HomeMy WebLinkAboutMOUNTAIN MANOR BLK 2 LT 2Mountain
Manor
Block 2
Lot 2
#050-671-19
Municipality of Anchorage
Development Services Departmenttu
(\" Building Safety Division +E
On -Site Water 8 Wastewater Program, 4700 Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 3
Onsite Wastewater Disposal System and/or Well Inspection Report
Permit Number. SW070170 PID Number. 050-671-19
Name: MIKE ENSCH
Wastewater System: ❑ New ■ Upgrade
Address:
18746 ROAD ENDS CIRCLE is EAGLE RIVER, AK
ABSORPTION FIELD
Phone: No. of Bedrooms:
(907) 229-7384 4
ClDesp Trench ClShallow Trench O Bad ClMound O
LEGAL DESCRIPTION
See Rakq.
Twa Down rrpm arpiro ad.:
it
GPD/Sq. R
Block: Lot: Subdivision:
D.pth to pipe bw e«a w4inal orad.:
Gravel a«walh pip.:
2 2 MOUNTAIN MANOR
FL
FL
Township: Range: Section: —
C'a k' 4ay.
_ _
R
R
Gravel .fan:
Name« awe:
Detawe wt. we:
WELL: ❑ New ❑ Upgrade
R
R
cbwlicolwn Prlwl., A&C . T.W D+ptn: cowl To:Tela)
e6 twn Dna:
type awl«faF.
PRIVATE t r+ n
so. rL
M1aINr.
GEG Ltd.
Da. kwlaMd:
7/27/2007
paver, \C'`1`-i�7 stave ww« Lin*::
Eic 7
R
YI.10:
Pump Set AL
GaeY,p NwgM Apse GrOwb:
TANK
R
R
SEPARATION
DISTANCES
■Septic 0Holding 0S.T.E.P, bother
To
Septic
Absorption
Lift
Holding
MK/PrMa.
Y0r"d°Nu«`
GREER
capacly eerw:
N ee
1250
From
Tank
Field
Station
Tank
s..« Lk,..
Well
100'+
—
—
—
25'+
Nat« . STEEL
Nwna of cemp« 14;
2
Surface Water
100'+
-
-
-
-
LIFT STATION
Su. M psepne:
WMowwer.
Lot Line
5'+
—
—
—
—
an l.vel w: wnp oll iwel eL
a « abrin aL
Foundation
5'+
—
—
—
—
Pu wkoe !
4 al Inspectlom p.A«mW br:
Curtain Drain
NONE KNOWN
BENCH MARK
Remarks: OLD SEPTIC TANK WAS FILLED WITH
I.acaaan end D.rvlpaan:
DRAINROCK.
BOTTOM OF TRIM ON NORTHWEST CORNER
OF HOUSE.-•
� ed EWmban: 100.00 n
Inspections performed by: GEG, Ltd. Dates: 1st 7/27/2007
ENGINEER's SEAL
_00 pp
Op
2nd —Lgs*,
3rd
�0
QQQ
Development Services Department Approval'?
4
Conditional approval: Date:
•"••
QQ '•,
f r y A. arness: Q
P
E/-79 3 e0
Reviewed and approved by: Date: t�
�0 "r'�oraastahaoo
44000�p00
(Rn. 4/06)
J A
PERMIT NUMBER: PARCEL 10 NUMBER:
SW070170 AS -BUILT DRAWING 050-671-19
EXISTING TRENCHES /
(APPROX. LOCATION
\ .: yF"OC/CO
R�
NEW 1230 GALLON C A
SEPTIC TANKS
EXISTING M
4 oo
N�
A B
23.3
23.7
I
13.8
29.01
--•„^---�•--• •••-•--»� CONSULTANTS d GENERAL CO>��•>i—�
NTRACTOR3
13.8
30.12
......• ••••••
12.7
30.8
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GARNLSS ENGINEERING
GROUP, Ltd.
9
I
--•„^---�•--• •••-•--»� CONSULTANTS d GENERAL CO>��•>i—�
NTRACTOR3
�......••• •• • •
......• ••••••
3701 L IUCM IIOM. }A[ 101 • ANOORKL Alf N00) . F101( (IJ>)3]I-1171 • FM (W?JU 0)N • Ym91L• —..p�wgY�wYgmn
a.••
PREPARED FOR: PHONE NUMBER:
PACE NUMBER:
•••• • • ••••••
Je A.
