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GLACIER VIEW HEIGHTS BLK D LT 15
Glacier View Heights Block D Lot 15 #050-501-02 Municipality of Anchorage On -Site Water and Wastewater Program • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP191494 PID Number: 050-501-02 Dwelling: ® Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New ® Upgrade Name: JOSEPH CASEY ABSORPTION FIELD - EXISTING ❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address 23105 MYRTLE DRIVE, EAGLE RIVER, AK ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot Fill added above original grade Ft. Gravel length Ft. GLACIER VIEW HEIGHTS D 15 Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Ft' -- -- Ft. Well 100'+ NA 100'+ NA NA TANK ® Septic ® S.T.E.P. ❑ Holding ❑ Other Manufacturer GREER Capacity 1250 Gal. Surface Water 100'+ NA 100'+ NA Material HDPE Number of compartments 2 Lot Line 5'+ NA 5'+ NA NA Foundation 10'+ NA 10'+ NA LIFT STATION Manufacturer ORENCO / GREER Capacity 1250 Gal. Curtain Drain NA NA NA NA Remarks Existing tanks decommissioned Pump on level at 108 in. FROM TOP OF MH Pump off level at 119 in. High water alarm at 106 in. per code, new STEP connected to existing fields w/ valves. Pump make and model Franklin 2445040117 — 1/2HP Electrical Inspections performed by PLC Tank to PIPE MATERIAL House to tank 3034 3034 Installer DENALI EXCAVATING d ainf eld Drainfield CO/MT 3034. Inspector FWCS / MNA BENCH MARK (Assumed elevation) 100 ft Inspection 1" 11/8/19 11/11/19 Location and description 2nd 3`d 4`" DOOR SILL COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Conditional Approval: Date ®* TH* MICHAEL N. ANDERSON: No. CE 9469 Approved 8/15/0 r 11/14/19..- C3 / Date '®%Pzssiol� "W mspecuon mepon_y- i- i Z.00c GLACIER VIEW HEIGHTS BLOCK D, LOT 15 PID: 050-501-02 ii PERMIT: OSP191494 „W 6\ S SCALE: 1" = 30 208S�n'• A -C=12.9' B -C=48.9' A -D=14.6' B -D=51.6' A -E=17.3' B -E=55.5' A -F=19.9' B -F=58.4' A -G=22.6' B -G=60.4' SEPTIC SECTION SCALE NTS SUPPORT SERVICES: _ PREPARED FOR: OF AZ `4 \ JOSEPH & THARETH CASEY GLACIER VIEW HEIGHTS BLOCK D, LOT 15&—I / �� 49 TH * 23105 MYRTLE DR., EAGLE RIVER, AK 99577/�� 0 Michael N. Anderson P.E. DATE: 11/14/2019 MICIIAEL C ANDERSON / No. CE 9469 4661 Natrone Ave. e.0� AO Anchorage, Alaska 99516 DRAWN: FWCS Sb 11/14/19 e tph'OFESSIC��'ti i (907)727 8864/FAX: (907)345 1391 SCALE: 1" = 30' X'`__� Electrical installation of Lift Station power and Control PuUg BnG And EWkbM LLC ISI DP Pr Er r Rkw �- OW 77 �7P 22.5211 PFa�rrrreff;g`u mti FrcWt MISS Vrnlo (Du arkaI hsahLbn d tA iutw I Omirkx1an TMpamhrira ramal+alma inMUlYllvn vl 56.01111TYZI rnw L inE!:mlk d �ovdn4 Ln Mh lalnol me God! r4941r��G t+N 15 241$ Moth I IYra Um ftr vm a a,++ i'dOM Ye M ft *W& Q. Sent from my Phone TM S62`O8'4U L I JU. MYRTLE DRIVE _ ANCHORAGE R CORDING DISTRICT ,ALASKA AS -BUILT OF: GLACIER SUBDIVISION LOT 1.5 BLOCK 3 ' SURVEY CERTIFICATE: 1, John L. Schuller, Have conducted a physical survey of this property as shown on this drawing and that the improvements situated hereon are within the property lines and no enchroachments exist other than noted, Under no circumstance should any information on this drawing be used for construction offences, structures, improvements, or for establishing boundary lines. EXCLUSION NOTES: It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. WORK ORDER NUMBER: DATE sc"' E -MAIC N0V 13, 2Q19 1"=3Q' 19-110 BY CHECKED BY CRA NUMBER: I BOOK/PA JLS SV0159 1 190168 Q = FND 5/8" REBAR Aw x.....49 .CTi...... .JOHN L. SCHULLER.: � LS -1040$ 10J, fession LAND Zr � 44_4 �y 1 ma 1831 Talkeetna Street Anchorage, Alaska 99508 (907) 227-1455 office (907) 274-4992 fax 11/1/19 MUNICIPALITY OF ANCHORAGE v Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 050-501-02 Property owner(s) JOSEPH & THARETH CASEY Day phone 8034060045 Mailina address 23105 MYRTLE DRIVE, EAGLE RIVER, AK 99577 Site address 23105 MYRTLE DRIVE, EAGLE RIVER, AK 99577 Legal description (Sub'd., Block & Lot) GLACIER VW. HTS. BLOCK D, LOT 15 Legal description (Township, Range & Section) Lot Size 23,139 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial El Single Family (SF) Q (w/wo ADU) Septic Tank Upgrade Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 01�S Date of Payment: s 11/11/q Receipt Number: ogig ! Lam%I Permit No. 05p 1 q ! Lig i -i Waiver Fees: Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc Michael N. Anderson, P.E. Civil/Structural Engineering and Construction 4661 Natrona Ave. Anchorage, Alaska 99516 Phone 345 -3377 / Fax 345 -1391 Support Services Brent M. Western 907-440-4601 October 30, 2019 On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC TANK UPGRADE PERMIT LEGAL: GLACIER VIEW HEIGHTS BLOCK D, LOT 15 To whom it may concern: The owner has requested we proceed forward to obtain a septic permit to upgrade the aged septic tank and lift station on the subject lot. The proposed upgrade will serve the existing 3-bedroom house. The lot and area are served by private water. The proposed design will not impact any of the neighboring properties due to the lot layout. Please contact Brent M. Western or me if you have any questions. Sincerely, Michael N. Anderson, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191494, Rebecca Carroll, 11/01/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191494, Rebecca Carroll, 11/01/19 www.sullivanwaterwells.com Pump Installation Log Well Drilling Permit Number: SW Date of Issue Parcel Identification Number: Legal Description Property Owner Name & Address Glacier View Heights Block D Lot 15 Joe Casey Pump Installation Date: 2-4-19 Pump Intake Depth Below Top of Well Casing: 150 feet Pump manufacturer’s Name: F&W Pump Model: 4F07P07301S Pump Size: 3/4 hp Pitless Adapter Burial Depth: 10 feet Pitless Adapter Installer: Unknown Disinfected Upon Completion? yes no Method of Disinfection: Chlorine 50 PPM Comments: Pitless Manufacturer: Unknown Pump Installers Name: Sullivan Water Wells Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. Municipality of Anchorage Page Of� DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report %5 Q i l 2Cn_gj 66Oo5`DI,nZ. Permit Number: PID Number: Na a: s Aad/� ✓ � Wastewater System: ❑ New gvpgrade Aut o. Bo l4j d e6AjikI q I I ABSORPTION FIELD Phone 10 I No. of Bad rooms: eep Trench O Shattow Trench ❑Bed ❑Mound ❑Other LEGAL DESCRIPTION Soil Rating: O. & Total Depth from original grade: t ipr< GPD/Sq FI Lot: ,"J 8105 � Subdivision, Depth to pipe bottom from ongmal g; e: Gravel depth beneath pipe I d / 14 y Ft. FI. Township: Range: Section: Filla ded above original grade: Gravel length: / . �f-.. --:50 FI Ft. WELL: ❑New ❑Upgrade GravelOepne "7:> / Numberollines: I DOtance /en laws: �7 Ft F-1 Ft. Cl e f cation (Private. A.B.C): Total Depth: Cased To: Total absorption area // Pipe material: 10-4r,2r- f Ft. Ft. 100 SO Ft. Driller. Date Drilled: Static water Level: Istella 9r: � n` S ��•� Date installs0: �p -1 FL Iw yield:Pump set at: Casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES Asepti Ho i 0S.T.E.P. To Seplic Absorplim WI Holding blie/Pdvatw Manufacturer. Capacity Vn3aln From Tank Filed Stalion Tank m Sawar Lia ��� . Well I D�. f I CQ / 1167, n t !�� G. Materiel: Number o1 Compartments: Surface GYW4- IC0/+ JCO�F — LIFT STATION I LOt Line 10 3� Size In gallons: SOD Mg§��nufactur + r: 14C+ E TAtiIIL Foundation / � 1 / 1 G, / 22 «� "Pump on" [evel�t: 28 "Pump Ofl" level at: ✓ High water alarm at: 3 �r Curtain D Pump Make 6 Moo el EI trical lnspectior)goerlormad by, Drain (•( Alf (y'j 0� Remarks:: BENCH MARK LOT dDescriQlion : D� —DI 4.3Cpt l C-15 -:exc,7—noer -1 LVIr -, toti l Assumed Elevation: Ft Ob0 AL F OOANI ti e %�Os��d �'t?rf Q�► a% Inspections performed b � Gly —I P14 Dates: is � �1 ••«.«.1 « 60.0 I 2nd r.RODE ,HAFER. W �+ Department of Health and Human Services approval J". No. 15 c�/ by: Urhv &It t7H Date: -7z : Reviewed and approved '1 72-017 (1/91) MOA 25 IPermitl4o. G✓1��120G�i� Page sof ?7 - Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report DescriotionZL_At-,tk: . 1-fa2a=- T��jLOlplAo; 6G.0�5b I DZ ipo' Ill [b, IO 4l- t1 lam° 14gG Y- 1535 we WAV2¢oa1 to hGALX_f 1-= 10' nn ptw.lEn x,14- \cr_ 1�rX� GSL. ��PriG�R'►�tL 5� 4Ac^ :R SMAFER No. 215 1 72-017 A (2121) MOA 25 NORTHSTAR * ELECTRIC COMPANY June 29, 1992 To whom it may concern: Northstar Electric Company has done the electrical wiring to a newly installed sewage lift station and alarm at Lot 15, Block D, Glacier Heights Subdivision in Eagle River, Alaska. The wiring has been done in accordance with the 1991 National Electrical Code. Alaska State Contractor License AA17485 Sincerely, V%'k Boone Jw P.O. 80x 772886 EAGLE RIVER. AK 99577 907-696.8608 HEALTHAWHORITY APPROVALS SEWER 8 WATER MAIN DMNSIOIS SEWER&WATER DISPECTION ENGINEERINGSTUDIES ANDREPORTS WELL INSPECTION 6 FLOW TEST SITE PLANS ROAD DESIGN SOLTEST PERCOLATION TEST STRUCTURAL& MECHANICAL WPECTIONS CN SITE WASTEWATER DISPCSAL SYSTEM DESIGN PA6E 1 of Z ROBERT C. COWAN, P.E. ROBERTA. SHAFER, P.E. Jul 11 19 9 6 CML ENGINEERS Y . (907)694-2979 FAX(907)694-1211 oeZ10- Sol -On MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AR. 99519 . Lot 15, Block D, Glacier View Heights S/D This letter is to inform you that a flow diverter has been installed in between the existing 1000 gallon septic tank and the existing 500 gallon lift station. The purpose for this addition is to provide more leachfield for future use. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/gk Attachment RECEIVED JUL 15 1996 Municipality Of Ancnuraye Dept' Health & Human Sery)ces 17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER. ALASKA 99577 Permit No. Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal Description: LOT 15, BLOCK D, GLACIER VIEW HEIGHTS PID No.: 05050102 72-017 A (Rw. 9/91( MOA 25 100' YELL RADIU. N INSTALLED FLO DIVERTER EXSI BED H TING 3 OOM USE 411003[A' EXISTING 1000 GAL. SEPTIC TANK EXISTING 500 GAL. LIFT STATION QNSTALLE 8-10-87) SCALE 1' - ' , e .p ROBERT C. COWAN ec� CE -8801 72-017 A (Rw. 9/91( MOA 25 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON—SITE WASTEWATER DISPOSAL SYSTEM PERMIT NUMBER:SW920095 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:VICTORS CHRIS M & BONNIE OWNER ADDRESS: P.O.BOX 1410 KENAI, ALASKA 99611 PARCEL ID:05050102 LEGAL DESCRIPTION: GLACIER VIEW HEIGHTS BLK D L T 15 LOT SIZE: 23139 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 �/y/rZ SIS /0 tic) AV, E/:j/4L SES (UPGRADE) PERMIT li z, 5(5 DATE ISSUED: 5/22/9!'2 EXPIRATION DATE: 5/22/93 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 FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: IF THE EXISTING DEEP TRENCH IS TO BE ABANDONED, THE ABAND- ONDEDMENT MUST BE SUCH THAH IT CAN BE RETURNED TO SERVICE AT ANY TIME IN THE FUTURE THAT IT IS NEEDED TO SUPPLEMENT THE UPGRADE SYSTEM. THE UPGRADE SYSTEM MUST BE INSTALLED PER THE APPROVED ENGINEER'S DESIGN DATED 5/16/92. A WAIVER TO THE 10 FOOT LOTNEr�SETBACK IS GRANTED UNDER WR920025. RECEIVED BY: �("JDATE : Z_Z- 7z__ ISSUED BY: DATE: / S 11 MUNICIPALITY OF ANCHORAGE 1 DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 1 ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 2644720 ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME OYs DI/ `off PHONE NEW ❑UPGRADE MAILING ADDRES —1?