work as stated in these specifications and drawings. PERCO ATM TEST Location of utilities will be the contractor's responsibility. STRUCHNLS MECHANICAL NSPECTICHS CNS11C WASTEWATER 01SPOSAASVSTEAI OESICN 17034 NORTH EAGLE RNER LOOP • SURE 204 • EAGLE RNER. ALASKA99577 Page 2 Lot 1, Block 1, Foxhlll SID February 1, 2002 SEPTIC TANK / LIFT STATION / AIR COMPRESSOR A. General The work under this section consists of the performance of all operations pertaining to furnishing and installing the septic tank/lift station, air compressor and piping to the sand filter. B. Materials 1. Tank a. Septic tank shall be a two compartment tank of at least the minimum size indicated on the drawings and MOA approved. b. First compartment shall have a separate 4" pump -out riser. The second compartment shall have a separate 4" pump -out riser. 2. Manhole Riser or Lift Station Tank a. An additional second compartment manhole riser shall be capable of being equipped with the following: A junction (Nema 4x) box or equal, bonded or attached to the pump basin. 2. UL listed electrical cord grips, installed in the J -box. aM b. An additional tank (M.O.A. approved) may be provided for the effluent pumping assembly and the items in (a.) above. 3. Effluent Pumping Assembly, Controls, Alarm & Piping a. Effluent pumping assembly shall be of approved materials, including the following: 1. A 110 volt or equal U.L. Listed effluent pump. 2. Iligh-density PVC cylinder housing the pump, with level controls and screen, serving as a baffle to prevent the screen from clogging. Page 0 Lot 1, Block 1, Foxhlll SID February 1, 2002 3. All piping shall be PVC or other non -corroding material. b. Pump controls and alarm system shall be an approved system with the following options consisting of: 1. Event counter 2. Elapsed time meter 3. Program timer 4. 10 watt heater 5. Remote alarm panel option with a minimum of 80 DB sound pressure at 24", operating temperature 30AC to 65AC, continuous sound to be located in the home. 6. Oil -tight visual alarm with push -to -silence feature. Automatic audio -alarm reset. 7. 15 amp motor rated toggle switch, double pole, double throw with three positions; manual (man), automatic (auto) and center (off) (II.O.A.). 8. Nema 4x -rated, fiberglass, or equal, enclosure with hinged cover. 9. All controls to be installed as per manufacturer's recommendations. 10. Control panel to be installed on outside wall of home within sight of septic tank/lift station. c. Piping from the septic tank to the sand filter is to be 1 1/4" PVC schedule 40 solvent weld piping properly bedded as described in Materials Specifications and sloped to drain back to the lift station. Insulation board 2" thick and 2' wide centered over pipe is to be placed where soil cover is less than 4' depth over pipe. d. The air line from the house to the filter is to be IIDPE arctic insulated pipe 3/4"-2" SDR - 11. The compressor will have a gauge (0-10 psi) and be installed in a heated area, crawl space, or garage. Page 4 Lot 1, Block 1, Fozhill SID February 1, 2002 4. Air Compressor a. Air compressor shall be a DIOMAs LINEAR SERIES model number 5060-A or 5070V -A or M.O.A. approved equal. CONSTRUCTION SEQUENCE In order to insure proper installation, the system is recommended to be installed in the following order: I. Sewer line from house to tank Il. Septic tank/lift station 111. Sand filter IV. Leachfield bed (if required) V. Final grading CONSTRUCTION 1. Construction Instruments Contractor shall provide instruments such as transits, or levels, for establishing proper elevations and levelness of pipe or materials. 2. Pipe Laying All pipe shall be laid with material free of large or sharp rocks and organic matter. Each section of pipe shall be handled carefully and placed accurately. The spigot end shall be fully inserted pointing in the direction of flow and glued in place to make a water tight seal. Each section of pipe shall be properly supported to insure true alignment and an invert which is smooth and free from roughness or irregularity. At all times, when work is not in progress, open ends of pipe and fittings shall be closed so that no undesirable substance will enter the end of the pipe or fittings. Page 5 Lot 1, Block 1, Foxhill SID February 1, 2002 3. Bedding of Pipe for Sewer Lines The pipe should be bedded with materials free of large or sharp rocks and organic matter, compacted. Native materials may be used as back fill material above the pipe, provided it is free of large rocks and organic matter. All lift stations shall be installed in accordance with the manufacturers recommendations and standards. Electrical installation is to be in accordance with the National Electric Code (latest adopted edition) by a licensed electrical contractor, with M.O.A. inspection where required. If MOA inspection is not required, a licensed electrician is to provide a letter to the Engineer stating that the system meets or exceeds all applicable codes. 4. Excavation Excavate to proper depth to allow gravity flow, install tank level, tolerance 0.05 foot, on undisturbed or compacted classified sand fill material. Create a level sand surface over the tank and add 2" burial foam +35 PSI directly over tank. Mound unclassified soil over tank with a minimum of 2 feet of cover and anti -flotation weights that may be required in areas of shallow ground water. 5. Connections All connections to be as per MOA requirements, PVC 3034 piping with Caulder or equivalent couplings for inlet riser pipes. All tank connections are to be completely water tight. SAND FILTER The work under this section consists of the performance of all operations pertaining to furnishing and installing the sand filter. A. Materials 1. Sand Filter a. Liner (if required - not required for bottomless sand filter) - OSI Model LI or equivalent. 30 mil PVC cut and fabricated to provide water tight enclosure of filter sand volume. Seams to be permanent as per Manufacturer's recommendations. All connections, such as boot flanges, through sand filter to be permanently bonded to the liner. b. The Contractor shall provide a washed sand to meet ASTM C-33 Concrete Sand Specifications with the additional requirement that all but 1% of the materials Page 6 Lot 1, Block 1, Foxhill SID February 1, 2002 passing the #100 sieve be removed. All aand shall be approved for use by the Municipality of Anchorage (M.O.A.). If the sample does not meet specifications, all sand will be removed and replaced. c. The Contractor shall be responsible for providing pea gravel that shall be a washed material containing no fines (0% passing the #100 sieve) and a maximum size of 1/4" diameter. d. The Contractor shall provide the manifold assembly. The manifold assembly shall be of approved materials with orifice shields and flushing assembly. All drilled holes to be cleaned of burrs and pipes flushed, prior to assembly. Flushing valve to include riser to finish grade. Lateral distribution piping is to be laid level (@ t 0.05'). e. Side walls and top of the filter box to be insulated with 2" direct burial polystyrene insulation. f. The Contractor shall be