......•
MIKE ENSCH 229-7384
2 OFA
OQO 753
ess:'
LEGAL DESCRIPTION:
MOUNTAIN MANOR, LOT 2, BLOCK 2
DRWN BY:
B.F.M.
a
404040p�OOOoo
TYPE OF WORK:
DATE:
AS—BUILT FOR NEW SEPTIC TANK
7/30/2007
I".. Ulm)
PERMIT NUMBER: ASDRAWING PARCEL ID NUMBER:
SW070170 050-671-19
TOP OF TANK
AT INLET = 94.80
INVERT OF BUNG
AT INLET = 94.35
INSULATION
FINAL GRADE - 99.10
STt ST2
/— TOP OF TANK
n__i n-, / AT OUTLET = 94.80
NEW 1250 GALLON
SEPTIC TANK INVERT OF BUNG
AT OUTLET = 94.01
GARNESS ENGINEERING GROUP, Ltd. p;? `•y
•--•-a«.----�-„>. -::, CONSULTANTS d GENERAL CONTRACTORS-----�•-•-�.— O
JMt C nnw ena, WIC 101 • ANOIDR L M N901 • h1o1L (907)W?- In • FM (M�lY-]]w . Y�IL wA.p. rYiyaan
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: .••• • ......• ......•••••
MIKE ENSCH 229-7384 3 OF 3 f arness.
LEGAL DESCRIPTION: DRAWN BY: oOo vv CE -7953 �0 1
MOUNTAIN MANOR, LOT 2, BLOCK 2 B.F.M. OO e e'7�3p�4.'/ A�'
TYPE OF WORK: DATE: 4':U�l Profes 00is
0O��.�o
AS—BUILT FOR NEW SEPTIC TANK 7/30/2007
(R”. 01100)
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Silo Water 8 Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519.6650
(907) 343-7904
ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Jul 20, 2007
Expiration Date: Jul 19, 2008
Permit Number: SW070170 Parcel ID: 050-671-19
Legal Description: MOUNTAIN MANOR BLK 2 LT 2
Design Engineer: 0855 GARNESS ENGINEERING GROUF Site Address: 018746 ROADS END CIR
Owner Name: MIKE ENSCH Lot Size: 45318 SO. FT.
Owner Address: 18746 ROADS END CIR Total Bedrooms: 4 Permit Bedrooms: 4
EAGLE RIVER. AK 99577-7920
This permit is for the construction of:
❑ Disposal Field ❑,/ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction must be In accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ).
3, The engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By.
Issued By.
Date: ZO
Date: % O
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Bragaw St.
P.O. Box 196650
Anchorage, AK 99519.6650
www.ci.anchorage.ek.us
(907)343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. nS0-(nq 1- (q
Property owner(s) — MIKE ENSGH Day phone 229-7384
Mailing address 18746 ROADS END CIRCLE * EAGLE RIV R
Site address
Zip Code 99577
Legal description (Sub'd, Block & Lot) MOUNTAIN MANOR S/D: BLOCK 2. LOT 9
Legal description (Township, Section & Range)
Lot Size 95SI% Sq. Ft.
THIS APPLICATION IS FOR ( ®all that apply):
Absorption Field
❑
Septic Tank
Holding Tank
❑
Privy
❑
Private Well
❑
Water Storage
❑
Number of Bedrooms
THIS APPLICATION IS AN:
Initial
❑
Upgrade
Renewal
❑
certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal codes.
GARNESS ENGINEERING GROUP, Ltd.
Permit/Rush Fees: y6C7. r7b
Date of Payment: % / %/4 /�7/ Q
Receipt Number: 6 5 {7
(Rev. 11/05)
Waiver Fees:
Date of Payment:
Receipt Number:
GARNESS ENGINEERING GROUP, Ltd.