� L S / P4 Ghi a SO LEGAL DESCRIPTION OT /5- 91K D r2ladet View LOCATION Myrtle Drive NO. OF BEDROOMS & -►ort Y DISTANCE T0: Well 1D� �� Absorption area Dwelling � PERMIT NO. W< ~L Manufacturer Materia lSTeC' No, of compartments �J to U7capacity in gallons 6 0n I IF HOMEMADE: Inside length Width Liquid depth d Y DISTANCE TO: Well Dwelling PERMIT NO. JD2 _ f Manufacturer Material Liquid capacity in gallons D DISTANCE TO: We It a ion v Nearest lot It eO PERMIT NO. W = Y. W Z No. of lines Length of each line Total lengthf I' es Trench wi Distance between lines Z W i" Inches H Top of tile to finish grade ^ n Material beneath tile Total ellect6 absarptkn area Length Width Depth PERMIT NO. W Q- Type of crib Crib diameter Crib depth Total effective absorption area W4 to DISTANCE TO: Well Building foundation Nearest lot line E J Class Depth Duller Ois �f !pa PERMIT NO. J 1N DISTANCE TO: Building foundation Seer wline 0I psepyrN Absorption steals) OTHER PIPE MATERIALS el P vc SOIL TEST RATING #5 = f'Pc{roo INSTALLER 144�r REMARKS y 6fT 2 3.6"c' SLOG w f t t G e. S r •s ew r � �� La�;tfi'o✓► O!C'ed �y 9 I �,. 9 G lLi s Mmes L Thiso v . APPHOV EDS Jf•.•• CE 5035 •:• `?W =-f9fo'•••••••••' E„�js� DATE LEGAL BIK D, Glacier V;e4.P 14 s/ "'.► pRpF wR� 72-M3 (Rev. 3/78) ow- . aoaa frr.afird Bri11i by '}� ... • cot Ca err SULLIVAN WATER WELLS 1 s`''�! `?.0.K'%M. CHWIAK. ALASKA �y;�•. a,.� = .. . 0%tN1tR0F LAND c Y �RR'/ G iSTF. DEPTH OF WELL ,] e�✓Pi�1 f!; ��'7PSa7' /rrOAl/f %/iwcc /%\/C! "T`JATICLEVEIOFWATERFT :Z"'`•I*L.- •i %r .. (t`iS AcK O Gl.rcl�' ✓irN NC7J ! .` _ : �`,%7`,•+Sr�`'i. LRGALDt1CkWflOI4 DIL%W DOWN ri + Or► 1fY111M ' ' 3 Eww—?�'F�i % GALS. PER HR , j Pt1RYtf M1Y!!i KIND OF CASING, A ' KD7D OF FORlIATION �. •�, , S 1 Y}i 15' �'t\-i. r. l i : , 01 F�'�<,Y, , e y .• s r•s.. +. . w� � ,w.l J i f� •.._ter . Fran Ft to .t4 .' FL t 6: �.0%a1 From , Ft IS Ft Q ' t ,•. Aj -� • �. ^ Ax. rnrrAlNV L•rt. •y..♦ 1 a�L1F1:_et 4 Y f,e.r v.rc •� Fran Ft. ro � Ft ' ^"� r :�• to— � Frons Fl.roFe- - i. Id-,iYl.1�FL 0 ,<-AnG k From Fl.lo f F �!? is t•. ! ., ,... w ,� t r'St •. ,:.11OGK F•%ltr•e{ O .i .i,: tint r•:�,at �) t-%r�< rl rFrom FL to Ft t , �� F«•_."' �'` Fl. to FL (_ OM From Ft.to t .FL`'-s.,:.r::te{=i Fwf4(' haiDe Ft LEOleaK sit From FL10 ' Ft IF .".YL to Pt- Fran 'i' Fww hM FLFrew FL to Ft.• Frew FLIa Ft • `�''' '� �-�ti'E:a f.y FtMdi rr. b�Ft Fran - FL le Ft. From FL ►L From _FL to Ft from FL Ie FL Front—Ft. to 1 F4 to—FL, Fran FL Io FL Frere .w - j i4 N FL From Pnw °�FttaFL Frow Fl.le Ft � v _ .I CAf..vL .. 4 I `'�.1 _ o.:.J<a- rli!i• .1. '� -r�. i•3}V��,'/1' i01 01t. � r t[ art }fr •d. �4aii '7j ♦' /�... •'•if 1 syr+. , •F', r 4... DRILLERS NAME •N t 'C3:°s by DOC Co. dba SULLIVAN WATER WELLS P.O. BOX 272, CHUGIAK, ALASKA 99567 • TELEPHONE 6882759 OWNER OF LAND fl /! 'i G yS t E.- DEPTH OF WELL ADDRESS Jr".�C �r+0+'jri� v�rSTATICLEVEL OF WATER FT. LEGAL DESCRIPTION [- /S PLIC O 6L64t lE.M fLf"J J t6DRAW DOWN FT. DATE -Started ct'4a /'F'' Ended /��r GALS. PER HR �< <' PERMIT NUMBER KIND OF FORMATION: KIND OF CASING 1, !i� OQ From n Ft. to 12 Ft. --/'t ' ✓ 4,6 "54- From Ft. to Ft. From = Ft. to � Ft. dd✓lO X141 From Ft. to Ft. r From :SLS' Ft to L�LFt. Ci_ Al /•s N�(< From Ft. to Ft. From Ft. to Ft. X?o From Ft. to Ft, From ` ' 7 Ft. to /�Ft. A e," ° ° /' From Ft. to Ft. From Ft. to /s' �Ft. /_11<71j/ "From Ft. to Ft. From Ft. to Ft. " C F n7 From - Ft. to Ft. From ' `> Ft. to_f`' o Ft. 0 C ) c. 'O 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 Fl. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft, MISCL. INFORMATION: yo -7 / ioirl< DRILLER'S NAME O MUNICIPALITY OF ANCHORAGE Department^f Health and Environment,`)Protection 825 Street, Anchorage,.AK. X9501 264-4720 Permit# f * * * HANDWRITTEN PERMIT WEL ANDAV ON-SITE SEWER PERMIT Applicant: Mailing Address: Z� �di�lL &qcA a 7c Location: Phone Number: Legal Description: zo7`- /5 zo_e l l/� -fLl.0 Lot Size: Type of Soil Absorption System Is: Trench:_ Drainfield: Seepage Bed: Holding Tank: Maximum Number of Bedrooms: _ Soil Rating(sq.ft/br) /Y,5- The Required Size of the Soil Absorption System Is: DEPTH LENGTH . GRAVEL DEPTH XII�DooTooH o,v s The length dimension is the�ength(in feet) of the french or drainfield The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(fi6) TANK SIZE _ /DOO GALLONS Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * *.* TWO(2) INSPECTIONS ARE REQUIRED Backfilling of any system without final inspection.and approval by this departmen will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 fee for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 8 3 I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the residence is remodeled to include more that 3 bedrooros.. Signed: Issued by: A 1'can Date: 67 Date: .S/,44tzacu�'/dam SWP/0244 (1�/8�1) �7 S� 3to jae�.uu�•ti.� � •a%�o- to� /�-' 9 SOILS LOG MUNICIPALITY OF ANCHORAGE \ ri DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 0 PERCOLATIONTEST 825 L Street, Anchorage, Alaska 99501 2643720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: 7,qQ7 DY --57-f P— DATE PERFORMED: S/-22-183 LEGAL DESCRIPTION: LOT IS', GL//C/E/L ✓/E K/ NTS. Sd 8. SEG /61_T/VN, p/K/ . 5, M. DEPTH SLOPE SITE PLAN(No 6 - CE) (FEET) Sic_r 2 3 4 5 6 7 s 9 10 11 12 13 14 15 16 17 16 19 2D S/LTS/ SANOYG�AVE_G� SAND /R/ Pct,L'e7s ff SE,gi7ff / L005E 5/LT� SRNoY WAS GROUND WATER '. // S h ENCOUNTERED? NO L GQ7/�i✓tet . ✓EKY O J CNS P IF YES, AT WHAT E DEPTH? MG 517- 664vE) 146or-rv,#f eF Pr - Reading Data Gross Ti Depth to Time ,��� (C [Jl `' Water Net Drop �P • •� ....,e*a s•L x; 49 i I$,* •aa INN N .NN .N• •a, l a•• HI1N • •••.• W% %1� T% I P. Ellis •t s •e ' f•IN a•M• �At•a,•F�� I I PERCOLATION RATE (minutes/inch) 11�� TEST RUN BETWEEN FT AND FT COMMENTS NO .6&02oc1,-1 _r--1yc0c Al ,F2E0 g SL oiE C> P,,r = f;S-- 40%.' OEt/ECOO SEE/�GE �fE!J 1,V A4 6,5 no ecv /Y2- Fao7- PEPTN.,EXCA✓,?7-a2 61?410.vD dP (o Ali T. PERFORMED BY: E/1.2c. �LL/S CERTIFIED BY:___ -13 72-008 (6/79) q G �p G/ut.<.1 A� r., municiA- lity of Anchorage Department of Health and Human Services 825 "L" Street Tom Fink, Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 February 1, 1989 Robert A. Shafer, P.E. S & S Engineering 17034 Eagle River Loop Road Suite 204 Eagle River, Alaska 99577 Baa= Subject: Waiver Request for Lot 15 Block D Glacier View Heights Waiver Request #WR890005, PID #050-501-02 Dear Mr. Shafer: Your request for waiver of the required 100 foot separation'of a septic system to a private well has been approved. The approved separation distance is 92 feet. This waiver approval applies to the existing septic system to well separation only. Any future upgrade to either will require all separation distances be met or another approval from this department. Sincerely, Daniel J. Roth Civil Engineer On-site Services DJR/ljw#6 HEALTH AUTHORITY APPROVALS SEWER! WATER MAIN EXTENSIONS SEWER A WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURALS MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN Januarty 30, 1989 Municipaefity o6 Anchortage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Strteet Anchorage, A aAa 99501 ROBERT A. SHAFER CIVIL ENGINEER 694.2979 REFERENCE: Lot 15; Btock D; Gtaciert View Heights Subdivision Request you grtant a waivert bort the hortizontat aepatation distance between the prtivate weft and the teach6ietd Located on the rte6ertenced prtopertty at a distance o6 92 beet. The septic system was insta ted under a Muni.cipa.t pertmit .issued May 25, 1983. A aepartation distance uaivet was approved by the Municipaeity o6 Anchorage (MOA) durting the instattation to 96 beet. A aurtvey done rtecentey shows the hortizontae 6epartation to be c[osea to 92 beet. A 2iak anatyaia has been pert6okmed and it appearta that no bacten.iatogicaf pottution is poaaibee 6rtom this aounve. Attached boa yours Aeview ane the 6ot.towing documents: 1. A plot pian showing the rtetative distance between the we t and septic system. 2. A aiak anatys4s work sheet. 3. Satis6actorty coti6ortm and nitna.te anatyaia rtesueta 64om the rte6etenced wee£. 4. A we t, .Cog bort the 4e6ertenced weee. It is out opinion that the hoaizontat aepartati.on distance prtescnibed by 18AAC72.021 is not rtequirted in this case. 16 you rtegcr�lA,' a additional in6o, mation, please contact us. VASHAFER, P.E. as0-5 o F33 ��� F�liJQ111-P-1� 17034 EAGLE RIVER LOOP. SUITE 204. EAGLE RIVER. ALASKA 99577 SO 7/ SCALE i A t,{LI't F1 �. (icy-. '� � 'C�-��1'fl--. Gcv�C�-��•�r, � � •r �{ 1 �C.. X7.7' 1R�w�jV 1� �f�a'h•� Z l�G sti, or- 2 7 ?,e,. , > tm � N 2 —1 •A �•'d.L'4.Y S.. Y municipality of Anchorage Department of Health and Human Services Tom Fink, 625 "L" Street Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 May 22, 1992. Roger A. Shafer, P. E. S & S Engineering 17034 Eagle River Loop Road Suite 204 Eagle River, Alaska 99577 Subject: Waiver Request for Lot 15 Block D Glacier View Heights S/D Waiver Request fWR920025, PID #050-501-02, SW920095 Dear Mr. Shafer: Your request for waiver of the required 10 foot separation between a septic system and a lot line has been approved. The waived distance is 1 foot from the west property line to the leachfield. This approval applies to the existing septic system lot line separation only. Any future upgrade to the septic system will require all separations be met or another approval from this department. Sincer,9ly, C� Robert W. Robinson Civil Engineer On-site Services ljw#7 CPrt ohn Smi Program Manager On-site Services MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR# PID# 050-501-02 HA# Permit # ri a[ylq� Date Received: May 19, 1992 Legal Description: Lot 15 Block D Glacier View Heights Engineer: Roger A. Shafer, P. E. S & S Engineering 17034 Eagle River Loop Road, Suite 204 Eagle River 99577 Applicant: Chris Victors Waiver Requested: Lot line waiver - west property line - 1 foot Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Waiver is Granted: Waiver is NOT Granted: List Conditions or Reasons for above: -/4 D/0.1r.Z /ni .., Date: By or xeviewer Rec #: 23700.2167 Amount: $ 70.00 Date Paid: May 19, 1992 1/, May 19, 1992 ROBERT SHAFER, P.E. ROGER SHAFER, P.E. CIVIL ENGINEERS (907) 694-2979 FAX 6941211 HEALTH AUTHORITY APPROVALS Municipatity o6 Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Boz 196650 Anchorage, AWka 99519-6650 SEWERBWATER MAIN EXTENSIONS REFERENCE: Lot 15; Bloch D; GtacieA View Heights Subdivision Request you issue a permit to upgrade the septic system serving the re6erenced propeAty. SEWERSWATER INSPECTION The existing system was tested and a Heatth Authority Approval .issued on Manch 20, 1992 (w/COMMENTS). Due to questions o6 the existing systema' adequacy. (SEE FILE) .lending institutions wilt not accept the Heattth ENGINEERING STUDIES CeAtijicate. TheAe6ore, an upgrade to the system is proposed. AND REPORTS As can be seen 6 -tom the attached site pian/design there .is tittCe room on the p)topeAty 