responsible for providing filter fabric. g. Air coil in sand filter to be geoflow WF16-4-24 150 LF placed 6" above bottom of sand. Construction of Sand Filter The sand filter construction is to follow procedures as outlined below, as applicable to this design. Pea gravel and filter sand are to be hand leveled to proper depth (tolerance within 0.05 feet) in filter, taking care not to allow mud or fine soil material into the filter or gravel layer. This would include any soil material picked up by excavation machinery buckets while loading specified material. The Contractor should estimate filter material volumes such that allowance is made for wastage of material in contact with the ground at site. The area over the sand filter to be finish graded with a minimum of 2 feet of cover and to prevent ponding of surface water run off. Side slopes shall not exceed 3:1. The Engineer will reject any sand or pea gravel that does not meet specifications or is contaminated in transit or while handling. If such material is placed in the filter, all soil material may be required to be removed and replaced with new material. CONTRACTOR/INSTALLER FEB -01-2002 15:59 S&S ENGINEERING 907 694 1211 P.02/02 Municipality of Anchorage Development Services Department fcry Di � Building SaDivision : •+ Oe -Site Water and Wastmatcr Program 4700 Bragaw Stmt a' "' P.O. Box 196650 ilnehorage, AK 995196630 www•ci.anchotage.ak.us (907) 343.7904 PROPERTY OWNER AGREEMENT FOR THE MAINTENANCE OF AN ON-SITE WASTEWATER DISPOSAL SYSTEM This agreement, dated 1--e A / 1e0 L , is made between the Municipality of Anchorage Development Services Department (DSD) and the property owner(s) of: Lo—j I QLO C.K. / P OX#1 L f.- Sip This agreement is made for the purpose of maintaining an on-site Wastewater disposal system on the subject property. The property owners agree to the following: Submit to the Municipality of Anchorage, on an annual basis, an inspection and operation statement from a registered professional engineer. This inspection and operation statement shall verify that the engineer has inspected all effluent and air pumps, timers, and alarms, d that any deficiencies have been repaired and that the system is functioning gas designed. �— (S1 ure) (Signature) Name) Name) The Foregoing Instrument was acknowledged before me by jt) ll nn £ . chPrn A �jrh ai�e on this day of 20p_J. W; tness rhy hand and sea ,o_Nq Public (Signature; onritU Zvi. Kendall (Notary's printed name) My Commission Expires TOTAL P.02 "i MUNICIPALITY OF ANCHORAGE DEPARTMENT 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 PHO/NE EW /VS ! 7��� 7 !95 ❑ UPGRADE MAILING ADDRESS '/ i �N P 6 INFER //t /G ,r6 f e e" < LEGAL DESCRIPTION f c� J -r /s r LOCATIONS ( TIT-"/ / I'd NO.OF BEDROOMS II Absorption area Dwelling P T NO. DISTANCE TO: / i �„f�Manufacturer Material No. of compartments klo� pacit in gallons IF HOMEMADE:DISTANCE Inside length Width Liquid depth TO: WellManufacturer Material Liquid capacity in gallons oWell Foundation Nearest lot line PERMIT NO. W = DISTANCE TO: LL Z No. of lines Length of each line Total length inTrench width Distance between lines F, 2 W 1 inches f Top to finish neath the Total 2 of file gradeMaterial effective absorption area p r inches Length / Width Depth / q r� PERMI NOACE. W _ G UNDE C Type of crib Crib diameter Crib depth Total effe4tive absorpt area / a DISTANCE T0: Well I"' Building fQ1,tildlion V Nearest lot line Class0 Depth Driller Distance to lot line PERMIT NO. J , T/' W 3 DISTANCE TO: Building foundation Sewer line Septic tank Absorption areafs) OTHER PIPE MATERIALS SOIL TEST RATING ^ 1 O 1V B INSTALLER < N a REMARKS 73 OF Ak •5�� M �,•.� P1a. 147•f f jV=�• its APPROVED SRB 196X DATE Eagle ";—.r. Alaska 99 9 'q �j 72-013 (Rev. 3/78) �1 �L I T'T Cm F=' F-1H1:�E •- DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTIOJ 825 L STREET, ANCHORAGE, AK' • 99501 264-4720+ %,U1 ✓ -�tJ—_•ITE _•CIJEi2 t': L_ L_ F�EFZ_t•1 I T PERMIT NO: 840015 GATE ISSUED: 02/17124 APPLICANT: EXCAVATING ENGINEERI A� ADDRESS: SR.E: i9c. X Yi/VJ1f, EAGLE RIVER, AK 99577 LEGAL DESCF:IF•: SUEDIVISIOJ: FO,;HILL LOT: 1 BL0CJ,:R� SECTION: 4 TOWNSHIP: 15N RANGE: 1W LOT SIZE: (501. FT. OF. ACRES>, BEDROOMS: I LISTED BELOW ARE THE OPTIONS AVAILABLE TO YOU IH DESIGNING YOUR. SEPTIC SYS=TEM. CHOOSE THE OPTION' THAT BEST FITS YOUR SITE. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - BEC DEPTH TO PIPE BOTTOM (FT. ? 2. 5 *»: GRA'JEL DEPTH (FT. ) 0. 5 TOTAL DEPTH (FT. GRAVEL WIDTH (FT. ) 27. 0 GRA', -'EL LENGTH (FT. > 52. 0 GRAVEL VOLUME (CU. YDS. ? `2. 0 t TANK SIZE (GALS) 1,000.0 »:+: SOIL RATING (SG. FT. /E;F:) 307 *» DEPTH TO F'IF'E BOTTOM C -s. 5 FT. REQUIRES INSULATION DEPTH TO PIPE BOTTOM < 4.0 FT. NAY REQUIRE A LIFT STATION TAN1:: MUST HAVE AT LEAST TI.10 COMF•ARTtIEPJTS - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - I CERTIFY THAT: 1. I AN FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE (PIOA) AND THE STATE OF ALA_J'A. 2. I HILL INSTALL THE SYSTEM IPJ ACCORDANCE WITH ALL P101A CODES AND REGULATIONS, AND IN COMPLIANCE WITH THE DESIGN CRITERIA OF THIS PEF.MIT. _. I I -JILL ADHERE TO ALL NOR AND STATE OF ALASKA REQUIREMENTS FOR THE SET BACK DISTANCE_- FROM ANY EXISTING WELL, WASTEWATER DISPOSAL SYSTEM OR, PUBLIC SEWERAGE SYSTEM ON THIS OR ANY ADJACENT OR NEARBY LOT. 4. I UNDERSTAND THAT THIS PERMIT IS VALID FOR A MAXIMUM OF 3 BEDROOMS AND ANY ENLARGEMENT WILL REQUIRE AN ADDITIONAL PERMIT. IF A LIFT STATION IS INJSTALLED IN AN AREA COVERED BY MOA DUILDING CODES, THEN (:1) AN ELECTRICA Lt HIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS I -JILL NOT BE AFPROV d_ WIT AN ELECTRICAL INSPECTION REPORT; .AND (3) THE ELECTRICAL WORK I T E;F yj�j(�! _P LICENSED ELECTRICIAN. SIGNED - DATE: - - --------------------- -�--- - AFPLICANT: i TIN:; ENG 'rERI (yy ISSUE[- BY DATE: PERFORMED LEGAL DESCRIPTION: A'E Pg � � L 2 3 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 254-4720 SOILS LOG — PERCOLATION TEST 4 5 S/C, T C [.0/I/ ,If'7( Ae'll 6 ' G 3 f�� J 9 2NA W4 11 11 12 13 14- 41516 Date GrossNet Time Time is- Net Drop �J Z •r :3a A 3.� '� 16- �� a 3 3 i 17 17 - t. 9 3 q to 67 18 18 3 I c 1, S_ sr 19 20 ❑ SOILS LOG PERCOLATION TEST f DATE PERFORMED: Z 3 SLOPE CF //o[.6 I WAS GROUND WATER s L ENCOUNTERED?�j/� O P IF YES, AT WHAT E DEPTH? d- Robert A. Reading Date GrossNet Time Time Depth to Water Net Drop �J Z •r :3a A 3.� '� 3 �� t. �� a 3 3 i t. 9 3 q to 67 13 /t ' 3 I c 1, S_ sr top /0 11 3 3 y, J�4 PERCOLATION RATE1�9 (minutes/inch) TEST RUN BETWEEN IS FT AND /94 FT Z(, 69F / .v f7H c,c 75y s�R : v7 44 PERFORMED BY:. F. i� E'1!1f Q r^� "' CERTIFIED B DATE: DRo1 - ' £.S7 72-008 (5/79) F11- U04-2070 . t by 1DOC Co. aba SULLIVAN WATER WELLS ' P.O. BO)t'272, CHUGIAK. ALASKA 99567 • TELEPHONE 688.2759 `.'OWNER OF LAND DEPTH OF WELL ,:'ADDRESS �/ QSTATIC LEVEL OF WATER FT. /0�0 '> LEGAL DESCRIPTION_( I .64G lion RI DRAW DOWN FT DATE -Started q Ended/ may CALS. PER HR . M PERMIT NUMBER KIND OF CASING 6 Q KIND OF FORMATION: From Ft.to__5�_Ft. wE<L�t�d'•.1 From Ft. toli?—Ft. CtN7' r6i!!