V- CONSULTANTS & GENERAL CONTRACTORS
July 16, 2007
Municipality of Anchorage
Development Service Department
Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragraw Street
P.O. Box 196650
Anchorage, Alaska 99519-6650
(907)343-7904
Ref: Septic Tank Upgrade for Mountain Manor Subdivision; Lot 2, Block 2
To whom it may concern:
The owner of the referenced property is proposing to add an addition onto the deck. The existing
deck is currently over the X 1250 gallon sunset fiberglass septic tank. Due to the proposed
location of new sonotubes for the deck addition, the owner would like to upgrade the septic tank
and move the location. Attached is a site plan and design drawing showing the proposing tank
location. There are no surface waters within 100 feet of the proposed upgrade. There are no slope
concerns in regards to the new septic tank.
I am unaware of any adverse impacts this installation would have on adjacent wells or septic
systems. If you have any questions, please contact us at 337-6179. Thank you for your
assistance.
P.E., M.S.
NOTE: Attached is a site plan drawing, a design drawing, and a S page construction
specification letter which are all part of the design package for this septic system.
3701 E. Tudor Road, Suite 101 *Anchorage, AK 99507-1259
Ph: (907) 337-6179' Fax: (907) 338-3246 0 Website: www.gamesscngincering.com
LOT 11. BLOCK 2;
MOUNTAIN
MANOR S/D
NO ENCROACHMENT CONCERNS
q0
1 EXISTING SEPTIC SYSTE
CSE AR EAC �\
"� ORZDSED TANK UPGRADE `•,�
LOT 3. BLOCK 2; —
MOUNTAIN MANOR S/D
CSEP
AREA \,
LOT 12, BL IC 2; \
MOUNTAIN MR S/D
I \1I
x / /
/ 1
CSE,PTIC
ARLAD \
XISnNG 4 BEDROOM HOUSE `
\ C�\F
\`\S
1. BBLOCKMANO;
E: ` e
MOLOT
UNTAIN
1' 1D0' \
LOT 1. BLOCK 4;
\
\
\ MOUNTAIN MANOR S/D \
\\ NO ENCROACHMENT CONCERNS
\
\ LOT 2. BLOCK 4;
\ MOUNTAIN MANOR S/D
_
\\ NO ENCROACHMENT CONCERNS
LOT 3. BLOCK 4;
\ \
MOUNTAIN MANOR S/D
\
NO ENCROACHMENT CONCERNS
-------------
------------
---------------------
-----------
�• •-9s;U00
GARNESS ENGINEERING GROUP,
Ltd.
CONSULTANTS d GENERAL CONTRACTORS .......
O
sA1 C TANt RO.D. AAC 101 • MCMDWC Y! MSO) . h1b[ f10)i551-IIA IY (401)00!-3)N RBSIR:
PREPARED FOR: PHONE NUMBER:
mow. mn 0
PAGE NUMBER: .••
MIKE ENSCH 229-7384
. •••• •. ••.....
1 OF 2 OO ' y A. arness.:
p
LEGAL DESCRIPTION:
MOUNTAIN MANOR S/D; LOT 2. BLOCK 2
DRAWN BY: OO D• C 7 S3 eQ
J.L.M. ��ne, �!7�0.3' �AoO
TYPE OF WORK:
DATE: 4�ec1pro/esslo"pl
�D�Ooo��oa
SITE PLAN FOR SEPTIC TANK UPGRADE
7/16/2007
\ I
EXISTING TRENCHES
(APPROX. LOCATION}— \
INSTALL DO CLEANO • `�, CO`-
PROPOSED 1250 GALLON
E%ISTINO M
A BEg
HOU`'
DECK
EXISTING SEPTIC TANK TO
BE COMPLETELY ABANDONED
ULU. Ltd. HAS A 5 PAGE SPECIFICATION
LETTER THAT PERTAINS TO THIS DESIGN.
TO OBTAIN A COPY OF THE LETTER
CONTACT GEC. BY PROCEEDING FORWARD
WITH THIS INSTALLATION, THE ENGINEER,
WELL DRILLER. CONTRACTOR AND
PROPERTY OWNER AGREE THAT THEY
HAVE READ THESE SPECIFICATIONS AND
AGREE TO ACCEPT THE TERMS AND
CONDITIONS OUTLINED.