6or an upgrade. To maintain a 100 6t. separation distance to the wet aerving the propeAty, we propose encAoaching the west propWy WELLINSPECTION .tine. There6ore, we request a waiver 6or the distance between the west a PLOW TEST prope)tty .Line and the propo6ed teach6ield trench at 1 6t. This encroachment ahoud not e65ect the adjacent property since the system is on the west side o6 Lot 14. SITE PLANS 16 you have any questions or require additionat in6ormation 6or your review, ptea6e contact as. SinceAely, ROAD DESIGN vv ROGER J. SHAF R, P.E. soaTEsr QJS/gm PERCOLATION TEST STRUCTURALS MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSALSVSTEM DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR:y� LEGAL DESCRIPTION: L 2—IF 3 i "C 4- 5- 6 5 7 b o. 8- 9- 10- 11 9 10 11 / 'd 12 ,O 13- 14- 15 3 14 15 r 16 �ld 17 U 18- 19- 20- COMMENTS 81920COMMENTS 610 T/•fl irt. DATE PI Township, Range, Section: 1 ' SLOPE WAS GROUND WA' ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water MoniWrinpT PERCOLATION RATE `A1' h) (minutesanch) PERC HOLE DIAMETER �l TEST RUN BETWEEN K FT AND i FT PERFORMED BY: S & S ENGINEERING( CERTIFY THAT THIS TEST WAS PERFORMED IN 20 17034 Eagle River Loop Rood No. 4�j ACCORDANCE WITHIN EFFECT ON HIS DATE. DATE: 72-008 (Rev. 4,851 Er(alllls MUNICIPALITY OF ANCHORAGE 0 �` Development Services Department= Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 050-501-02 1. GENERAL INFORMATION Expiration Date:" 15, c'� O a Complete legal description GLACIER VIEW HEIGHTS BLOCK D, LOT 15 Location (site address) 23105 MYRTLE DRIVE, EAGLE RIVER, AK 99577 Current property owner(s) JOSEPH & THARETH CASEY Day phone Mailing address Real estate agent 23105 MYRTLE DRIVE, EAGLE RIVER, AK 99577 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ® Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ g5o Date of Payment k 1 _rc_lc� Receipt Number OTGoa COSA # osc1115� 1531A Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm ANDERSON CONSTRUCTION & ENGINEERING Phone 345-3377 Address 4661 NATRONA AVENUE, ANCHORAGE, AK 99516 Engineer's Printed Name MICHAEL N. ANDERSON, PE Date 11/7/2019 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic+ applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, � A or local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the ! ' system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the * well and septic system. Therefore, any estimate of how long a system will function satisfactory } for current or future occupants or guarantee that no unseen encroachments, deficiencies or F discrepancies exist can be given by FWCS and Anderson Construction & Engineering. o, CE QQIQ 6. DSD SIGNATUREk . 11/7/19.• Aw ./ System #1 Approved forbedrooms *�ti' System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following stipulations: ,�tlllll((((ftfr.. v W ER A�1� tM �17J WA Ar PR OG J�o R R,y,l By: Original Certificate Date: -1 15 1 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet COSA Checklist Legal Description: GLACIER VIEW HEIGHTS BLOCK D, LOT 15 Parcel ID: 050-501-02 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA Well log is filed with Onsite (or attached) Date drilled 8/4/1983 Total depth 200 ft Cased to 130 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 24+ in. Date of flow test for COSA 10/25/2019 Static water level at beginning of test 74 ft. Well production at time of test 0.92 gpm Water storage tank volume gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date of Sample 10/25/2019 Comments __________________________________________________________________________________ B. TANK DATA – NEW TANK Age of tank(s) 0 years Tank type/material STEP/ HDPE Measured operating fluid level in septic tank Standpipes/foundation cleanout per record drawing Date of pumping NA – NEW TANK C. LIFT STATION – NEW TANK Required maintenance completed Age of lift station 0 years Lift station material HDPE Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 8/5/1983 ALL standpipes present per record drawing Total measured depth from grade 8.7 ft (max) Measured depth to pipe invert from grade 4.7 (min) N/A – pressurized field Monitor tubes go to bottom of effective. If not, state depth into effective Appears to Code-required soil cover over field System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Adequacy test date 10/25/19 Results Pass For 3 bedrooms Fluid depth prior to test 0 in Water added 600 gal New depth 7 in Elapsed time 1200 min Final fluid depth 0 in Absorption rate 450+ gpd Any rejuvenation treatment (past 12 months) N If yes, enter date Comments/Deficiencies: E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No * 92 ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Property Line > 5’ Yes if No ft Absorption Field > 5’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10’ Yes if No ft Property Line > 10’ Yes if No **1’ ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft If absorption field is under driveway comment below Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft F. ENGINEER’S COMMENTS *1983 Trench (WR890005) **1992 Trench (WR920025) G. ENGINEER’S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. 11/11/19 • '� Municipality of Anchorage = On -Site Water and Wastewater Program (907) 343-7904 s n E T CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 050-501-02-000 1. GENERAL INFORMATION Complete legal description Glacier View Heights Blk D Lt 15 Location (site address) 23105 Myrtle Dr; Eagle River AK 99577 Expiration Date: I Z -,;2-- / Current Property owner(s) Joseph & Darmaly Williams Day phone Mailing address Real Estate Agent 23105 Myrtle Dr.; Eagle River AK 99577 Les Baily Office Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Corrn unity Class Well ❑ Commui Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: «,,-" COSA to be released to the engineer, unlessb 116V requested by the engineer. COSA Fee $ 490.00 Date of Payment Receipt Number COSA # O�C- 1313"11 Date ;', - ' / �; Waiver Fee $ _ Date of Payment Receipt Number. Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ARCTERRA CONSULTING, INC. Phone 696-6111 Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 7/26/2013 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, - ArcTerra can not give any estimate of how long a system will function satisfactory for current or future r OFoccupants or can ArcTerra guarantee that no unseen S� Z encroachments, deficiencies or discrepancies exist. / � 4S, C)TH *4, 6. DSD SIGNATURE P„ KENNETH N\�DU S x / System #1 Approved for _ bedrooms. 6/ System #2 Approved for 3 bedrooms. , �o .7 1;2 AW P FE5510 �vPL Disapproved. Conditional approval for bedrooms, with the following stipulations: By: /'&1L/( Original Certificate Dater The nicipa �y ® Q, c�rage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory X Other COSA blue sheet 10-10-12AM If more than 1 septic system is on the lot: COSA Checklist # _of _ Structure served by this system _ Certificate of On -Site Systems Approval Checklist Legal Description: Glacier View Heights Blk D Lt 15 Parcel ID: 050.501.02-000 A. WELL DATA Well type PRVT If A. B, or C provide PWSID # Date completed 81411983 Sanitary seal (Y/N) Y Total depth 200 ft. Cased to 130 ft. FROM WELL LOG Date of test 814183 Static water level 60 ft. Well production 6 g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate ND mg/L Arsenic: ND ug/L Date of sample: 7/1212013 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC 1 STEEL Tank size 1000 gal. Number of Compartments 2 Well Log (Y/N) Wires properly protected (Y/N) Y Casing height (above ground) 12+ in. AT INSPECTION 711212013 ft. g.p.m. Collected by: ARCTERRA Date installed 8/10/1983 Cleanouts (Y/N) Foundation cleanout (Y/N) Y Depression over tank (YIN) N High water alarm (Y/N) N Date of pumping 7/11/2013 Pumper JR's C. ABSORPTION FIELD DATA ** TESTED 1983 SYSTEM" Directed Diverter to 1983 system Date installed 616-9192&"815183 Soil rating (g.p.d./f:2 or ff/bdrm) 0.61 145 System type Trench Length 381** 55 ft. Width 31**2 ft. Gravel below pipe 10.01"4.0 ft. Total depth 17.61 **13.7 ft. (Meas. 7/13/13) Eff. absorption area 440 ftz Monitoring tube Y Depression over field N Date of adequacy test **711312013 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 0_0 in. Water added 600 gal. New depth 24 in. Elapsed Time: 1,440 min. Final fluid depth 5 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) N If yes, give date D. LIFT STATION Date installed 61511992 Size in gallons 500 Manhole/Access (Y/N) Y "Pump on" level at 28 in. "Pump off' level at 18 in. High water alarm level at 31 in. Datum Bottom of Tank Cycles tested 3 Meets alarm & circuit requirements? Yes E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ Public sewer main NIA Sewer /septic service line 25'+ Animal containment areas 504 SEPTIC/HOLDING TANK ON LOT TO: On adjacent lots 100'+ Public sewer manhole/cleanout NIA Holding tank NIA Manure/animal excrete storage areas 1004 Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main NIA Water service line 104 Surface water 1004 Wells on adjacent lots 1004 ABSORPTION FIELD ON LOT TO: Property line 10'+11' Building foundation 104 Water main NIA Water Service line 104 Surface water 100'+ Driveway, parking/vehicle storage 3' Curtain drain 50'+ (NONE KNOWN) Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name KENNETH M. DUFFUS Date 7/'/-1 COSA brown sheet_10-10-12.doc OF ALS i4.ATH I*+, + NKENNETH71M. D S / +gymAlf q 16 a16 � �r \`� P FE551DNaV Municipality of Anchorage Development Services Department Building Safety Division a 5 , t. r c On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ei.anchorage.ak.us (907)343-7904 Water Well Advisory Certificate of On -Site Systems Approval (COSA) # 131377 During a recent COSA on-site inspection and test of the potable water supply well on Block D, Lot 15 of Glacier View Heights subdivision, the well's productivity was determined to be 0.68 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 -bedroom residence is 0.31 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. Municipality of Anchorage Development Services Department Building Safety Division On -Site Water 8 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 / _:�G/Gt APPROVAL j - FOR A SINGLE FAMILY DWELLING Parcel l.D._056'Jrl /-n,P COSA# 1. GENERAL INFORMATION Expiration Date: / % - 0 CI Complete legal description GLACIER VIEW HEIGHTS SUBDIVISION; LOT 15 BLOCK D Location (site address) 23105 MYRTLE DRIVE + EAGLE RIVER AK 99577 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address JOHN GILLMORE Day phone 980-5068 23105 MYRTLE DRIVE • EAGLE RIVER AK 99577 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 Day phone Day phone 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well N Individual On-site N Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my application, investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this app 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 (les 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 Finn GARNESS ENGINEERING GROUP, Ltd. 