}06—c 'FromFt.to-7ff--Ft. 14of-0 From 7,44 Ft. to—gft>—_Ft._ L r_i;A ilt 4 From ?D Ft. to I /O Ft. sAN4 �Fi�P�..i?t From110 Ft. to121 FL d;—cet From-/o11 Ft..to_42_r_Ft.' Sg..04 4. JllkJ- 4- FromFt. to r^Ij2 Ft.F's .vim From Ft. to Ft i d At vel, From IqQ Ft.to t. J -40,d 60"O'tLVC- -9 ,'From Ft.to Ft. k.)OWE2 From Ft. to Ft. i From Ft. to -Ft. � From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From.' Ft. to Ft. From Ft. to Ft From Ft. to Ft From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to -Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. . t ;.From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to-FtLJNrTv - DEPT. OF,H A MISCL. INFORMATION: - ErNIRONMENTAL PROTECTION 1: r:. ST 2 81986 RECEIVED DRILLER'S NAME RUc Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519.6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. /)5/-093 —/Iq COSA# Ob os(:v 1. GENERAL INFORMATION Expiration Date: / t7 — 2 q —06 Complete legal description FOX HILL SUBDMSION: LOT 1. BLOCK 1. Location (site address) 21615 WOODCLIFF DRIVE • CHUGIAK, AK 99567 Current Property owner(s) WILLIAM SCHNABEL Day phone 786-1912 Mailing address 21615 WOODCLIFF DRIVE • CHUGIAK. AK 99567 Lending agency Day phone Mailing address Real Estate Agent RANNA FEKRAT w/ PRUDENTIAL J.W. Day phone 441-5815 Mailing address 3801 CENTERPOINT DRIVE • ANCHORAGE. AK 99503 Unless otherwise requested, COSA will be held by DSD for pickup. SEPTIC SYSTEM SIZED 2. NUMBER OF BEDROOMS: 3 FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Individual On-site Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Onsite Systems Approval (COSA) based only upon the representations given in paragraph 4 by an Independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of Onsite Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions In the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based ort 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,Tunbtidnal and adequate for the number of bedrooms and type of structure indicated herein. I further verify thatbased on the 4 information obtained from the Municipality of Anchorage files and from my investigation and inspection, the, on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, LID. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSO Guidelines & Regulations. The reported results described the performance ofthe system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by Me system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provido any warranty or future estimate of how long the system will continue to meet the operational requirements of tho 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. 5. DSD SIGNATURE V Approved for _3 bedrooms. Disapproved. 337-6179 Date '7'21 IV/, Conditional approval for bedrooms, with the fllowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Reort Other V .• , •, 1 :. STER AND p - PROGRAM By: I /.T�L1 �it�. Original Certificate Date: 7 02 1 1-06 ./ l�— IFw 11M Municipality of Anchorage Development Services Department Building Safety Division OnSke Water & Wastewater Program 4700 Bregaw Street P.O. Box 196050 Andxmge, AK 995195650 www.muni.ag/onsft (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legai Description: FOX HILL SUBDIVISION; LOT 1, BLOCK 1, Parcel ID: A. WELL DATA 'TESTED BY S&S ENGINEERING. Well type PRIVArE If A, B, or C provide PWSID# N/A Well Log (YM) YES Date completed 9/1984 Sanitary seal (Y/N) YES Wires properly protected (YM) YES Total depth 195 ft. Cased to 40+ ft. FROM WELL LOG Date of test 9/1984 Static water level 120 ft. Well production 19 9 -P.M. WATER SAMPLE RESULTS: Coliform _ a colonies/100 ml. Nitrate 0,610 m9A. Casing height (above ground) 12+ in. AT INSPECTION •6/8/2006 119 ft. 4.2 g.p.m. Other bacteria 0 colonies/100 ml. Arsenic: NO ug./L. Date of sample: 5/8/2006 Collected by: S&S ENG. B. SEPTICIHOLDING TANK DATA Tank Type/Material PREMIER PLASTICS Date inatatied 5/24-25/2002 1000/ Tank size 55 gal. Number of Compartments 2/1 Cleanouts (Y/N) YES Foundation deanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (YM) YES Date of pumping 6/7/2006 Pumper SANITARY PUMPERS C. ABSORPTION FIELD DATA Date installed 7/13-14/2006 Soil rating ftlbdnn) 2_0 System type BOTTEMLESS ISF Length 34 ft, Width 10 ft. Gravel below pipe 0.56 ft. Toted depth 43.1-3.3 ft. Eff. absorption area 340 ft° Monitoring tube YES Depression over field NO Date of adequacy test NEW Results (Pasa/Fail) PASS For 3 bedrooms Fluid depth In absorption field before test = in. Water added =gal. New depth =in. Elapsed Time: = min. Final fluid depth = in. Absorption rate n - g.p.d. Any rejuvenation treatment (past 12 mo.) (YM & type) NO If yes, give date - D. LIFT STATION Date installed 5/24-25/02 Stm in gallons 550 Manhole/Access (YIN) YES "Pump on" level at TIMERin. "Pump ofP level at Tl�n. High water alarm level at 48 in. Datum BOTTOM OF TANK Cycles tested 3 Meets alarm & circuit requirements? YES E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAiff station on lot 100'+ On adjacent kris 100'+ Absorption field on lot 100'+ On adjacent kits 100'+ Public sewer main N/A Sewer /septic service line 25'+ Animal containment areas 50'+ Public sewer manhole/cleanout N/A Holding tank N/A Manurelanimal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property One 5'+ Absorption field 5'+ Water main N/A Water service fine 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line '0' Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parkfng/vehide storage 10'+ Curtain drain 50'+ Wells on adjacent kris 100'+ F. COMMENTS *WR020022 G. ENGINEER'S CERTIFICATION I codify that l have detemr/ned through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date -1(Z ) I oL COSA Fee Date of Payment Receipt Number (Rev. 11103) Waiver Fee $ Date of Payment Receipt Number urr ao, cuw aa. uu DurcrDr Dow 1'C.IDGKI IC JL"Ic JK NA(-k 92 ,sAa Root ... .. ... .. sed utlw bCDMOWOWM� r .. _ (. ,,.. :R,: .•• t •,O:lOrc. •• P : - --::,_iii.. AIAV04 •i1 • ,C ,'r.•�ri� � V.rr .r, _1 �. y, ••�•!i_ w �' �+.a� .•• � •. ,'rte \� Y.: ., ir• • �' • SURVEY Ci'R�ICATION ...:.. ,�yry1f11L>r� .. of ••.•'' ' .. P Y Pre cred b Robert E. Johns, Jr. & Assoc. P. r w+ r P.ee.I rwa ew L •�P� , •, �. �i� (7 Professional Land SJFVeyers •: ,7160 WZVW 0R. uw �wM•ri+�r�•. uRw r Nw w�rr P.... N e+Ps a PMIA'r s.+ow •,J r ,SS•.•tr ' , �} �`•. ', ANCNCRACS ALASKA 99-604 . . Fde No. Rs4•Pl. � Rea lot S.F. at r• Q C� ' • FOLMAMN AS-WAT e eww a A:e. r X.•.r «^N Pe l ,c :.' ... Dke Sury °7s4 Dro.n .0;c Cf,sd.eC 6X ... — '•A ii Gots G�.e: :M • ...�..� ..N.ew. rNAI STIIVCISPK AS-emT j� �� ••.,• 1 Lege C. .ptan N. rw...a« .N •"'mow N ♦YM � W .1 W r M \�. iJ.P' fw«. �aP ��r•ir `II,R r`o I.19Kn�' S BIS' 1 ..... MIPM M 11YwP• rt MP.1 MA •• ••••• � ••••+-•• e•'I ^ ,Yw•.'.'� Fox'i[i31• evbclivisian va P,a.:, _' SURVEY TYPE' _'.04 SYY6EBtxS - wWT ROAR�aep�GRAIn AGS rNN. SeaRnme I„rayLT s IPwa1 rP[eAr. �: PppON a Ce •• C mw RM... n-.ua,... l0r SumeY... r6AoeeAe n ASSUvn E Ev, r-,r-1� .arAc ♦ Mn CT>AA1E Aa^ PLOT PLANS t LOT SURVEYS . • • ITIS THE. RESPOI'NSISIU7Y• OP 'IME-SLiIL eR OR OWNER. PRIOR TO CNLT THOU LMWROVr—UC?4*= •abOVL•60L:W yANO•Y3:cLL J`011. SC- CONTAUCTION. To VCRIPY ♦ROPOSU VVIIC'NO "ACC RCLAT.t/r TO FINISNEO GRATA AND UTILITY CCNNErP.CNS AND T7 DETERMINE Swo". rENCe:X WELLS. SA•'RC CLCANOVTS. VIOVWXLJG. 