DECK ADDITION
FN /
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS& GENERAL CONTRACTORS .......
l"l L TOOK ROAD. Art[ 10, • MOOAMO. M N!0) • AKK (207)337�IT • IM (O7)M-"" • A91L wgsnnrynwwymn
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
MIKE ENSCH 229-7384 2 OF 2
LEGAL DESCRIPTION: DRAWN BY: oOo°P,
MOUNTAIN MANOR S/D; LOT 2, BLOCK 2 J.L.M. 04ra
TYPE OF WORK: DATE: 0`
DESIGN OF SEPTIC TANK UPGRADE 7/16/2007
....... .........
A. G ness:
Municipality of Anchorage Page
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: ,~WJ 4:'~¢-~· O'~''/~J PID Number:
N~: ' ' Wastewater System: ~ New ~Upgrade
C~,~ ~ c ~ ~ ~ s ~
~g¢~ ~s ~o ~'~7 m~ ABSORPTION FIELD
Phone: ~-~ No, of Bed~s: ~eepTrench ~ Shallow Trench ~Bed ~Mound ~Other
LEGAL DESCRIPTION Soil Rating: Total Depth from original grade:
~,~ GPD/Sq. Ft. Md~o I~.~
Lo~: ~ ~ Ad~,~M~ ~ 7~ 5 CZ ,t. ~ ' ~t.
Township:1 ~ ~ Range: ~ l ~ Section: ~ Fill added above original grade: Gravel length:
Ft. ~5-- Ft.
WELL: D New ~ Upgrade Gravelwidth: Number of lines: Distance between lines:
~ Ft. t ~ Ft.
Driller: Date Drilled: StaticWaterLevel:Ft. Installer: W~ ~5~ Daleinstalled:~//
~: Pum, Se~ ~: C.s,,g .~g~ A~o,. ~,o~,: TAN K
GPM Ft Ft. ~ S~
SEPARATION DISTANCES ~Sept~c ~ Holding U S.T.E.P,
Su~a~ LI~T STATION
Water) 00 ~
Line ~O~ IO
Foundation ~ ~ ~ ~ ~ "Pump on" level at: "Pump of~" level at: High water alarm at:
Remarks: BENOH
[ Assumed Elev?i~:o~ ~,
. ENGI~$~A~
Inspections performed by: Dates: 1st ~/{t/ff3
Department of Healed Hu~rvices appro~l/ '~;;;~.......;, ~' ~ *~ '/~
Reviewed and approved b ~¢- ~" Date: ~//Z~
72-013 (Rev, 9/91) MOA 25
Permit No. ~' V.J c~ ?_. () 5 '"/.~ Page ~ of ~
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: (...
PID No.:
.¸2
72-0i3 A (2/91) MOA 25
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW920373
DESIGN ENGINEER:DAVID R. DAYTON, P.E.
OWNER NAME:ENSCH CHARLES MICHAEL &
OWNER ADDRESS:18746 ROADS END CIR
EAGLE RIVER, AK 99577
DATE ISSUED:il/03/92
EXPIRATION DATE:il/03/93
PARCEL ID:05067119
LEGAL DESCRIPTION: MOUNTAIN MANOR BLK 2 LT 2
LOT SIZE: 45318 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT: 4
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS
15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL
REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AACS0).
3. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
ISSUED / /
D. R. DAYTON, P.E., R.L.S.
~;~~ Chugiak, Alaska 99567
20210 Donalar Street
(907)
October 24, 1992
Lot 2, Block 2, Mountain Manor Subdivision
Septic System Upgrade
Although the absorbtion system on the subject lot has not presented
any problems to the occupants and the septic tank appears to be in
good shape, the system failed an adequacy test for 4 bedrooms. Therefore
an upgrade is necessary to satisfy the financial institution for re-
financing.
The upgrade will consist of connecting to the existing solid pipe
below the tank, (leaving the original trench connected) running a
solid pipe beneath the driveway to a new absorbtion trench.
The lot is steep from the South side of the house to the South
lot line. From the house to the North lot line it slopes toward the road
at approximately 8%.
The new trench will not affect wells, other waste water systems,
reserved space or drainage on this or neighboring lots.
David R. Dayton P.E.