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, VD. attempted to provide a thorough, conscientious engineering analysis of the system In accordance with ADEC and MOA DSD Guidelines d Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily Identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory atictoy test results do not guarantee future performance of the system, nor do they guarantee there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. S. DSD SIGNATURE V Approved for bedrooms. Phone 337-6179 Date Disapproved. Conditional approval for bedrooms, with the fllowing stipulations: Attachments: V COSA Checklist Arsenic Advisory Septic System Advisory Maintenance Agreements (Z'16/O tU rn1�®fYfi A. G ness: CE— 3 dZ ,l aD t111,.,,,, QQy��Y OF giy�y ' 0 ' ON-SITE G7's WATER AND WASTEWATER PROGRAM ' "J"mil l Well Flow Advisory Supplemental Engineer's Report Nitrate Advisory Other - 7 By:4 Original Certificate Date: /o'7-- / / - g (Rev. 11105) Municipality of Anchorage Development Services Department Building Safety Division On -Site Waler & 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 CHECKLIST Legal Description: GLACIER VIEW HEIGHTS SUBDIVISION: LOT 15 BLOCK D Parcel rOL02 A. WELL DATA Well type PRNATE If A. B, or C provide PWSID# N/A Date completed 8/4/1983 Sanitary seal (Y/N) YES Total depth 200 ft. Cased to 130 ft, FROM WELL LOG Date of test 8/4/1983 Static water level 60 ft. Well Log (Y/N) YES Wires properly protected (Y/N) YES Casing height (above ground) 12+ _in. AT INSPECTION 4/22/2008 70 ft. Well production 6.0 g,p,m. 0.70 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate ND mg./L. Other bacteria 0 colonies/100 mi. Arsenic: ND ug./L. Date of sample: 12/2/2008 Collected by: _ GEG, ltd. 4 22 2008 B. SEPTIC/HOLDING TANK DATA Tank Type/Material STEEL/S.T.E.P. Date installed _ _8/10/83 & 6/9/92 1000/ — Tank size 500 gal. Number of Compartments 2 Cleanouts (Y/N) YES — Foundation cleanout (Y/N) YES Depression over tank (YIN) NO High water alarm (Y/N) YES — Date of pumping 5/19/2008 Pumper JRs PUMPING _ ,C. ABSORPTION FIELD DATA Fe - LOW EXISTING GRA 6/6-9/92 0.6 Date installed - 8/5/83 Soil rating (g.p.dAt'or ft'/bdrm) 145 System type TRENCH _ Length 38/55 ft. Width s 3/2 ft. Gravel below pipe 10/4 ft. 760/ Total depth '17.s 10.1 ft. Eff. absorption area 440 ft' Monitoring tube YES Depression over field NO Date of adequacy test "12/15/2008 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth In absorption field before test 40 in. Water added 450 gal, New depth 50 ir. Elapsed Time: 900 min. Final fluid depth 38 in, Absorption rate >= 450+ P g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date **TESTED THE 1992 TRENCH ***NOTE: ON (12/15/2008) LIQUID LEVELAN THE 1983 TRENCH WAS 1 FOOT BELOW THE INVERT NOTE: DO TO WINTER CONDITIONS THE CLEANOUT IN THE 1992 TRENCH COULD NOT BE FOUND. ON OUR 2003 INSPECTION IT WAS FOUND. THE TRENCH CAN BE CLEANED OUT BY USING THE CLEANOUT ON THE OTHER END OF THE TRENCH AND FROM THE LIFTSTATION. D. LIFT STATION Date installed 6 5 1992 Size in gallons 500 Manhole/Access (Y/N) YES 'Pump on" level at 28 in. "Pump off" level at 18 in. High water alarm level at 31 in. Datum BOTTOM OF TANK Cycles tested 3 Meets alarm & circuit requirements? YES E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankA!ft station on lot 100'+ Absorption field on lot '927••100.38' Public sewer main N/A On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A Sewer /septic service line 25'+ Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: 5'+ Property Ime 5'+ Absorption field 5'+ Building foundation P rtY Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: N/A P Pro a rtY •+10'+/••'•1' 10'+ line ' Building foundation Water main "' 1 100'+ Driveway, parking/vehicle storage "0'+ Water service line 10'+ Surface water Y. P 9 Curtain drain NONE KNOWN Wells on adjacent lots 100'+ *WAIVER GRANTED TO 1983 TRENCH (WR 890005). F. COMMENTS* DI 19A83 FROM THE EDGE INSPECTION REPORT. • '9WR9 0025 (12 TRENCH 9920TRENUT OCH). ••' EDGE 0'0' (1983 F WELL ET TRENCH) D. PER G. ENGINEER'S CERTIFICATION 1 certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date 12'1 L //o & COSA Fee Date of Payment Receipt Number (Rev. 11105) Waiver Fee $ Date of Payment Receipt Number Municipality of Anchorage I Development Services �Division Department Building "�•: I'� � . 4: g Safet y Di vision On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchomge.ak.us (907) 343-7904 Water Well Advisory Health Authority Approval # 080153 During a recent Health Authority Approval on-site inspection and test of the potable water supply well on Block D, Lot 15 of Glacier View Heights subdivision, the well's productivity was determined to be .70 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 -bedroom residence is 0.31 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Health Authority Approval. U 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. nrC' ,Q 1-Qa D COSA# O I53 1. GENERAL INFORMATION Expiration Date: -� a rs Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address GLACIER VIEW HEIGHTS SUBDMSION• LOT 15 BLOCK D 23105 MYRTLE DRIVE • EAGLE RIVER AK 99577 JOHN GILLMORE Day phone 980-5068 23105 MYRTLE DRIVE • EAGLE RIVER AK 99577 Day phone Real Estate Agent Day phone Mailing address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ■ Individual On-site 0 Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage Is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage riles and from my Investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE. AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date s -/ z C/0 6 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 DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily Identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outsido the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report Is for 5. DSD SIGNATURE Approved for 3 bedrooms. Disapproved. 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 vr� ................. • ON-SITE WATER AND WASTEWATER PROGRAM •' 11 By:� 14-1. ' �� Original Certificate Date: (R. 11*5) Municipality of Anchorage Development Services Department Building Safety Division On -Site Water 8 Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orglonsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: GLACIER VIEW HEIGHTS SUBDIVISION; LOT 15, BLOCK D Parcel ID: A. WELL DATA Well type FRNATE If A. B, or C provide PWSID# NIA Well Log (YIN) YES Date completed 8/4/1983 Sanitary seal (YIN) YES Wires properly protected (YIN) YES Total depth 200 ft. Cased to 130 ft. Casing height (above ground) 12+ In. FROM WELL LOG AT INSPECTION Date of test 8/4/1983 4/22/2008 Static water level 60 ft, 70 ft Well production 6.0 g.p.m. 0.70 - 9— p.m-WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate —)J ---O mg./L. Other bacteria 1 n colonies/100 mi. Arsenic: 1J Q ug./L. Date of sample: 4/22/2008 Collected by: GEG, Ltd. B. SEPTIC/HOLDING TANK DATA Tank Type/Material STEEL/S.T.E.P. Date installed 8/10/83 do 6/9/92 1000/ YES Tank size 500 gal. Number of Compartments 3 Cleanouts (YIN) Foundation cleanout (YIN) YES Depression over tank (YIN) NO High water alarm (YIN) YES Date of pumping5/19/2008 Pumper JRs PUMPING C. ABSORPTION FIELD DATA BELOW EXISTING C.6 ?E 6/6-9/92 Date installed 8/5/83 Soil rating (g.p.d./Wor felbdrm) 145 System type TRENCH Length 38/55 ft. Width3/2 ft. Gravel below pipe 10/4 ft. 760/ Total depth *17.6 /10.1 ft. Eff. absorption area 440 ft= Monitoring tube YES j Depression over field NO Date of adequacy test "9/26/2006 Results (Pass/Fail)PASS For 3 bedrooms Fluid depth in absorption field before test"_4 In. Water added 450 gal. New depth 21 in. Elapsed Time: 120 min. Final fluid depth 19 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date TESTED 1983 TRENCH ***NOTE: ON (4/22/2008) LIQUID LEVEL IN THE 1992 TRENCH WAS 1 FOOT BELOW THE INVERT AND IN THE 1983 TRENCH LIQUID WAS 1 FOOT BELOW THE INVERT i D. LIFT STATION Date installed 6/5/1992 Size in gallons 500 Manhole/Access (Y/N) YES "Pump on" level at 28 in. "Pump off" level at 18 in. High water alarm level at 31 in. Datum BOTTOM OF TANK Cycles tested 3 Meets alarm & circuit requirements? YES E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot '92'/•• 100.36' On adjacent lots 100'+ Public sewer main N/A Sewer /septic service line 25'+ Public sewer manhole/cleanout N/A Holding tank _ N/A Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line "•10'+/*"•*1' Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS ,WAIVER GRANTED TO 1983 TRENCH (WR 890005). DISTANCE FROM THE EDGE OF 1992 TRENCH CLEANOUT TO EDGE OF WELL HEAD. ***PER 1983 INSPECTION REPORT. 04+•WR920025 (1992 TRENCH). G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and per* 4 I 9* review of Municipal records that the above systems are in �......"" .. ....... •••••.••• conformance with MOA COSA guidelines in effect on this date. f A. G nese: Engineer's Printed Name JEFFREY A. GARNESS �Q �. C 3 6M, Date S/2olo8 �4p e� ' •S.?a�o�da v oresso.• o �4000p0o COSA Fee $ / 2> U. uy Waiver Fee $ Date of Payment ZU ) V Date of Payment Receipt Number Receipt Number (Rev. 11/05) Municipality of Anchorage e ,; • Development Services Department Building Safety Division „ On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 Nater Well Advisory Health Authority Approval # 080153 During a recent Health Authority Approval on-site inspection and test of the potable water supply well on Block D, Lot 15 of Glacier View Heights subdivision, the well's productivity was determined to be .70 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 -bedroom residence is 0.31 minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Health Authority Approval. Municipality of Anchorage • Development Services Department ° j Building Safety Division .. .,. On -Site Water 8 Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 \ill CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 0-50 x.02 COSA# 0,61 1. GENERAL INFORMATION Expiration Date: 3 — Z 1— 0 % Complete legal description Location (site address) Current Property owners) Mailing address Lending agency Mailing address Real Estate Agent Mailing address GLACIER VIEW HEIGHTS SUBDIVISION; LOT 15, BLOCK D 23105 MYRTLE DRIVE • EAGLE RIVER. AK 99577 DANA do STACEY PRATT Day phone 622-9599 23105 MYRTLE DRIVE • EAGLE RIVER, AK 99577 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well N Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site 0 Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered In the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 1 further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) In compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. 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, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines 8 Regulations. The reported results described the performance of the system under the conditions encountered of 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 the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE .__L Approved for `3 bedrooms. Disapproved. Phone 337-6179 Date 1.2 Lo /of, ®Wws — Conditional approval for bedrooms, with the filowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Reort Other 1.............. CE -795 1.Z'ZcDb ON-SITE WATER AND WASTEWATER PROGRAM By:/��y// rl/ i✓, �1 Original Certificate Date: (Rm. 1115)r//J Municipality of Anchorage Development Services Department Building Safety Division OnSke Water & Wastawater Program 4700 Sragew Street P.O. Scor 190850 Anchorage, AK 995196850 www.muni.orglonsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: GLACIER VIEW HEIGHTS SUBDIVISION; IAT 15, BLACK D Parcel ID: A. WELL DATA Well type PRIYAn If A. B, or C provide PWSID# N A Data completed 8/4/1983 Sanitary seal (Y/N) YES Total depth 200 ft. Cased to 130 ft. FROM WELL LOG Date of test 8/4/1983 Static water level 60 ft. Well production 6.0 g.p.m. WATER SAMPLE RESULTS: Well Log (YM) YES Wires property protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION 9/26/2006 72 ft. 0.83 g.p.m. Coliform 0 colonies/100 mi. Nltmte d mgJL. Other bacteria 0 colonies/100 ml. Arsenic: r. v ugA. Data of sample: 9/26/2006 Conected by: GEG. Ltd. B. SEPTICIHOLDING TANK DATA Tank Type(Materlel STEEL/S.T.E.P. Data installed 8/10/83 & 6/9/92 1000 Tank sizel 500 gal. Number of Compartments 2 Cleanouts (VIN) YES Foundation cleanout (Y/N) YES Depression over tank (YIN) NO High water alarm (YM) YES Date of pumping x0/5/2006 Pumper JRs PUMPING C. ABSORPTION FIELD DATA 8 OW EXISTING 2 Date installed s e� 83 Sob rating (g.p.d./ft'0r ftlbdrm) 011 .6 System We TRENCH Length 38/55 ft. Width 3/2 R. Gravel below pipe 10/4 ft. Total depth 017.6/10.1 ft. Eft. absorption area446 76O ft' Monitoring tuba YES Depression over field NO Date of adequacy test 009/26/2006 Results (Pass/Fab) PASS For 3 bedrooms Fluid depth in absorption field before test 4 In. Water added 450 gal. New depth 211 in. Elapsed Time: 120 min, Final fluid depth 19 in. Absorption rate >= 450+ g,p,d, Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date — •• TESTED 1983 TRENCH D. LIFT STATION Date installed 6/5/1992 Size in gallons 500 Manhole/Access (Y/N) YES "Pump on" level at 28 in. "Pump ofr level at 18 in. High water alarm level at 31 in. Datum BOTTOM OF TANK Cycles tested 3 Meets alarm 8 circuit requirements? YES E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAift station on lot 100'+ Absorption field on lot '92'/"100.36' Public sewer main N/A Sewer /septic service line 25'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/deanout N/A Holding tank Animal containment areas 50'+ Manurelanimal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 1000+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 'ee10'+/et•et' Building foundation 100+ Water main N/A 1' Water service line 10'+ Surface water 100'+ Driveway, parkinglvehide storage+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS *WAIVER GRANTED TO 1983 TRENCH (WR 890005). DISTANCE FROM THE EDGE OF 1992 TRENCH CLEANOUT TO EDGE OF WELL HEAD. •••PER 1983 INSPECTION REPORT. 0•e8WR920025 (1992 TRENCH). G. ENGINEER'S I certify that I have determined through field inspectlons 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 17 rhy/66 COSA Fee S `/3C� . C O Waiver Fee $ Date of Payment Receipt Number. (Rev. 11M5) Date of Payment Receipt Number Municipality of Anchorage ,.• _•. Development Services Department Building Safety Division $ On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Water Well Advisory Health Authority Approval # 060599 During a recent Health Authority Approval on-site inspection and test of the potable water supply well on Block D, Lot 15 of Glacier subdivision, the well's productivity was determined to be 0.83 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 -bedroom residence is 0.31 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Health Authority Approval. Sep 22 06 12:30p THE STEPHENS TEAM P. WV 19072737205 p.2 M -W Drifting. iac. resrPLw fts Iwr Conducted Sheet of Date: 04 -Alm, 24QIo- M-W Job No W D* 0461 Well Location: J4�' Arit Mgr4if . 15' L .#Vt ,d bie, c, U'd of Ar" lin/. LE. pap&fu l' Well InformDePthey{p' Dation: Tatai ' 1 Screen: From—TTT� Depth of Casl^9'1�._ Casing Sizer Screen Diameter.-:_- Screen Slot: Aemarks: Pump Information: Intake dept : — Pump Size:. -Z --Water LeveJ AAeos.: Static water level:Ii.V Arg. discFw Ve: — GPM, max, drawdown: Misc. Pump Info.: Pump On: DGte! At&!6 Time 1 :00 Mtr. Reading: Pump Off: Date:0k-jD1—v*Tirme:l3.8D Mtr. Reading: _-� R WE • .. r �_�- Sep 22 06 12:31p THE STEPHENS TEAM PJM 19072737205 p.3 L "Cr �Z N W � wj� u k N Q Y Q O an I e ww l\ I 8 19072737205 p.3 r�r an I I GrAllc.Bull e r�r Municipality of Anchorage T • 'i-'' Development Services Department ► = • t`• Building Safety Division " On -Site Water & Wastewater Program 4700 South Bragaw St. W� P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING r Parcell.D. 050-501-02 HAA# W15L �-5 1. GENERAL INFORMATION Expiration Date: :;%42 r10 t Complete legal description GLACIER VIEW HEIGHTS SUBDIVISION; LOT 15, BLOCK D, Location (site address or directions) 23105 MYRTAL DRIVE • EAGLE RIVER, AK 99577 Current Property owner(s) HARRY & HILDEGARD SPEAKMAN Day phone 622-5840 Mailing address 23105 MYRTAL DRIVE • EAGLE RIVER, AK 99577 _ Lending agency Day phone Mailing address Real Estate Agent ROLF MILTON w/ PARTNERS REAL ESTATE Day phone 694-4994 Mailing address 11940 BUSSINESS BLVD. • EAGLE RIVER, AK 99577 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well B Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site 0 Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water 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. Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $ at, or prior to closing for the engineering services provided. 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 riles 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 ALASKA WATER & WASTEWATER CONSULTANTS, INC. Phone 337-6179 Address 6901 DEBARR ROAD, SUITE 2B • ANCHORAGE, AK 99504 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, AKWWC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines 8 Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of 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. AKW WC, Inc. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Date 3 ✓ Approved for 3 bedrooms.(,;r(;:((rFrr rrir 1,1tZY OFq�,',�i� Disapproved. ���r�: rte• ' ' 'C,f Conditional approval for bedrooms, with the fllowing stipns: ON-SITE ' WATER AND : m PROGRAM it„/1/1(111'' Attachments: HAA Checklist Manitenance Agreements Septic System Advisory Supplemental Engineer's Reort Well Flow Advisory Other By: r �^ Original Certificate Date: 1z 1/01 1 (Rm. I Municipality of Anchorage • Development Services Department Budding Safety Division On -Ste Water 8 Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-66W www.ci.anahorsge.skus (907)343 -79tH HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: GLACIER VIEW HEIGHTS S/D: LOT 15, BLOCK D. Parcel ID: 050-501-02 A. WELL DATA wen type PRIVATE it A, B, or C provide PWSID# N/A Date completed 8/2-4/1983 Sanitary seal (YIN) YES Total depth 200 ft. Cased to 130 ft. FROM WELL LOG Date of test 8/2-4/1983 Static water level 60 R. Well production 8 g.p.m. WATER SAMPLE RESULTS: Coliform 0_ colonies/100 ml. Nitrate _.QmgJL. Well Log (YIN) YES Wires property protected (YIN) YES Casing height (above ground) 12+ in. AT INSPECTION 4/1/2003 59 ft. 1.2 g.p.m. Other bacteria _0_oolonies/100 ml. Arsenic: N/A mg./L. Date of sample: 4/2/2003 Collected by: AKWWC. INC. B. SEPTIC/HOLDING TANK DATA Tank Type/Material STEEL/S.T.E.P. Date installed 8/10/83 & 6/9/92 1000, Tank size 50o gal. Number of Compartments E Cleanouts (YIN) YES Foundation deanout (YIN) YES Depression over tank (YM) NO High water alarm (YIN) YES Date of pumping 4/1/2003 Pumper JR'S PUMPING C. ABSORPTION FIUNR ELDDA— A /9 0. Date installed �� Son rating (g.p.dJR'or ftlbdrm)` System type TRENCH Length 38/55 R. Width 780j 3/2 R. Gravel below pipe 10/4 R. Total depth •17.e 10. ft. Eft. absorption area 440 R= Monitoring tuba YES Depression over field NO Date of adequacy test "4/312003 Resutts (Pass/Fan) ***PASS For 3 bedrooms Fluid depth in absorption field before test _221 In. Water added 768 gal. New depth 38 in. Elapsed Time: 969 min. Final fluid depth 21 In. Absorption rate >= 450+ g.p,d. Any rejuvenation treatment (past 12 mo.) (YM & type) NONE KNOWN If yes, give date — **TESTED 1983 TRENCH. PRE—SOAK PERFORMED ON 4/2/2003. ***1992 TRENCH SURCHARGED. D. LIFT STATION Data installed "Pump on" level at _in. E. SEPARATION DISTANCES Size In gallons High water alarm level at Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankllift station on lot 100'+ Absorption field on lot $927"100.36' Public sewer main N/A On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/deanout N/A Sewer /septic service line 25'+ Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wens on adjacent lots too'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parkingivehide storage 0' Curtain drain NONE KNOWN Wells on adjacent lots 1000+ F. COMMENTS *WAVER GRANTED TO 1983 TRENCH (WR890005). **DISTANCE FROM EDGE OF,41992 TRENCH CLEANOUT TO EDGE OF WELL HEAD. ***PER 1983 INSPECTION REPORT. 'N+WR920025/11992 TRENCH G. ENGINEER'S CERTIFICATION 1 cerW that I have determined through field inspections and.; .-" ! ri review of Municipal records that the above systems are in " conformance with MOA HAA guidelines in effect on this date. . ................ e as., Engineer's Print N% JEFFREY A. GARNESS a E-79` Dategra/ j 'IP. .... b► �orsssWo HAA Fee $ 3175- — Waiver Fee $ _ Date of Payment 3 Date of Payment Receipt Number. Receipt Number, (Rev. 1?101) 04/07/2003 10:09 FAX 6944993 PARTA•ERS REAL ES Q02 •e: •J � r I SCK' ` —i,/�. �\a 1• •. 0--f! WC Rc: v =.... .. �. �%i ••• fit). eC.v �, ti YV Gt•r•-6 .. ASBWLT I hereby artily ilue 1 haee naveycd the fo&mkq'desr&a Popery. Lel- [fes 1/f.CW .%lr-f i17fT iL/�,N. a urc ,�• pet•. I,n,m aitualed tLe�ed� am wihin propert ovoUp each a the ptopag a y �ill3 W do m[ aotlratoem Ad DO an Ord tt thee!+! ptmraes 8ogrgnutels�t�eim atd m o0 loedwsls. e6+dk steed M.oe visile encenee on said peppery' Dated et Emee Rma. Alaska this '7 n �y u(_AA r r � ag SCALE: Mal - pwad S SON I raw f9�mf 69f�30�' Municipality of Anchorage Development Services Department Building Safety Division . On -Site Water and Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK.,'99519-6650 www.ci.anchorage.akus (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 050-501-02 9.' GENERAL INFORMATION HAA # F/A DltQ 2 4 Expiration Date: 8- .2 9 - O Complete legal description Lot 15 Block D, Glacier View Heights Location (site address or directions) 23105 Nyrtle Drive Current Propertyowner(s) John Emmi Dayphone 694-0371 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 23105 Myrtle Drive, Chugiak. AK 99576 Day phone Day phone Unless otherwise requested, HAA will be held by DSD for pickup. _'WG _ 1fzr-X' S Ac !0/ 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 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 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 neer water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER 'As certified by my seal affixed hereto and as of the validation date shown below, I verify that my Investigation, based on procedures outlined In the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(aie) 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. C [{ % q Name of Firm Robert C. Cowan, P E. Phone' Address Engineer's Printed Name ENGINEERING 1 Eagle River Loop K04 . 