0RIWW4y, CTC.. ARE SMCWN IN TNCIR APPROXIMXTI: LOCATION, ONLY. SNOW TNC CDSTENCE a ANY EASEMENTS. COVENANTS OR RESTroCTIONS MAY PREKNT'SC I'E IMPROVEMZNTS FROM 6E'd+G =;j;; AND LOCATLM, ' WMIC 00 NOY AP►EAR ON CGROEO 6 OMS N PLAT. A1! NC L'SEG FOR A (STAN F "FQQQO tIMI r Z CCN"TUGMOW PR FOR ESTABU24NO 101AWY OR FLNCC LINES i� LIN21t I40 CIRCVNSTANW SHOULD AS-111U1T SNE SJRY['!OR TA+KCS RQPONSIMUTY FOR THE WfTiAL TRANSACTION .ONLY AND ►S9lMCS "ANCIAL LIASIUTY ONLY FOR THE COST Or TIE SAVEY. LISTED WAN ES FEi4n. OVCR SCA1-mG RCPROWCTON VAY CAVSC CPDDRS W ECALL i zoo •a Kr sE:zo iaa soot-Iz-Inr JLN-30-2006 15:0 S&S ENGINEERIIJG ItKr11A1n11n1rN wr+rv+n q v w9n4wAlEn IwrrnlEucklM {Ewcn{wAr{n w"M'Cnou tixmtt/wlosluovs AWONronls wE1t Mr(CIUYJ 4rumnsl mrtMA+ . rKmhf)esou ".Ml 14nectA11d1 tart l4c,1 kvicnoua o11V1t wAtttwAltN bslacks.siku btswal liq 907 694 1211 P.02/04 itouElR c. t:()wAll. Is Ixmrn r A. sl IArr.n,1IF. CIVIL t1Jt:9Jrmq 00 r1 6,94,29P.? WELL KoW TEST BATA' rnx(goT)894•1211 cLIEIJt: �RIIL JFE1u1F�El - nnrE: (� to o(o LLGALbESCRIPTION: LoT-I Ru>. Fo?cj+ja_— WELL bl:rTif: (ate, CASING EPTII: bATt bhILLING t:oMPLLtEb: q 8 -� ohtLLER: S Vu -LVA -00 ISC A A• cAsIka Ilrl(;l IT: tz t, -t- SANITARY SEAL: WINES ItJ coNbUltt GRAUINO o.k bACTlLnIA AIJb MlIhAIE SA PLES ColLLCTEp TL$T bAtA: J cLbck TIME METER hEAbING (oAL) PUMPING ITAit jcaM) OEPTII TG WA1E12 (rT) RkMARks 2q 11 -7S -M O )(C, swl - - — 2.S 1.7-7053 D _ 'o s,.Lq177982 Ll a 3 l'1 Bbl z0 ,o q- 2 e Ls s: Wt_LL CUtihL 'LY hhbbOct?; go GrM Whll A �� bhnwuowN iLttkb by.,1 KbW kAtk Nbt OARAWtkkb-sUUstaUtH f VAhIATIONS cAN ocCUO. y-1q.s %..h:-. py.,%A- I io34 Nohl I I tAGLL hktti loos+ I butt 2oJ I tAGLE htvrrt ALASKA Ons? r Jul 18 06 10:46a 801 Easl 82nd Avenue, XA-9 TERRA FIRMA TESTING Anchorage, AK 99518 LaboratoryTes!ingl onmucBon Morutor rg f CLIENT: r NAME r NO.: LOCATION: NO/ D EPTH 'TION: STED: BY., -D BY: 125 0 120.0 115.0 110.0 105.0 100 0 p.2 Telephone: (907) 344-5934 Far. (907)344-5993 terraOrma(g a)aska. com %GRAVEL: 0.0 %SAND: 99.9 % SILTICLAY: 0.6 USC: SP FC: .02 mm: ASTM D1557 uneonecled er ASTM D4718 (corrected) Ccf OPTIMUM M.C.% (4cnec+e� 0.075 1 NATURAL M.C. 1 0.6 ASTM 418 WE ... LL��f1•le 1111 HYDROMETER RESULT CE® Si airs SILT or CLAY • , ■1 ' ■11���1���1111���11� ���I���IIII���n� I.II��IIIf1f1•�INI�.�f1�1111�1 n ' n.u�gglm��nlI��.��nnul ull�+w� Ills ME rm- TAM ®•:: ©��, MOISTURE -DENSITY RELATIONSHIP 125 0 120.0 115.0 110.0 105.0 100 0 p.2 Telephone: (907) 344-5934 Far. (907)344-5993 terraOrma(g a)aska. com %GRAVEL: 0.0 %SAND: 99.9 % SILTICLAY: 0.6 USC: SP FC: .02 mm: ASTM D1557 uneonecled er ASTM D4718 (corrected) Ccf OPTIMUM M.C.% (4cnec+e� 0.075 1 NATURAL M.C. 1 0.6 SIEVE S'EW TOT"Lx S2E(mm) 6CE(n.) PASSING SPEC '-1 152.4 1 (i• 12.0 14.0 16.0 18.0 20.0 22.0 Y.0 17 i11iV Degradation �YOICCO� 0.075 1 3200 1 0.6 ASTM 418 WE ODt GDDI HYDROMETER RESULT CE® Si airs SILT or CLAY 12.0 14.0 16.0 18.0 20.0 22.0 IAST4 owe) RISE Degradation �YOICCO� Attarberg Limit ASTM 418 WE CE® Si airs 12.0 14.0 16.0 18.0 20.0 22.0 Penn IAST4 owe) 0—� Degradation (ATA T-13) Attarberg Limit ASTM 418 1 Penn IAST4 owe) Degradation (ATA T-13) Attarberg Limit ASTM 418 ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT AIEMORANDUAI OF UNDERSTANDING BETWEE ' UNICIPALITY OF ANCHORAGE ANDf.Z..1ti,-�l. z THIS MEMORANDUM OF UNDERSTANDING made and entered into asofthis Day of ( of 2000, by and between v7hD herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Memorandum of Understanding agree as follows: 1. ADVANCED WASTEWATER TREATMENT SYSTEMS. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as ZbSF located at Aby, &LL L% Anchorage, Alaska. o2j &i5 W 64d L % jo_r _ 2. Definitions. A. Alteration. Any change to the design or function of an AW WTS that includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Prior to performing any alterations to an AW WTS the owner must obtain a Wastewater Disposal System Construction Permit from the Municipality pursuant to Anchorage Municipal Code (hereinafter, "AA1C") 15.65. B. Certificate of On -Site Systems Approval. An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with AMC 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. C. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. D. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an AW WTS that were included in the original design which would allow the AWWTS to continue to perform as designed. E. Permit (Construction) An On -Site Wastewater Disposal System Construction Permit as defined by AMC 15.65. F. Permit (Operating) An Advanced Wastewater Treatment System Operating Permit. An annual permit, issued by the Municipality, that allows the Owner to operate an AW WTS, upon meeting all the requirements of this agreement, the conditions of Operating Permit, the requirements of the On -Site Wastewater System Construction Permit and all relevant provisions of AMC 15.65 3. Fee. Owner shall pay to Municipality an annual fee of 0696 ($4.00), payable on or before the issuance of the operating permit and annually thereafter. The annual fee is due on or before the anniversary date of the approval by the Municipality of installed system. 4. Term. The term of this Memorandum of Understanding shall be for the life of the AW WTS. The term begins on the date of approval by the Municipality of the installed system and shall continue while the AWWTS system is in use or operational or until the property is sold or title is transferred by owner and a new certificate of On -Site approval is issued to the new owner or transferee of the property. 5. Alterations, Installation and Removal of Additional Equipment. Owner agrees not to make any alterations, removal of parts or additions to the AWWTS without a Construction Permit from the Municipality. 6. Maintenance and Repairs. A. Throughout the term of this Memorandum of Understanding, the Owner shall maintain AWWTS in good repair. In addition, it shall be the responsibility of the Owner during the term of this Memorandum of Understanding, and any extensions or renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs. Further, Owner agrees to comply will all applicable ordinance, laws, regulations, rules and orders for the AWWTS. B. Owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system pursuant to the terms and conditions contained in the Owner's AWWTS Operating Permit. This schedule shall be submitted to the Municipality annually upon the renewal of the permit. The schedule of maintenance and repair contained in the Owner's AWWTS Operating Permit is: C. Owner acknowledges that the fine schedule for failing to maintain and repair an AW\VTS are codified in AMC 14.60. D. Owner agrees that only maintenance, repair personnel certified by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. E. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. F. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. G. Owner agrees that the relevant provisions of the standard specification guidebook for AWWTS is the governing professional guidelines for the construction, maintenance and repair of the Owner's AWWTS. 