20210 Donalar St.
Chuglak, Alaska 99567
' I
David R. Dayton P.E.
2~21'0 Donalar St.
'Chutltiik, Alaska 99567
Municipality Gl Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L' Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PERFORMED FOR: ! t"' ~'
LEGAL DESCRiPTIoN:LoT' 7- ~h-~.,~J/'~ou.~l~,~j~-~oc_Township, Range, Section: ~ ~, -7--/¢/0,
SIT'~ PLAN
3
4
5
6
7
8
9
SLOPE
WAS GROUND WATER /'~l /O
ENCOUNTERED?
S
IF YES, AT WHAT ~
DEPTH? p
E
10
11
12
13
14
15
17
18
19
2O
Depth Io Waler Alter ~ /,
Monitoring? ~,P'O Date:
Reading Date Gross Net Depth to Net
,y,~,/2~.,//'~ Z'Time Time Water Drop
:5- /-~ : ~ ~ d. "
iz.'~/ /Q ? ,, ~"
PERCOLATION RATE "~"~ (mmutestmch) PERC HOLE DIAMETER
TEST RUN BETWEEN "~ FT AND ~' FT
COMMENTS
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES iN EFFECT ON THIS DATE.
72-008 (Rev. 4/85)
CERTIFY THAT THIS TEST WAS PERFORMED IN
DATE:
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PERFORMED FOR: ~-~ ~-~bJ~ DATE PERFORMED:
LEGAL DESCRIPTION:~;~'i- ~' ~' ~--,"~V~"-~I~,~--~j~'~''~'~c--'T°wnship' Range, Section: ~ (.~ ,'--yl~,,J,
SLOPE SITE PLAN
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
2O
WAS GROUND WATER
ENCOUNTERED?
S
L
IF YES, AT WHAT O
DEPTH? P
E
Deplh to Water After
Monitoring? Date:
Gross Net Depth to Net
Reading Date
/,~./~.~?/~:~ ~___ Time Time Water Drop
PERCOLATION RATE __
lm~nutes/inch) PERC HOLE DIAMETER __
TEST RUN BETWEEN __ FTAND __FT
COMMENTS
PERFORMED BY: I CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THiS DATE. DATE:
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
- ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAM IP"ONE [ NEW
LEGAL DESCRIPTION
NO. OF BEDROOMS
LOCATION R~
~ ~ Manufacturer
Material ~o.~ompartments
~ Inside length ~d~h~ ~ klquig depth
~iq. capacitg in ~aHons
~ ~ ~ Manufacturer ~ateria~ LiquiO capacitg in ~allons
o _
~ ~ Z No. of lines Length of each line Total length~f lines Trench width Distance between lines
~ ~ ~ Top o~ ~le ~o fi~sh grade ~ria$ beneath ~il~ To~al
O ~ ~ inches
hength Width Depth PERMIT NO.
~ ~ Type o[ crib Crib diameter Crib depth Total e~fect~ve absorptio~ area
~ Well Building foundation Nearest lot line
~ DISTANCE TO:
~ Class Depth Driller Distance to lot line PE~~
m Building foundation Sewer line Septic tank Absorption area(s)
~ DISTANCE TO:
OTHER
PIPE MATERIALS ~ ~3g
SOIL TEST RATING
-
APPROVED . DATE LEGAL
r_n
te
,,ertifird Drilling
by
A & L DRILLING COMPANY j°
BOX 97, EAGLE RIVER, ALASKA 99577 • TELEPHONE 6942588
OWNER OF LAND L -E ro?_M ,Q 5 DEPTH OF WELL :] 7 3"
I'll / r,A 1064 r.4Cc1 ,�,JE2
ADDRESS f' STATIC LEVEL OF WATER FT. ell 4
LEGAL DESCRIPTION t2 644 -1 J>"00 -✓724„0 /MOi1a-eDRAWDOWN FT.
DATE • Started hS17P - EndedID th 8 GALS. PER HR l �o
T
PERMIT NUMBER 7 o a a KIND OF CASING Czk On
KIND OF FORMATION:
From
Ft. to---21—Ft.
b JEQ 6u-',0E"J
From
Ft. to
Ft.
From
Ft. to_L�__Ft.