9957/ Date' 5. DSD SIGNATURE 1/ Approved for 3 bedrooms. Disapproved. p ROBERT C. COWAN /f`i3� .� CE • E 301 ++tl�i<p • ��,� Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: a , ( In Original Certificate Date: (Rev. 12LC( N Municipality of Anchorage •' '�'} Development Services Department Building Safety Division s On -Site Water & Wastewater Program • �' 4700 South Bmgaw St. P.O. Box 196650 Anchorage, AK 9951M650 www.dAnchorage.ak,us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L/67; FS `ipt i✓C,a 645 Parcel ID: DSD - Sal A. WELL DATA Weil type IiAA' If A, B, or C provide PW SID # Date oompteted19 Sanitary seal �J) Total depth A@ft. Cased to ±40fft. Well Log (Y/N) Wires property protected (YM) Casing height (above ground) __Z tgtin. FROM WELL LOG AT INSPECTION Date of test Static water level 4O ft. Well production co g.p.m. / Z g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 ml. Nitrate o• 5 mg -fl. Other bacteria D colonies/100 mi. Date of sample: O / Collected by: B. SEPTICIHOLDING TANK DATA Tank Type/Material G Date installed J61101,03ta�9 'i i Tank size /QAi gal. Number of Compartments _.3 M Cleanouts (Y/N) YGrd Foundatio�00 eanout (Y/N) t 1l Depression over tank (Y/N) �J High water alarm (Y/N) ��,d��� t .Date of pumping � Pumper L % � S C. ABSORPTION FIELD DATA __.D-,ta Inq!alie / v.`Sod rating (g.p.dJft2 orf 2/bdrm)66 Svstwm type �LENG h Length 3 ft. Width 3 ft. Gravel below pipe ft. Total depth lo ft. Eff. absorption areaavue Monitoring tube 45 Depression over field MO Date of adequacy test S 110 0 / Results (Pass/Fad) P* c For bedrooms Fluid depth in absorption field before test in. Water added gal. New depth 'n. / r Elapsed Time: !(Q min. Final fluid dep 4 in. Absorption rate >= 450 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) /V ONE I&IWW If yes, give date '—' D. LIFT STATION Data Installed G S QZ "Pump on" level at .8 in. Datum E. SEPARATION DISTANCES Size in gallons "Pump oft level at ZE in. Cycles tested Z SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankfilff station on lot Absorption field on lot /00 f -F Public sewer main N 1h S%W-fseptic service line -PS r4" Manhole/Access (Y/N) High water alarm level at _ 3 f-_ in. Meets alarm b circuit requirements? C 5 On adjacent lots 1/00 1'F' On adjacent lots i eVp r 06 - Public sewer manholaldesnout N�h Holding tank A( /4 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: / Building foundation f Property line 5 /f f ,3 (4L51Absorptk)n Heid S ry" i Water main N A Water service line r, Surface water /OD r Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Building foundation �� f Water main N r f Water Service line 0 f Surface water 00 1` Driveway, parkinyvehide storage Curtain drain MIME A/M(W Wells on adjacent lots OD 1, F. COMMENTS * H!Q t1 G. ENGINEER'S CERTIFICATION I certify that I have determined through Reid inspectlons and review of Municipal records that the above systems are in conformance with MOA HAAvgurdelines in effect on this date. Engineer's Printed Name /c d Q't =%/ C. Co w A. -J Date HAA Fee $ 3 a 0 Date of Payment 1/26 1 A / Receipt Number O 0 V 6 3 (Rev. 12100) Waiver Fee $ Date of Payment Receipt Number At \A,\ pc�@F�OWAN C .0601 ...;,,nom MUNICIPALITY ANCHORAGE - - • '� .DEPARTMENT OF HEALTH 8 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. # C SO S`c I -0 2 1. GENERAL INFORMATION HAA# 4l(�glnr,ISS'R Complete legal description Lot 15; Stock D; Gtaciek View Heights Location (site address or directions) 23105 Mytttc Dntve Eaqte RiveA, AK Property owner Chattes b Stacy St><Lcktand Day phone 696-1340' Mailing address 23105 Hyxtte DaLvo Eagtp Rivp2. AK 99977 Lending agency ..Mailing address. Agent Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water 3 XXX Day phone Day phone fly C 04l 11'1yOF EPMq`SERVI� pl�sON R 04 1986 E�El QED NOTE: If community well system, provide written confirmation from State ADEC attest - Ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XXX Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-0ri1R".1/91) Front MOAR21 5. - STATEMENT OF INSPECTION BY ENGINEER. As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system Is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and Inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations In effect on the date of this inspection. Name of Firm S & S ENGINEERING Phone G 4 y' 2-9 -7 "f 17034 Eagie River Loop Road No. 204 Address Eagle River Ales a 995 Engineer's signature Date 7 6. DHHS SIGNATURE By: %C Approved for -_ bedrooms. Disapproved. Conditional approval for Additional Comments bedrooms, with the following stipulations: i 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. rI'M Vh- W1 eo UOA. 'PAUTY OF ANrHO4A(�.. YAEWAt StgviU-S Dryig ,., Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICE6"p 04 1996 Environmental Services Division r r t 825 L Street, Room 502 • Anchorage, Alaska 99501 • (90 C&, , E Health Authority Approval Checklist Legal Description: S Parcel 1. D.: 06- © 5 0 1 02 A. WELL DATA t4 Lz i4vs. Well type FP -kJ &T -C, If A, B, or C, attach ADEC letter. ADEC water system number A Log pmsent&l) Date completed 4b -4 — S-5 Total depth 'Lo®I Cased to 1$ . f 3,2 7 N Casing height (above ground) 12- k( Sanitary seal &) q Wires property protectedON) J FROM WELL LOG Date of test `3 - LA -9 3 Static water level Well production g.p.m. WATER SAMPLE RESULTS: Coliform O Nitrate j / O AT INSPECTION °b L`1 —9 L. 1.3 g.p.m. Other bacteria Date of sample: g .20 -9 V Collected by: .S/S &14g= S. &EMrCIHOLDING TANK DATA 0 Date installed 'd-10Tank size Imo Number of Compartments Z Cleanouts ON)_ Foundation cleanout O1) N( Depression (1;W_ ! High water alarm (YM) 0 A Date of Pumping Pumper .ZZ. 4zMt'_"j C. ABSORPTION FIELD DATA Date installed (n - 9--'7Z Soil rating (g.p.dAI* or ft'/bdrm) 0• to System type 7 "e f-/ Length •39 r Width 4 r Gravel thickness below pipe D r Total depth 7-2 \r Effective absorption area 7fb Monitoring 7iibe present(VN)__Y_ Depression over field (Yt� zf Date of adequacy test Results ssRFal9 &ng For 3 bedrooms Fluid depth in absorption field before test (In.); G2'` Immediately after(.(2 gal. water added (in.): Fluid depth g� r (ins) Minutes later: /Q� Absorption rate = 7SD;d• g•R Peradde treatment (past 12 months) (TLY jr yes, give date 72-028 (Rev. 3/98)• D. UFT STATION Date Installed L-11 -I -Cl Z Size In gallons 15-00 Manhole/Access&04) V "Pump on" level at' of 00� "Pump oft" level at' �� N High water alarm level at* Cycles tested E. SEPARATION DISTANCES 'Datum a FF t%Irti'n SEPARATION DISTANCES FROM WELL ON LOT TO: Se olding tank on lot 1 b"1 On adjacent lots 1 do L Absorption field on lot tom t On adjacent lots U t 4 - Public Public sewer main .1(or Public sewer manhole/cleanout t -4 - Sewer /septic service line IS Litt station 1 0=.% 4 SEPARATION DISTANCES FROM&M!rVHOLDINGTANK ON LOTTO: Foundation l p t Property line t o Absorption field Water main1service line __J'� Surface water/drainage Wells on adjacent lots 14=0 t+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line j t (nmLo Building foundation tS I Water main/service line lc7 Surface water to C> k 1- Driveway, parkingNshicle storage area I o k Curtain drain t 104- 0-r34 ,tel r: Wells on adjacent lots too %+ F. ENGINEER'S CERTIFICATION 1 cerW Mat 1 have determined thru 116M Inspections and review of Municipal in conformance with MQAt�del�tiect on this date. Signature Engineers Name t� b Q i AL;- C Date 9 /3/d? HAA FeeW $C� '�/ Date of Payment / 7Z 9r. Receipt Number 72.026 (Rev. 3/98)• Waiver Fee $ Date of Payment Receipt Number AMM C, COWAN CE -8801 are MUNICIPALANCHORAGE • :' DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D.# 11�-_1421 -C)Q HAA# �An�l��aR 1. GENERAL INFORMATION Complete legal description Lot 15: Bloch D: Gtaciea View Heights Location (site address or directions) N.H.N. MyUte Drive Property owner C. V.ictoka Day phone 283-1017 Mailing address P. 0. Sox 1410 Kenai, A£aaha 99611 Lending agency Mailing add Day phone Agent-Tnnn inrbe_1XIM if 7TF aFAI FCTATF Day phone x9- 13135 OCd Gtenn Highway 0100 Address —€ag8e 91ver-4&6ka 995571 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 y 3. TYPE OF WATER SUPPLY: Individual well XK Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XX Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025(Aa 1/91( Front MOA121 5. 6. 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 e IS ENG `-__RING Phone 77034 Eagle River Loop Road No. 204 Address —Etg;e Rivet, Alaska 99j/1 Engineer's signature DHHS SIGNATURE Approved for 3 bedrooms. Disapproved. Conditional approval for Additional Comments Date 0-2-1-611— bedrooms, with the following stipulations: By: —)OR tJ 's"m f TI -F Date 5,11. C?Z 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 thei r lendi ng 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(11«-1191) 8+ k MOA.21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L.,=:,,r IS -&L-Y, i7 Parcel I.D. A. WELL DATA Well type ,Sal ^ ,. L - If A. B, or C, attach ADEC letter. ADEC water system number Log presentON) U Datecompleted 0-4'-63 Driller Total depth; % Casedto 13017. Casing height- 12�� Sanitary sealdl?N) / Wires properly protected�Y N) Date of test Static water level FROM WELL LOG it E3 lOo AT INSPECTIP#UNICIPAL11 OF ANCHORAGE IRONMENTAL SERVICES DIVISION SZ ^ 1 1992 Well flow (.0 g.p.m. t I VE D Pump level U�. 1(02 'F tiow TFT 'f�—Ra'r�M�D 8y a✓.�-.E.S. SEPARATION DISTANCES FROM WELL TO: %I-"%, f%iWLwS t%AoAr. Septic/holding tank on lot f o7 ; On adjacent lots Absorption field on lot t 1 ; On adjacent lots 1 A_ Public sewer main a A, Public sewer manhole/cleanout <' r 1� Sewer service line ZS Petroleum tank -A C" er, WATER SAMPLE RESULTS: Coliform Nitrate t,1M Other bacteria Date of sample: Collected by: S 5[ sz B. SEPTIC/HOLDING TANK DATA Date Installed B-10' e2 Tank size tom Compartments 2 Cleanouts4VN) T_ Foundation cleanouk�?JN) `/ Depression Y -�J High water alarm (Y/N) Alarm tested (Y/N) Date of pumping. — 13 — 9 2 Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: 1. Well(s) on lot J 17 - On adjacent lots Foundation 101 1 Topropertyline " 1':� Absorptionfield S Watermain/serviceline 111 a Surface water/drainage - I <nr,� t { 72-026 (Rev. 7/91) Front .. CONTINUED ON BACK PAGE C. LIFT STATION Date Installed "") 2 Manufacturer Size in gallons Manhole/AccessXPN) T M y VentQV'N) "Pump on" level at 121e> "Pump off' level at 1 . . 11 High water alarm level Cycles tested Meets MOA electrical codeso7N) —!� SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot `� 4 On adjacent lots (� Surface water fit+ D. ABSORPTION FIELD DATA •Date installed Soil rating �•�/tt System type 1 3t r Length 38 Width Gravel thicknes s (cai Total depth 22 Total absorption area —7 to O Cleanouts presentd77.N) Depression over field (YM5 N Date of adequacy test Results�laii) for bedrooms Peroxide treatment (past 12 months) (Yea,>. tJ If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: .t 1t Well on lot Oo On adjacent lots 3 '� Property line To building foundation S To existing or abandoned system on lot Onadjacentlots 301 k Cutbank t4 A Water main/service line �cI Surface water tk Driveway, parking/vehicle storage area (dt Curtain drain �o�� Y=:�� E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this Inspection. .� 01 AL 1%% S ti S ENGINEERING i�.Q�•••'�•,,,•ti��n� a, Signature 17034 Eagle River Loop Road No. 204 g age rver, as a / *?QGin 3 Engineer's Name •• «•«• .•..• ••. G� O Date g— 21� `Z ��;•R04 • J-76AFER : W�+ `OF 'Ns HAA Fee $ %7 Waiver Fee: $ Date of Payment 'z/- L Date of Payment Receipt Number P57131 (-5S Ur Receipt Number 72.ON(Aw. 1191)Bwk MOA 21 MUNICIPALITY ANCHORAGE O DEPARTMENT OF HEALTH t£ HUMAN SERVICES M 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.# JOL�:�l'n� HAA# 1AIDg2011^3 1. GENERAL INFORMATION Complete legal description 2. Lot 15; Bt.och D; G4ac.ien View Heights Location (site address or directions) N.H.N. Mytae Dtive Property owner Ch)tistophen Vi toaa Day phone 283-1020 Mailing address Ht s4 Sr,Y i546 Eag�v—BsvP)t. AfaAhn 99577 Lending agency Day phone Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 3 V 3. TYPE OF WATER SUPPLY: Individual well XX Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest - Ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XX Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC . attesting to the legality and status of system. 72-025 (Ft".1/91) Front MOA h1 5. STATEMENT OF INSPECTION BY ENGINEER 6. As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this Inspection. Name of Firm Phone Address 17034 Eagle River Loop Road No. 204 Ecnle River. Alaska 99577 Date—t3-`i2 Engineers signature DHHS SIGNATURE + //� I' / Approved for bedrooms. JCC GOnww?ePn7`I 4 h4WWsd/ Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: 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 engineers work. non (R«. w1) SKk MOA#21 Health Authority Approval Lot 15 Block D Glacier View Heights Subdivision HA920163 March 25, 1992 Following an extended period of vacancy, the on-site wastewater disposal (septic) system marginally satisfied the minimum adequacy requirement or handling 950 gallons of wastewater per day. Even after the extended period of vacancy and non-use, the subsurface disposal field continues to have over 50% of the absorption area standing full of water. At best, this absorption system is in the final stages of failure and has a limited remaining effective life expectancy. Additionally, the subsurface disposal field is installed or a severe (approximately 50`s) slope which could result in the septage effluent day lighting at any time during the remaining life of the system. y Municipality of Anchorage AUL Department of Health & Human Services low HEALTH AUTHORITY APPROVAL CHECKLIST GODS Legal Description: Parcel I.D. bat-�,eq_, q%&V] A. WELL DATA Well type'`) If A, B, or C, attach ADEC letter. ADEC water system number Log present ON) �� Date completed 8-x-63 Driller-SJL- ►-1 Totaldepth � Casedto X30) :70 Casing height Wt t4- Sanitary seal ON) Wires properly protected( /N) Date of test i Static water level Well flow Pump level FROM WELL LOG 6-��f33 (oo g.p.m. SEPARATION DISTANCES FROM WELL TO: AT INSPECTION Zo 147 g.p.A lLog C Septic/hohiing tank on lot k On adjacent lots 14 - Absorption field on lot On adjacent lots ( ct�:> 1 4� / Z -I-el Public sewer main n/��F, Public sewer manhole/cleanout Sewer service line S' Petroleum tank 4DAI6 KribWd WATER SAMPLE RESULTS: Coliform 0 Nitrate .0 tom. t /�_ Other bacteria Date of sample:kk-2'I -9 t-2�1t Collected by: B. SEPTIC/HOLDING TANK DATA Dateinstalled-to"t33 Tanksize tC%-,o Compartments 2 Cleanouts (AN) Foundation cleanoutV?N) Depression (Ydlp t -I High water alarm (Y/N) Date of pumping Alarm tested (Y/N) _ Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot 1 5)� A' On adjacent lots l I ( Foundation (o) To property line tol.Ir Absorption field ::I� Water main/service line to'� Surface water/drainage 1C)r,>t•1' (3 i 72-026 (Rev. 7191) From CONTINUED ON BACK PAGE C. LIFT STATION DataIn ed Size in gallons Vent(Y/N) High water alarm level Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access(Y/N) at "Pump off" level at (Cycles tested SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA On adjacent lots Surface water Date installed Soil rating System type��•�� Length 45S Width 2 Gravel thickness ¢ Total depth 9 -17 VN -16:5 Total absorption area 440 Cleanouts present(IIYN) y Depression over field (Y/g Date of adequacy test 7-. 7 A 2 Results ((�N/fail) '{���`� for'� Fad bedrooms Peroxide treatment (Past t2 months) (Y �otit �-► 0101.1 If yes, give date SEPARATION DISTANCE FROM A13SORPTION FIELD TO: Well on lot 2 On adjacent lots �I �' Property line I btk 2-1- 511 ) To building foundation 20 '} To existing or abandoned system on lot �oN/t; On adjacent lots �� t Cutbankt�Water main/service line Surface water I 'Iri �= Driveway, parking/vehicle storage area Curtain drain E. ENGINEER'S CERTIFICATION 1 certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. S & S ENGINEERING "rQ�0 .••"••••.;1s'a� Signature 17054 Eagle River Loop Road No. 2(14 or Gj� . ~•. �Z+e� Eagle River, Alaska 99577 SC3�►�3�; Engineers Name /' NJN.M . NwiN•, r, Date �� �3 X92 j1 F �� •F •••EF, d. CHAFErI': C . No. 8215 r1. n HAA Fee $ Date of Payment /, Receipt Number Sa' MOO `T 72-026(A". 3/91) Suk MOA 21 Waiver Fee: $ Date of Payment Receipt Number p�3 I TA c Q l9 ,_or 14 W LCt /5 , SloCk Glacier Anchorage Recordir T.V. o� SLATE �f WELL CAS/NCaS cM�1 770,V ' 9AB/OW N RMIMAIG WALLS CTYR1 OffCK 141i .S%ANn #-1115-S57RUCTUREr, ni P/A:eS YRT05 40 t CE OR. 1 weal ewlar the, IMee ewoom the►roprtr ohard and Meorl►e1 her0en, M1 tdel M I►grM ere, 01114140 Owl" we o11Me the Mee• ctrl NM/1Me eo ee1 M•rle e1' ederoeM ed oelae.M erelerfr O,a t1e1 eI tmprewreeM14 M M1eoI M40wry evwlw M edereeM M fM ►reellee td evee,lM era Ides theM I Ne neawre, eHHry IMw, e1' Mhw det►4 eeunldls M MII Pro Y m"I w W1016e sweet. SCale /'� Date Ret. SVv 59 F. B. No. c eeIIMM14 of mor/ ettw thM thee. ehe+d M the Net of fNw1 we pot eeeVN Mreud "lose �EGENeMen14eo hwN. 40 0 Bross of Aluminum capped monumor o Iron pipe OW01' 11041' recovered. 17 2112 hub & tock recovered • • 5/9"jt3 dttbar 11t this survey OT 16 r �t d� 4 Y Ataww�,V'7t� r Prepored by. It. L. BUTTON R001,tr1nC Lmd SLrriyor (907J279.6200 b/9 W. £iyhlhArl. AnOwW A/mko99501 Property ot:/ChrisfOP% r Vl%C740/S 11 DEC -27-91 FRI 10:29 FORTUIJE PROPERTIES DEC -23-'91 13:13 ID:Pfa�MAL PF1AC 1713-T9-2 "1 Wk Buten, P.E. Rgl tcrcd Civil Ens;accr D=Mber 11, 1991 HoukNuTfs !~31101111 Arced 421 West Union Avenue Bound 8fook, NY 08805 itc. Glacier Ylow Heights, Lot 15, Block D NHN Myrtle Dr. MGI 9393 Dew Ms. Arcud: P.02 tt2W P02 1 - , i.. r• -i. At your request we have perrormod a acpde adequacy tat, well now telt end p0tabl1lty testins for the above rafueneed home. The well was found 10 produce at a sulttlnbd rase of 4.3 OPM over t e hour tett pt:riod as required by FHA guideIInes and meets Municipal Hulth criteris with 111,11fsetory water quality ana'ysis for coliform and nitrates. The well wire sheathing docs not meet code requirements And e -- will require rglhRSns tI an esdmaccd cost of 3100, Tho well is loattd 92' from the existing lachfield under a wavier of 100' separetinn disuce and if upgraded this wavl:r would bcco'nc invalid and would require respplicilion and rapproval by HeAllh AuthudI10• The optic system was sulljectod to an adequacy lestlng for acceptance ntc es required to coact 1`funlclpal Guidelines for Health Approval Cettificatlon, The Uachfield was delermtrod to e:cep: 430 gallons per day, howevef, the field did back up e(ltef approxirrately 90 gallons wa1 added and was found to be in a flooded of full state at the beginning of *e test. As per Municipal guidelines a lcuhAtld operad`g in a iW Health Aon Is c end n+aa tQ be limit to g teral Improperly and therefore would 1 Wj&A 5sAL. pp y financins. There is also a camera wlth the avallablltry of area for a rcplsccr..cnt icachf�etd due to extreme slope and driveway location in relation to potentia! replacemenr Ern. If Icachficld replacement is possiblo it would be very expensive. The deter4nallon of tltc flooded conditlun was made through surface inspection tubes. A better detg.rhinstion c0-s1d be srsde by excxvAtion into !tie field if so desired. 'Che cost of th;x excavation is estirrvtd at 5700.00. If you rave any quc3tion3 place call our office at 694.5195. slncenly, Loult Auters, P.E. ... Y.. tnr..� . 1'.+. Y..... �..... IYi �: . 6LJw.r Jin!, JELL.{w{ • rw 94C,1,0.1.1tq] 1-0 2x PRUDENTIAL RILOC 12-23-91 02!0A!4 P002 4'25 DEC—=7-91 FRI 10:`,.59 FORTUNE PROPERTIES P. OS . - DEC -23-191 13113 12-10-1921 10:50 TEST DATE' LEGAL. 1D1PFOOO�NTIFL F9 -CC a :713-7M-2300M*� 1120e P03 806 489 8560 - .... • . -;CjS6 rA T5M- S • ,.+ � "r r a op " IV EAGLE RIVER ENOINEER= SERVICES V.O. BOX 773294 BAOt F RIVER, AN 99577 wELL & SEPTIC ADEQUACY TEST REPORT Dewrabar 12.16, 1991 Oluicr View l;elghts, Lot 13, Block D LOCATION; N1IN I•tyras Drive RESIDENCE: Single Family, 3 1lsdrOoms PUMP YIELD: 4.5 01MODs per Minute WATER SYSTEM: private Wrll SEPTIC SYSTEM: From Munlclpal R000rds Tank: 1,000 011104 Absorption System: Trench Type INSTALLATION DATE; 1903 INSTALLED ABSORPTION AREA: 440 Square Peet ORIGINAL SOIL RATING: 145 (FtOm Odglaat Sotl Loa) TEST PROCEDURE SF.EI'IC: The luthGeld was initially charged with water from rho on -slit at a neo of UGpbt. The saptle unk and leachfield liquid levels were monitored referencinS r. mtswremcnt below the top of the standpipe. During the test, Water was added through the 10 clan cut tube Rnd the leach field water level Was monitored as water was added and then absorbed Into the altrro,tltdlvg soil. ons of water showing that the water level In the septic k leochfield was ra Icceptl nat fl u flow rate.% The Septic addNOn Uk Ie el c ctlnued to rise 3.50 aflor 3V gallons of *stat was added, A total rise in liquid ltvel in the IachGcld was recorded The A else in tacbneld level of 14.5". Mwow rate was tbgn u e;nentS were taken of the lover 49 hours to ar hfiold letllonl vel sifter 24 hour% with a serum to edema sttrdng�liquidYevel. The mordtorood catc-5 the however becsuse4the i *111 atUpt the requlred 130 91110" tda of tflluent, per R092% PRUDENTIAL RELOC 12-23-91 09:13AM POC3 025 DEC -27-91 FRI 10:.59 FORTUNE • DM -23-'91 1314 IDIPRt"*14ilAL PF1AC PROPERTIES P.04 a 1713-789-23c� i120B PO4 .. .. �.��..rtw a da .