7. Nonwaiver. The failure of either party at any time to enforce a provision of this Memorandum of Understanding shall in no way constitute a waiver of the provisions, nor in any way effect the validity of the Memorandum of Understanding or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 8. Amendment. A. This Memorandum of Understanding shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties, with the same formality of this Memorandum of Understanding was executed and such writing shall be attached to this Memorandum of Understanding as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this contract, the only authorized representatives of the parties are: Owner: Anchorage: Purchasing Officer C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 9. Jurisdiction: Choice of Law. Any civil action arising from this Memorandum of Understanding shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Memorandum of Understanding. 10. Severability. Any provisions of this Memorandum of Understanding decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Memorandum of Understanding. O\VNER: Date: '7-20-0(v STATE OF ALASKA THIRD JUDICIAL DISTRICT MUNICIPALITY: By: Title: Date: ) ss. The fore instrument was acknowledged before me this a day of 20& by • •&�x��L� — tunrrn�, �J-C1: MARS, (ee r�oitiR!< My Commission expires: Municipality of Anchorage Development Service's bepaliment Building Safety Division Onsite Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, Ak 99519-6650 www.ci.anchorage.ok.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 051-073-19 HAA # PA O a o o 3 (o Expiration Date: �i-I -O� GENERAL. INFORMATION ,Complete legal description int 1T1i1ncle 1' roxhill Subdivision Location (site address or directions) 21615 Woodcliff Dr. CurrentPropertyowner(s) Bill & Cheryl Schnabel Dayphone 786-1912 Mailingaddress PO Box 221196 Anchorage. AK 99522 Lending agency Day phone Mailing address Real Estate Agent Mailing Address Tarry Mauldin Dayphone i6o-8454 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well Q Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site a Individual Holding lank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given In paragraph 5 by an independent professional civil engineer registered in the Slate of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also Issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certifid'ales are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage Is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION by ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my Investigation, based on procedures outlined In the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system Is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the Information obtained from the Municipality of Anchorage files and from my Investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) In compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of Installation. Name of Firm S & S Engineering Phone 694-2979 Address 17014 a Eagle Rivor T.nnp Cram gni. Rag! River, AK 99577 Engineer's Printed Name_ Robert C. Cowan, P_F_ Date_ PI3110 (l�(,2.i6tT uNC:or4r�u�gL /lfj,Q SLPi. C 5YSr$ry uPC-AA44.0 PL'L ArrA-c.Nep tAfPtcT/on 4440277 . 5. DSD SIGNATURE 7j Vol ROBERT C. COWAN /v! It C,,% CE -8801 Approved for � bedrooms. tt "fe;`+� Disapproved. ttt���y;»S Conditional approval for bedrooms, with the following stipulations: Tar's HAA rae-ASCS Con c2; -1i Lo_ / Hsf,a nlC n•S-C'X Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements SUpplemental Engineer's Report Other By: a �� Ll/. �L4-�/� Original Certificate Date: (Re . 12 10) Municipality of Anchorage •., • Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 995198650 www.cLanchorage.ek.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: 1-0T I A Lo c K I FOX ft t 4 L S/Q Parcel ID: O S' )- 0? 3- i 9 A. WELL DATA Well type FR 1,4 ,4 r t: If A, B, or C provide PWSID 0 Date completed q/t 4 Sanitary seal ON) Y`LI Total depth Lots It. Cased to 6{0 t ft. FROM WELL LOG Date of test q / g q Static water level ) fL Well production WATER SAMPLE RESULTS: Coliform 0 colonies1100 ml. Nitrate O.S"y mg.A. Arsenic: Date of sample: B. SEPTICJHOLDING TANK DATA Tank Type/Medal irE r r i c NDP¢. Tankalre ) 000 gal. Number of Compartments Well Log 40N) Yf 1 Wires properly protected L9/N) y E Casing height (above ground) I f 7f in. AT INSPECTION �/ao/o2 13� ft. 11.0 f g.p.m. It L�jm'r'LO 00.y 000 00 4 raV^A&,rb Other bacteria A coloniesH00 ml. Collected i , S VM'N='NG 1703T�ri Rivard Me. 204 EsDN River, Alaska 99577 Date installed S-133-101 Cleanout UN) Y*J Foundation deanout®Nq jArJ Depression over tank (Ye 'vu High water alarm (Y* Dale of pumping ^,/4 - N !W Pumper NU C. ABSORPTION FIELD DATA Date installed r* t%a )- Soil rating (g.p.d.Me or ft2/bdrm) =0 System type 1.0. 5. F. Length '3 6 ft. Width )a ft. Gravel below pipe o. A s ft. Total depth S t Eft. absorption area 364 fe Monitoring tube 'y 46 f Depression over Held Date of adequacy test N 1/ A ' " rE w Results (Pass/Fail) For 3 bedrooms Fluid depth in absorption field before test _ in. Elapsed Time: _ min. Any rejuvenation tr�,aVAeV(past 12 mo.) (YIN & type) in. t_ gal. New depth_ in. Absorption rat >- g.p.d. If yes, give date D. LIFT STATION Data installed fl3r/a1 Size in gallons SS`y Manhole/Access ®N) YsJ 'Pump on" level at ±Y_ in. -pump ofr level st 3 S in. High water alarm level at g in. Datum 00776r. 0i- r4olc Cycles tested Z Meets alarm 6 circuit requirements? Yt..f E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tanknift station on lot 14 7 On adjacent lots , Absorption field on lot 10 y On adjacent lots I o v { Public sewer main >✓ 14 Public sewer manhole/deanout A0 14 Sewer /septic service One 1 f ; Holding tank /✓ 14 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 10 Property line 66 Absorption field s Water main ki A Water service line /� t Surface water / O d F Wells on adjacent lots 100 4 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line O Building foundation Sd Water main Al �A Water Service One %0 ; Surface water /40 �+ Driveway. parkingArehide storage 3 0 'f Curtain drdir. r �.g �- Wells on adjacent lots 100 r+ F. COMMENTS G. ENGINEER'S CERTIFICATION I cer* 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.' ' AN Engineer's Printed Name 90atA7 C. Cow.drj Date �0 HAA Fee Date of Payment Receipt Number (aev.12/ol) Waiver Fee $ Date of Payment Receipt Number © A o6 M X IEALTNAUTNORRY APPROVALS SEWER&WATER IAVNE%TENSKM SEWER& WATER INSPECTION DOGINEERINGSTLOIES ANDREPORTS WELL INSPECTION & FLOW TEST SITE PIANS SOILTEST PERCOLATION TEST STRUCTURAL& MECHANIC—N. INSPECTIONS ON SITE WASTEWATER DISPOSALS15TEM DESIGN ROSERTC. COWAN, P.E. ROSERTA. SHAFER, P.E. May 31 2002 CML ENGINEERS Y, (907)694-2979 FAX (907) 694-1211 MUNICIPALITY OF ANCHORAGE Development Services Department Onsite Water and Wastewater Program PO Box 196650 Anchorage, AK 99519 REFERENCE: Lot 1; Block 1; Foxhill Subdivision Request you issue a Health Authority Approval on the referenced property and grant a waiver for the separation distance between the north property line and the new leachfield at 0 feet. We do not anticipate any adverse effects to the referenced property or to adjacent properties. If you require additional information, please contact us. Sincerely, -�9/z � Robert C. Cowan, P.E. RCC/tS1N10M1 %aiver.dm Rae 01,0fio2 l& .00 („ nt kltiiJtf- W V,t)aa&-;Q 17034 NORTH EAGLE RNER LOOP • SUITE 204 • EAGLE RNER ALASKA 99577 Municipality of Anchorage *A1 Development Services Department Building Safety DivisionOn-Site Watuand WevtewaterProgram4700 Bragaw Stmt P.O. Box 196650 Anchorage, AK 99519.6650 www.ci.anchorage.akms (907)343-7904 Waiver Review Worksheet Criteria: AI r AZ TFr.rVFYL:. u•u rMilir1ril , i.pt .,.y.,%t: =.1 A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation f3�9 Permit#: Points: Waiver Is Granted: t Waiver is not Granted: Ust Conditions or Reasons for above: Date: By: 59'4_ � ................................. gn■■■nage . e■Of Rei:y:: �...