• ske 463 6550-• • • •may •��= 1WSTtR3 system was inl6eIly, to a Hooded condition It will not meet Municipal approval. WFT L: 'It,c well was pumped at aets�dy flow rate of 0 ()PM' There µ•ms no ehinje in the fate of pressun afteJ 45 mints. The ykld or flow nes of the well wu monttered and ra fThe well win will require lashcathlr¢ with conduit atculrted at a maximum rasa of 11 GPM' Connecilons to meet Code requirements. The well operate, under a waiver of stalca:ion distance whIeh expitea upon any apgnde. TEST RIMULTS The well ylcld or flew rate meets the Tequiremcnts of the Municipality of Anchors je (MOA) foc It 3 Wrtoom single latnily rafdcnce ss of the day the system was tested' The well (low rate eAterit Meets the FHA 4 hour well nw n4ulremtnts. furher inveedjadon and possible tcplacemerthe pdC system v 1_ l craw meet MOA Mtessment of existinj subsuffeca condidoot by the inspccdng engineer is linlitcd to infurlr•stion obtained from *..e available monitoring tuba and Municipal second X=h• We do rot guarantee the vallERy or quality of subsutfs: a IOU ssd IrspeCtions perfotmed by the ordinal insrPe"S enginoer or authority. T1111:100!1- Is Lm,itod to absorption tale testing sand surfnCc itpRrenan musaraments a our �'Y1oAw'� by P Y Murd� water Quality othuOf 'the t the bee cltia: teal n verify Integrity of the plping content. The operadonsl life and the natter of Complianco with State and hsunlelpsl codes, for all watcr and septk systems de`Q�nds on the local 3011 Wditions, Wondwatu levels that may Pat be wobitrvM fm, the ho s)' umroard theudetslt of tequlrCdtw<rsdnjeprnOced=. Septic aystcros cxphs wb cral with use ed future cnvironment2l eoneems may require more extensive WIN, which could rendor the leachfaeid unusaable. Ibis is true of all septie systems. Thtre is no gut" "t the well and septic system tested will mat the requirements our apptoval in the future. The best date a'td inves:;gation of existing e0nditiohs is p• anent for submil� em�f wMl'�+ 1�Isakry HWtpoo Dould be ciartmenes teased wifor thtlf t hlthe testa enginee'. approval. Any If it Is requested we w1il submit the report dlroCpy to the Mlmtctpetity' R-929 PRUDIt1TIAL F?' -CC 12-23-91 C9:13AD1 PC04 1:25 FED -23-92 TUE 14:43 McCI_ZNTOCK L -S -ER ENGINEER P. 01 Eagle River Engineering Services 11940 Business Blvd, Suite #205 P.O. Box 773294 694-5195 Eagle River, A. 99577 Fax 694-3297 Legal: Owner: .tet. Date: Time Meter Reading Well Level GPM ��►t..;i .,.e/ we_ d -moi ..�rr re,.,,o..G e.r i-e.c.{...: F/�..� r..ta c�!<✓ qir�� //i..%*>� S.i,'�e NY+ L[CL/MGIC ootr 73,30 • /i..r1 pf p i.✓ /:,w.? 3• ! o 74.r. /i..i Y1 � Yew GGA w f fn %4 i✓�i /�•� c -f/ N e Go • e i' ir..+. F. e 4/ Time Meter Well GPM Reading ILevell I REMARKS: �Y- p., a fa wC// ��►t..;i .,.e/ we_ d -moi ..�rr re,.,,o..G e.r i-e.c.{...: F/�..� r..ta c�!<✓ qir�� //i..%*>� S.i,'�e NY+ L[CL/MGIC ootr 73,30 • /i..r1 pf p i.✓ pv-^ A Z ./— rs o✓Cr /i..i Y1 � Yew GGA w f fn %4 i✓�i /�•� c -f/ N e Go • e i' ir..+. F. e 4/ Post -It" brand fax transmittal memo 7671 uwr eee� woiuum ® _ OZ l . . ill of—deyr aoueje/ey ea,y „ej6n4p/ieeJy e16e3 69 MS N�v3nvro r` , T /,,n /"PY 0460 A�� y ce/r %f - 7 5"YZ - LIL o�g o ' L -IV / r// 1/117 Stl ✓ fyf�G',`v/,/�7�/ate � `d717/i yM 6v/ MAR -13-92 FRI 10:36 MaCLINTOCK L£—ER ENGINF_ER P.02 Eagle River Engineering Services //;t- 11940 Business Blvd, Suite #205 P.O. Box 773294 694-5195 Eagle River, A. 99577 Fax 694-3297 Legal: L.r Jt iSisr 0 IYIT Owner: �,r'af Date: -j /, Type of test: Well Flow Test 0 Septic Test Only 0 Well & Septic Test 0 Other: Time Meter Reading Monitor Level Well Level Tank Level GPM PSI Remarks q Re, r.. rr te,r Y.n .Y..✓ /: r(./ • I: Ali 5 `gip _— 1:53 ?65"3 0 /oo' ?•t frd+lr / F/.. rsk y: ?70 ? .777/0 ' Sre Yom, r- t: fs l/L' 7:0s / e 2 7.2 /v /i1 +. r we/: �...r zio .t wo / r 3f/1' 777rb F'J �•J' /.:s r. F•... r. 7'7W0 7tlse So Z.70 /'r /. MAR-1Z—S'2 FR I 10:37 McCL I 1JTOCK L.S—ER Ef/G 11IEER P. O? Eagle River Engineering Services zlb- 11940 Business Blvd, Suite x(205 594_5195 P.O. Box 773294 Eagle River, Ak. 99577 Fax 694-3297 Legal: /wt W O G/tie v/r / N/>• Owner: 111f r pate' 3 /1 Z - Time I Meter 11-evell Well GPM Reading /: JfJr✓ 7� 0.7 /1:r5 2f3tS Sr S'� :/♦ ?4 yao /1� N,o .1 :Y7:r• 1 Jo 3;i01r) h Y l' 74 .T F rev / fe 3. N .Z P •a <v / L • .O Fhr♦�K i/r e�.HrJ 2:/7 GPM /fr2 Reading level 3;sv: 14 / .1 :Y7:r• 1 Jo 3;i01r) h Y 3:uH .7$6/r /7H �. 11 .Z P •a /Lp /1p oN U:ob �ri 760 /Go .+c•/ "1p 7:so: r9 y:ob: YJ /To Meter Well GPM lime Reading level 3;sv: 14 / If �53 18670 /1p oN U:ob �ri 760 /Go .+c•/ "1p y:ob: YJ /Sy Y; 13; /t -O 1�v �r't'i 2F V1 S & S ENGINEERING I'-22 17034 Eagle River Loop Road 14o.204 Eagle River, Alaska 99577 1%=-7 J "ID *•'-� U !! 2-6-92 z 1 bi44"7 Q 10 MT' ►� 06 off-, Diss �1- C17- Tt 11 =�v M��z I D�hY>S 33 `� ►►� MT I 2�3 S 8 S ENGINEERING 17034 Eagle River Loop Road No. 204 Eagle River, Alaska 99577 Z-1c>-el2 L4 i I �t�l..l Cb�-� or� '� TL � 14R� Ei ►� Ip.2�a MESS -n.= o 2-12 4 r�bll PPP�� _ ''o cotes 4 � PD 2 -k4 -92 -'.2o P �� 1 L a 1_� c> I 1 10 M ,'T s S 8 S ENGINEERING 3 /� 17034 Eagle River Loop Road No. 204 Eagle River, Alaska 99577 i) M���I1I207 11 4 -- '11i � l5 l.�o SSP-E+e✓._ f<��b��—t� ffAh� 1�JI-r��-�,' 'amu-�-�,-I ►�T� �rL-�z,��. I`✓ v 6V //RNs �14Y7 .87- la;ro RY /07.SA5' TO 3 to;2o. 1013/0. A97. l �s �ii ti.5 " 4FI IDS 10 ff .: 4 zl. at' 2'•%'� nLf 'C `ILt(i?p II I D I I SOI 35j �lG�.��J - Q6 .3'. ;Lo ' I1 1 �0� ; 14 6 �l bo sl' 3g1 �7°•�'I�� loz ASL- .�• I .c�-jl �,': s�,r�..-: �,�� 3g3y '�a�/�,�J 0-1 pP"^:Ovfhv Ovt�/�� 'o 5qp ell 0/ : '7*; %•�. f T. -e' cr'yf�G.s.uk�S ./✓tGht f.e (� : /.' ' �� 1 l4a72: U). k 50 ��/vC—( �o 53 I �� ,- w l4G .r�rrdc-1 Get r�n." ot & pic"N G GSvA V\.UG\PPS\ `\RpNME MUNICIPALITY OF ANCHORAGE Department of Health & Human Services a iDDIVISION OF ENVIRONMENTAL SERVICES (� C 343-4744 ?'CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # 0 Sn -5'0 / C y HAA # A� g9 t^ 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) P Lot 15 Block Q Glacier View Heights Location (address or directions) (b) Property owner AHI' Telephone: (home) 'Business Mailing Address sen . A4rh, Anrhnragp, AK (c) Lending Institution Mailing Address Telephone (d) Real Estate Company and Agent rack Mite ro -_Kath, Olmstead Address e •- - = Telephone _69,4 �6,X (e) Mail the HAA to the following address: (or check her` if hold for pick up.) List contact person and day phone number below: S & S ENGINEERING —t7034-Esg k-RLver-Loop4ioad-N*AQ 4 Eagle River, Alaska 99577, 2. TYPE OF RESIDENCE Single -Family IR Number of bedrooms g 3. WATER SUPPLY Individual Well q Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site G} Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the Iegailty and status. 72-0251R". 7/88) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and Inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. / ' `- NameofFirm Telephone S & 5 ENGINEERING Addre Date 6. DHHS APPROVAL Approved for 3 bedrooms by `' Date n l s Approved 9, 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 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 orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Ray. 7:88) Back Page 2 of 2 G [� G O o�P MUNICIPALITY OF ANCHORAGE (MOA) \tt 5 • Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 4 343-4744 Legal Description: S A. WELL DATA Well Classification If A, B, C. D.E.C. Approved (Y/N) Well Log PresentI'N) Date Completed 8— �'� Yield Total Depthl-_422�Cased to L22� Depth of Grouting Static Water Level _ gy� Pump Set At Casing Height Above Grourid t2 u+ Sanitary Seal on CasingONq Electrical Wiring in Conduitdl%) Depression Around Wellhead SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot 11!2� -- ; On Adjoining Lotsi— To Nearest Edge of Absorption Field Lot �� ZI ✓ ; On Adjoining Lots To Nearest Public Sewer Line �°r� To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected by j tx6Ld 0`-Y; Date — "—g9 Water Sample jest Results B. SEPTIC/HOLDING TANK DATA Date Installed 'B0- ' Size `rn-2<2 No. of Compartments ?� Standpipes CON) _Air -tight Caps4n7N) FoundationCleanouta7N) - Depression over Tank (Y/® tJ ate Last Pumped q --ZS- ) ✓ Pumping/Maintenance Contact on File (Y/Nx for Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water -Supply Well ` �� I'I' To Building Foundation 1 of ... ; To Property Line r�A To Disposal Field 1 I To Water Main/Service Line To Stream, Pond, Lake or Major Drainage Course l o�X 72-M (11".71W) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Stratayrc�; , �Type of System Design '�1( Date Installed Iv' g'� Length of Field 1 Width of Field Z Depth of Field 4� Gravel Bed Thickness Square Feet of Absortion Area �- f v Statndpipes Presentg5%) Depression over Field (Y/Q ���� Date of Last Adequacy Test Results of Last Adequacy Test �r^►�� i°-�'`� 'w=5 -Fx-2_- SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Wellg2 To Building Foundatiop �f Lot I" To Property Line . kc::, ; On Adjoining Lots To Existing or Abandoned System on tJo To Water Main/Service Line Ic> l-( To Cutback (if present) To Stream, Pond, Lake, or Major Drainage Course To Driveway, P Comments ly D. LIFT STATION D to Installed Size lions "Pump On" Lei Area, or Vehicle Storage Area High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments J N � u _ f=tLEr--1 •4�-aY� Dimensions _ Manhole/Access (Y/N) "Pump Off' Level at Vent(Y/N) Cycles during Adequacy Test. "Check Permitted Bedroom Rating Against HAA Request" I certify that I have checked, verified, or conformed to all MOA and HAA guidelines inspection. Signed Company 17034 Eagle River Loop Road No. 204 Eag a r, •Ka 99377 Date p ff9 MOA No. f a Ob–z Receipt Noo:2 lhh L D L (e Date of Payment �Z_,)/' o e—a / ., [/ c3 Amount: $ Receipt No. Waiver Fee: $ _ Date of Payment n -02e (Ra.7/U) Back Page 2 of 2 s.n A. Shwhr No. 1457E dafW6II->his Ely, �l a I a` ,9 � L �a4z. y �L .0 Q Time APPLICy" NT FILLS OUT UPPER HAL,',ONLY Props..; Owner / 2 y G c `7 I �✓F F. y/S?:F 2, `/r / 'N, %✓�/ G 3— q Mailing Add ess 7R 7o it b4 Sf! PL . zip code 99 Bu')! Date — %/-- ZIP Code Address TInspwtor Inspector InspectorInspector Phone Lending Institution �JtASKn SIA TE QAN� .` z7 *2-56W,/ Address iG0+fl- A r H ZIP Codei Field Notes: k C� O . Realty Co. d Agent --�- r Phone_ 1 /v/ _. : ZIP Code ! / Address .•r Legal Descriptbnr' I LK• �. Mr.)) -A r'IfR✓If Gal 1416H74'11.. /-/_ ,, ' ( ) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL Street Location 7 t i ! ( ) CO���^N111DITIONALQAPPROVAL' I t5 Type of Residence (Single Family Q ❑ Multiple Family _. No. of Bedroom Well To Absorption Area ❑ Other Well Log Received L___� Septic Tank Size I no CD' e— I C;) —83 Water Supply VIndlvidual J�For CH WELL LOG. A well log Is required for all watts drilled since June 1975. ellsdrilled prior to that date, give well depth (attach log if available). 0 Community "> i ❑ Public Utility Sewer Isposat Year Individual Installed: Individual ❑ Public Utility When Connected to Public Utility: ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. a I a` ,9 � L �a4z. y �L .0 Q Time Time ry Time Cl b \I tAnDate Date Dare TInspwtor Inspector InspectorInspector Field Notes: k C� O . 1 )o / V C) .•r ( ) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CO���^N111DITIONALQAPPROVAL' I t5 DATE —p,' BY: �lCAA Solis Rating Date Sewer Installed Well To Absorption Area Well Log Received L___� Septic Tank Size I no CD' e— I C;) —83 Well to Tank 91 xxan rven