■gnnnn.ggneneeee■.g� Rec#: 20642 Amount: $160.00 Date Paid: 61312002 Munic0 alh)7' of Anchorage JL George Il'uerch, Mayor Department of Public Works Building Safctv D117sion P.O. Bot 196650 • 4700 S. Bragaw Street Anchorage, Maska 99519.6650 • (907) 313-9301 http://A�w.cl.nnchoragc.ak.us 6/10/2002 Bob Cowan S & S Engineering Subject: Waiver Request for Fox Hill Block 1 Lot 1 Waiver Request #WR020022 Parcel ID 4051-073-19 Dear Engineer: Your request for a waiver of the required 10 feet horizontal separation from the absorption field to property line has been approved. The approved separation distance is 0.0 feet. This waiver approval applies to the existing absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Jeffrey W. Poet Engineering Technician On -Site Water & Wastewater Program Municipality of Anchorage • �-1 Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, Ak 99519-6650 www.cl.a nchorage.o k.us (907)34)-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY- DWELLING ` Parcel I.D. 051-67S- 1 q HAA # A 00 D 03 6 Expiration Date: 51:5��Lo2 1. GENERAL INFORMATION, Complelelegal descriplion Lot 1; Block 1; Foxhill Subdivision Location (site address`ordirections) 21615 Woodcliff Dr. Current Property owner(s)'Henry Bruneau Mailing address Lending ngency Mailing address Real Estate Agent Mailing Address Dick Brown Dayphone 688-6619 Day phone Dayphone 696-2850 Unless otherwise requested, HAA will be held by DSD for pkkup. � C� `� 2/9-/0 i 2. NUMBER OF BEDROOMS: 2 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well it Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Individual On-site Individual Holding lank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given In paragraph 5 by an Independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certifidates are valid tot 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. - . STATEMENT OF INSPECTION BY ENGINEkh ,' " t As certified by my seal affixed hereto and as of the validalioh daleshown below, I verify Ihal'my, InvesUgahon based on procedures outlined In the Health Authorlly,Approvel Guidelines for this application; shows4that the on-site water supply and/or wastewater disposal 5yslerri Is(are) 'safe• functional and adequate for the number of bedrooms and type of structure Indicated hereiri.I further Verify that based bin the Information obtained from the Municipality of.Anchorage files and from my N6sligation arid,inspection.'the on-sile water supply and/or, wastewater disposal system Is(are) Incompliance with'all applicable Municipal and Slate codes, or and regulations in effect at the time or installation. 5 d S ENGINEERING ' Name of Firm '„ri:. rBi: Qt,;, a'No'�o4 Phone _G �%t/ -a`y 7 J Address T Eayte River, Mrski Engineer's Printed NameRobertC(3owan` Dale --Aly 7.41. Z!. Tui 15. ro' :.CvJ✓41. iYc ffAA SO-A SY3T G.h' To "g'��o l��(F O s Y. . T.c.niE /� . ..zLoL) TH44c >s Nv C <,Np .�. i t'Ry.•1GINEE ii$QLT/F Ny 2A.4 � � G.e a..4re,4, 4Y; THr J /1 /?PRD v.fl Np - .. clavi D.�J COUffi Y/Ot-A Tio..�'./fND NUNDVe RJt /J;FFiLci.�' n/. ..�: AJ A �tiJir o1= TJ/E (r/lA.Yi: G oa 7NtJ c X./2?:.:/ ON4/jl A.`.1 L, . o i 5. DSD SIGNATURE' i /3 PPRDv.N.; fl "<^� ROBERT C Co Approved for bedrooms. Disapproved. j b —7VConey n the amount of°�.5 TIM t�ide`�iig i I of (allm nit`{lum o1101Mi ee bids --from-ftpproved-eon#raetors--shall b"ut-in—eSCFOw-#o-cons# Amt-"ew wast wat r di o<al ystem pursunnt to permit number SW020019 attached. Money in escrow shall not be released until this office has given final approval. Construction shall be completed no later than June"15, 2002: Additional Comments Attachments: HAA Checklist X htaintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other WAsrcivjrp rvv<re.,T�tw ObRH/T ' NfJHBEJ2 SW 02001 Q• By: Original Certificate Date: Z S G z OR". 12,00) Municipality of Anchorage ,• Development Services Department Building Safety Division On-Sfte Water & Wastewater Program 4700 South Bragew St. P.O. Box 195650 Anchorage, AK 995196650 www.clAnchorage.ek.us (907) 343-790A HEALTH AUTHORITY APPROVAL CHECKLIST A WELL DATA Well typeR&A-it: Date compl2*ft Total depth . r; jpx 4 1 LL a-05/ o Parcel ID: If A, B, or C provide PWSIID#_ Well Log (YIN) ./�c Sanitary seal (YIN) Wires property protected (Y/N) Cased to -432_ft. Casing height (above ground) JIn. FROM WELL LOG AT INSPECTION Date of test 47164 o Static water level Well production -t / 9•P•m. 9 -P.M. WATER SAMPLE RESULTS: �s77Gf �T%+� Qy 1 C 1 r t lot P I *(t—. Coliform _--e:--colonies/100 ml. Nitrate O• Sgl mg.A. Other bacteria $ colonies/100 ml. Date of sample: t Z Collected by: � (SKJ 6 -G- B. SEPTICIHOLDINO TANK DATA Tank Type/Material %( L ZDate installed %'184 Tank size / Ooy gal.. Number of Compartments Z Cleano is MN) y Foundation cleanout (Y/N) Depression over lank (YIN) _^/— High water alarm (YIN) N '� Date of pumping ±A O V Pumper ` ijk -a C. ABSORPTION FIELD DATA J Date instalted � Soil rating (g.p.d./fF or ft2/bdrm) � System type Length 4; 2 ft. Width 15f �) ft. Gravel below pipe ©'-s� ft. Total depth :3 ft. Eff. absorption area 15Yftaft2 Monitoring tube _)!�5 Depression over field --A/-v Date of adequacy test 1 IS DI Results (PasslFail) F4/ L For 3 bedrooms Fluid depth in absorption field before test % in. Water added,&gal. New depth_ in. Elapsed Time: _ min. aelilu depth _ in. Absorption rate >= g.p.d. Any rejuvenation nt (past 12 mo.) (YM & type) If yes, give date ry /S4*, UP64.406-:�> el�ek� QuFs7 e-2( 5q57E ^ I I 1 GAF /4- "44 , (�pN D iT r0AIA t, APP 20VOV- '4-Q u E sTc-0 D. LIFT STATION Date Installed _ `Pump on' level at Datum i Stre in gallons Manhole/Access (YM) _ in. 'Pump off' level at _ In. High water alarm level at in. Cycles tested Meets alarm ti circuit raquiremsnts7 E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankliAataWn-on lot / O© '-4- Absorption - - Absorption field on lot to O t rr Public sewer main ^1 1-1 /4- . §surer /septic service line 2�� On adjacent lots On adjacent lots / t7 O + Public sewer manhole/deanout A� R Holding tank N /A SEPARATION DISTANCES FROM SEPTIC1HOIJM a -TANK ON LOT TO: l 1 r l r Building foundation 4 Property line5 r Absorption field r Water main Water service line l ->- Surface water / eO �+ Wells on adjacent lots /00 r -4 - SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line /0 1•>~ Building tow dation /O 1� Water main /<Dr � Water Service line 1 D (•r- Surface water 1 QQ 14- Driveway, parkklp/verwie storage Curtain drain Zo '4- Wells on adjacent lots F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through held iupections and review of Municipal records that the above systems are in conformance wflh MOA HAA guidelines In effect on this date. NQj11F£R't3>" As p , Engineer's Printed Name RtlRg¢iii CO '�. 4414t 4 , Date HAA Fee $ 3 7 5�• 6" + / S'0. 0 v l; R. -r M ) Walver Fee $ Date of Payment a/Yh Receipt Number o i S 3 9 (Rev. 12M) Date of Payment Receipt Number MUNICIPALANCHORAGE • '� DEPARTMENT OF HEALTH b 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. # nE'nI - n1 S- \5 1. GENERAL INFORMATION Complete legal description Lot 1; Btock 1; Fox Hitt SubdEv.iaion Location (site address or directions) 21615 WoodcU66 12tive Property owner Ketfu Rich Day phone 688-0304 Mailing address P. 0. Box 670269 Chug.iak, A-a6ka 99567 Lending agency Mailing address Day phone Agent 7-12- Meachem rFNTt)nv 911rn)OtitA) Day phone 696-8600 Address 11901 Bu6.ine66 Blvd. #103 Eagle Rivet., AX.aaka 99577 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 2 3. TYPE OF WATER SUPPLY: Individual well XX Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- In_q 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.M(Rw.V91) From MOAF21 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 of this inspection. Name of Firm Phone Address 17034 Eagla Riverloop Road No. 204 Eagle River, Alaska 99577 Engineer's signature Date 6. DHHS SIGNATURE -A�-_- Approved for rte? ) bedrooms. M Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments FA 0WEld 1. 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. 72 =5(0bv.1/91) 8� MOAP21 e Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal D escription: LOT ���-� �X H�wtb Parcel I.D. A. WELL DATA Well type PRO P61= —if A. B, or C, attach ADEC letter. ADEC water system number 'I I,, r. Logpresent&N) II Date completed gl-a4 Driller SC1Ual Q i% -,A Total depth 154 Casedto Nc%4� Casingheight 1Za F Sanitary seal ON) 11 ` Date of test Static water level Well flow Pump level FROM WELL LOG y-li�4r Wires properly protected (YYN)y lLo1 iS o g.p.m. AT INSPECTION .. MUNICIPALITY OF ANCHORAGE 3-Z-S-`i4.c^NMENTAL SERVICES DIVISION 1113 t r P. `L 5 1992 „V. IV ED SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot 100 s � ;On adjacent lots 1001 }' 1� tr Absorption field on lot 100 ; On adjacent lots 1 Gfl Public sewer main �1 n. Public sewer manhole/cleanout '� A Sewer service line ZS 1 } Petroleum tank Z1 r WATER SAMPLE RESULTS: b'c•s.�/goo., C. 0.41 '^"9bt Coliform Nitrate Other bacteria Date of sample: 3"2�' "9'L Collected by: S ✓R S ENGINEERING 17034 Eagle River Loop Rood No. 204 B. SEPTIC/HOLDING TANK DATA Eagle River, Alaska 99577 Date installed C, Tank size /060 L.q-L Compartments Z' Cleanouts &N) —Foundation cleanout®/N) Depression (Y6 PI High water alarm (Y)O) Alarm tested (YO "J, Date of pumping S - i. S- 5 i Pumper T2 . GESS Io o L SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s)onlot too i+ Onadjacentlots /00 1 F Foundation �9 r Topropertyline` 10 line "'Absorption field /Dt Water main/service Surface water/drainage /ao 1 r 72-026 (Rev. 7191) F=1 CONTINUED ON BACK PAGE C. LIFT STATION - Date installed Size In gallons Vent (Y/N) "Pump on" level at High water alarm level Meets MOA electrical codes (Y/N) SEPARATION _ Manufacturer Manhole/Access (Y/N) _ FROM LIFT'STATION TO: On adjacent lots imIPyu-revei at tested Surface water'— D. ABSORPTION FIELD DATA ' Date Installed 9= �4-4 Ian Soil rating 2-6+System type Qa:D Length SZ Width 3o r Gravel thickness /v �r Total depth 3 � Total absorption area f Sb o ' Cleanouts present QYN Depression over field (Y((7� I Date of adequacy test 3-2S-11 2 - Results Results as /fail) �irsS for Tr�LFG t'�1 bedrooms Peroxide treatment (Past 12 months) (Y,& 4-) 'k— 11-4 lAf If yes, give date On11iyy 12e14'J S,% -n J(n A, 2-194. A}-P0,2oVA4_ y. . SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot toofi 1+ 1J Onadjacentlots- t•D0 Propertyline (C) To building foundation - 3Z1 To existing or abandoned system on lot - �a On adjacent lots 3a 14- Cutbank� �o. Watermain/service line 101, Surface 01-+- Surface water 100 1 Driveway, parking/vehicle storage area 1 Curtain drain It, .,- IJ Z _' E. ENGINEER'S CERTIFICATION ` r I certify that I have checked, verified, or conformed to ell MOA and HAA guidelines In effect on t ee date of this inspection. i t S ENGINEERING .0 � '•.;�;f i Signature - 17010 Eagle River Loon Road No 2U 4" co 41: Esgla Riva, Alaska 99577 *T r' Cr + �, Engineer's Name Date HAA Fee $ f�[) Waiver Fee: $ Date of Payment -3 a�'. 2 Date of Payment Receipt Number X3558 X35 Receipt Number 72-029 (R". 3/9f) Back MOA 21 ck J.f••HAFER No. l}' 15 MUNICIPALITY OF ANCHORAGE Department of Health & Human Services 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. # G S/ — 0 73 — 1'9 HAA # & d 9l' OOze' 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) LOT 1• BLOCK 1• FOX HILL SUBDIVISION: Location (address or directions) CohneA WoodCf..i44'Dtive 8 GP.aciert Chugi.afz (b) Property owner - Telephone: (home) Business 786 -6329 Mailing Address 0 Box 196639 Anchzoaae A 99519-6639 (c) Lending Institution Mailing Address (d) Real Estate Company and Agent Address Telephone Telephone (e) Mail the HAA to the following address: (or check here a. if hold for pick up.) List contact person and day phone number below: S & S ENGINEERING 17034 Eagle River Loop Road Na 1904 Eagle River, Alaska 99577 2. TYPE OF RESIDENCE Single -Family Q Number of bedrooms 3. WATER SUPPLY Individual Well CNX Community ❑ Public ❑ Note: It 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 W< Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 (Rw. vee) 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 witti all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address Date 5 8 5 ENGINEERING Eagle River, Alaska 9957: Telephone `! Z 6. DHHS APPROVAL (/ Approved forebedrooms by Date •� �Y/) ApprovedDisapproved Conditional Terms of Conditional Approval CAUTION 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 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. 72-025 (Fl".7/Ba( Back Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 343-4744 Legal Description: - Zi A -1� po- %W 11— '61, Al.. 17'1 vU A. WELL DATA Well Classification E, N9le f—A rm 1 114 Azf- If A, B, C, O.E.C. Approved (Y/N) wa Well Log Present (Y/N) --I—Date Completed Yield s4 pA 4, /;z -moo- 13 Total Depth 1 9 S Cased to 17.tL Depth of Grouting Static Water Level / / Pump Set At L11� rr Casing Height Above Ground 4 Sanitary Seal on Casing (Y/N) y Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot .1 00 �fi ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot / r0 fi ; On Adjoining Lots 100,1- To Nearest Public Sewer Line 0119— To Nearest Public Sewer Cleanout/Manhole A1 /14 i To Nearest Sewer Service Line on Lot C `; t Water Sample Collected by 464- S fey rNecd "y ; Date / .;� — a 0 — 8 C1 Water Sample Test Results A ( Is ']-Ar– 1 n (-4— Comments B. SEPTIC/HOLDING TANK V -M; Date Installed NSize 4 000 No. of Compartments Z Standpipes (Y/N) 4_Air-tight Caps (Y/N) q Foundation Cleanout (Y/N) Depression over Tank (Y/N) 1i Date Last Pumped / —.2 Pumping/Maintenance Contact on File (Y/N) for — Holding Tank High -Water Alarm (Y /N) llc Temporary Holding Tank Permit (Y/N)� SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water -Supply Well / 00 'r To Building Foundation / 9 To Property Line ' L0 r t To Disposal Field ► O To Water Main/Service Line To Stream, Pond, Lake or Major Drainage Course Comments r tc. 'A AN e, {� �,, IR.s Ce,yo�ld,PJ!� n-02e(A".7/88)Fmt Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata �t3� Type of System Design SccpgT CEJ Date Installed Length of Field !!7 a ,Width of Field O _ Depth of Field 3 Gravel Bed Thickness Square Feet of Absortion Area L O Statndpipes Present (Y/N) `+ Depression over Field (Y/N) N Date of Last Adequacy Test — 8 -7 Results of Last Adequacy Test 7 Air STilC7o r SEPARATION DISTANCE FROM ABSORPTION FIELD To Water -Supply Well / no 'I- To Property Line to ,1 - To Building Foundation 212 �' To Existing or Abandoned System on Lot rJonlc ; On Adjoining Lots so �t To Water Main/Service Line /0 To Cutback (if present) A) D NP To Stream, Pond, Lake, or Major Drainage Course Ale A) e 7 To Driveway, Parking Area, or Vehicle Storage Area S O Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Check Permitted Bedroom Rating Against HAA Request" 'Pump Off' Level at Vent(Y/N) Pumping Cycles during Adequacy Test. certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this Inspection. «� Sinned S g c ENGINEERING cE .QL Q.P.Q. Company 17C34 Eagle River Loop Road No. 2U4 Eag athe 9 77 , Date /LCL y< s 1 MOA No. Receipt No..>xl 6 //oZ (/ / ��b Date of Payment--�1.�1 d Amount: $ 72-M (Aft. 7188) Beck Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 "�' %9 f"6 • //3' MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 1. GENERAL INFORMATION Application Date September 26, 1986 (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 1; Block 1; Foxhill Subdivision Location (address or directions) (b) Applicant Name Bruce Phau Telephone: Home Business 786-6364 Applicant Address United Bank of Alaska (c) Applicant is (check one): Lending Institution ® ; Owner/builder ❑ ; Buyer ❑ ; Other ❑ (explain); (d) Lending Institution 11niYpd Bank of Alaska Telephone 786-6464 Address 440 F at 46hh Aypnna, Anrhnrana Al ask-- 99504 (e) Real Estate Company and Agent Address Telephone (f) I= the HAA to the following address: 2. TYPE OF RESIDENCE Single -Family 93 Multi , mily Other Number of Bedrooms 3. WATER SUPPLY Individual Well ® Cbmmunity ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. tr 4. SEWAGE DISPOSAL Onsite W 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. Page 1 of 2 72-025 111/94) • n 5. ENGINEERING FIRM PROVIDIhv INSPECTIONS, TESTS, FILE SEARCH, DAs 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 'LILKING Telephone 6/rV—Z?7f $-1 Address—SR96 DateE&GtHtiVER,-AK-99� /o �i3 AG 6. DHEP APPROVAL 2)) Approved for tL bedrooms by Approved Disapproved Conditional 16012411 R. Sh.kr Na 1{57.e Terms of Conditional Approval ' S4412L4u4 war 6X'C'''`' Z. i 148 CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending Institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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. Page 2 of 2 72-025 (11/84) _. .. - MUNICIPAUTY OF ANCWJKAu ^iV j�pip#M4AL PROTECTION r MUNICIPALITY OF ANCHORAGE (MOA) UCT 1319 HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST -FEBRUARY ION RECEIVE 264-4720 Legal Description: �- �xZkll /d A. WELL DATA Well Classification If A, B. C, D.E.C. Approved (Y/N) Well Log Presen ( Date, Completed B 474Yield�f�' Sy' Total Depth r Cased to Depth of Grouting K `� Static Water Level 120 Pump Set At u n Casing Height Above Ground Sanitary Seal on Casin (Y N) Electrical Wiring in Condui (Y N) Depression Around Wellhead Separation Distances from Well: To Septic/h')>al= Tank on Lot Ano rf ; On Adjoining Lots r4 - To Nearest Edge of Absorption Field on Lot 6470 (4 : On Adjoining Lots To Nearest Public Sewer Line N 1h To Nearest Public Sewer ZS CleanouVManhole A% l t4To Nearest Sewer Service Line on Lot Water Sample Collected by(�� S �n*�� ; Date Water Sample Test Comments B. SEPTIC/HOLDING TANK DATA Date Install T Size �C/00 No. of Compartments 2 Standpipes Y N) Air -tight Caps (Y ) Foundation Cleano (Y N) Depression over Tank (Y10 Date Last Pumped Pumping/Maintenance Contract on File (Y/N) -;for Holding Tank High -Water Alarm (Y/N) A114- Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/HYldiri -Tank: To Water -Supply Well 1W �4 To Building Foundation �9 t To Property Line �O A To Disposal Field r To Water MeirtFService Line �d To Stream, Pond, Lake, or Major Drainage Course AAO ^-!E Comments Page 1 of 2 72-026(11/64) 3f t,9 y Y/• � L C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absorption Area Depression over Field (Y/® _ Results of Last Adequacy Test v - LType of System Design5a",, ength of Field T 2 r _ Depth of Field Q i sr Bed Thickness - 1s6 0 `9" Standpipes Presen (Y N) Date of Last Adequacy Test _/b - 5 —8(0 SAitSFfk x QM ojtt Separation Distance from Absorption Field: To Water -Supply Well /00 '1, To Property Line y1,Q "A - To Building Foundation -72 # To Existing or Abandoned System on Lot N O N F ;On Adjoining Lots 30 r +c To Water Mam/Service Line /4:) To Cutbank (if present) ti0 rl/E To Stream/Pond/Lake/or Major Drainage Course 41c2 ^f E To Driveway, Parking Area, or Vehicle Storage Area _, !02 / �4 Comments A&dy R D. LIFT STATION / Date Installed Dimensions Size in Gallons— Znhole/Access (Y/N) "Pump On" Level at 4�.. ump Off' Level at High Water Alarm Level at Vent(Y/N) Tested for Electrical Codes (Y/N) Comments Check Permitted Bedroom Rating Against HAA Request •- Pumping Cycles during Adequacy Test. Meets MOA I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. SignedSR B996X S & S ENGINEERING Date Company �_�_JvtOA No. R6' U0 3 „ Receipt No.-��o / D AZ Date of Payment A Amount: $ hil Page 2 of 2 72-026 (11,84) Rd n HEALTH AUTHORITY APPROVALS SEWER 6 WATER MAIN EXTENSIONS SEWER S WATER INSPECTION AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL• MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSALSYSTEM DESIGN Ju£y 20, 1986 Municipatity o6 Anchorage Department o6 Heatth and Human Services 825 L Street Anchorage, Afadka 99501 ATTENTION: Sudan Odwatt REFERENCE: Lot 1; Block 1; Fozhitt Subdivision ROBERTA.SHAFER CIVIL ENGINEER 694-2979 An on-site wadteuateA didpoda2 system was in6ta.tted on the re6erenced property under an unnumbered permit on September., 1984. Inspections weAe per6o4med and are documented on an .in6peWon report on 6T.Ce .in our o66Ece. This report had not been submitted 6or record due to non-payment o6 6ee6 associated with the work. MUNICIPALITY OF ANcHoRAGE :iKA. SHAPER, P. E. DEPT. OF HEALTH & 64SENVIRONMENTAL PROTECTION IJUL 211986 RECEIVED SRB 196X EAGLE RIVER. ALASKA 99577