QIYI 6edisL d
llbOc 0,'CTrom
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From /2.
Ft. to—j!2--Ft.
%1e,<t7 004"1
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to�Ft.
^sem "�0 '�" 4.Q194iff- From
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<=Ft.
!
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to�Ft.
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From
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8
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S ��0 6 Pa„ -c
tr �,� rec.
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SIISCL.1NFORMATION:
r,j M 1'' 7-0 &C t'401<'60 -7;1 1=Qe.,. Ta 1 n F <.4SiN C,
DRILLER'SNAME r< '
r -y U r -a I o I F,�I T Y tD F Ft N C- H F"'1r 1 r E= -
DEPARTMENT
DEPARTMENT Lt._ _ALTH AND ENVIRONMENTAL F. ECTION
• 825 'L' STREET, ANCHORAGE, AY. 99501 Q S
264-4720
WELL F=ir-lC• nr-J—_•ITE SEt-JEF FEES:r-1 I/ 3U
PERMIT NO. ( 780222 )
j.cS 7-�
APPLICANT F'FPFFFg PO BOX 1064 694-967r
LOCATION MT MANOR SD
LEGAL L2 62 MT MANOR S/D LOT SIZE 43318 SQUARE FEET
TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH
MA;IMUM NUMBER OF BEDROOMS = 4 SOIL RATING (Sn FT/BR)= 195
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
E?EF'TH= 1Ey LECJGTH= oSF
THE LENGTH DIMENSION IS THE LE14GTH (IN FEET) OF THE TRENCH OR DRAINFIELD.
THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET).
THERE IS NO SET WIDTH FOP. TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
A14D THE BOTTOM OF THE EXCAVATION (IN FEET).
REG21_� I f=:ECa �E:F•T' I I'-Y-n"k_ lit=iLLLEtir•JS
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.
--- TI•JiD K_ � ? I t-4 PECT I "Fa'S F=1F:E FI:E1->!U I F<'ECs ---
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPAPTNENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN A 14ELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR A PRIVATE WELL; OR
150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS
OF THE 4JELL COMPLETION.
OTHER. REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
F='EF:r'1 I TE: :P I RES E}ECEr-1BEFt _ 1: :I- ED, f t:
I CERTIFY THAT
1: I AM FAr;ILIAR. WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE, MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
2: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
-RE'IDENCE IS REEM;ODELED TO INCLUDE MORE THAN 4 BEDROOMS.
SIGNED:'4-
---------------------------
APPLICANTePF'ERS
ISSUED BY2____ _ U -_ --- ----------DATE_�i_ V3. 2
0 Er E GEO'
Russell Oyster
694-2774
Soils ~' Foundations
Performed for: Name:
_,'HNICAL 8- DEVEL,
Box 90, Davis St., Eagle River, Alaska 99577
694-2774 or 688-2280
SOXL LOG
MENT CO.
Earl Ellis
688- ? ~_
Land Development
Tel. No. ~q ~- ¢~/,,'?/
Legal Description:
Depth (feet)
o
Sotl Cha~acterlstlc)
?
8
9 ,
zo
]_2
]-~,,
Ground Water Encountered: Yes
Proposed Installation: Seepage Pi~
Comments:
No
~ If yes, what depth
Drain Field
Performed by: . Date:
•
• Municipality of Anchorage _°`
=•
_ qo
On-Site Water&Wastewater Program 4 -8 �'
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 050-671-19 Expiration Date:
1. GENERAL INFORMATION
•
Complete legal description MOUNTAIN MANOR S/D; BLOCK 2, LOT 2
Location (site address) 18746 ROADS END CIRCLE, EAGLE RIVER,AK 99577
Current Property owner(s) JOE FREITAG Day phone 601-212-0882
Mailing address 18746 ROADS END CIRCLE, EAGLE RIVER,AK 99577
Real Estate Agent BROOKE STILTNER WITH REMAX OF E.R. Day phone 244-6742
2. TYPE OF DWELLING:
III Single Family (w/wo ADU)
n Duplex
Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well I Individual On-site U
Individual Water Storage ❑ Individual Holding tank ❑
Community Class Well ❑ Community On-site ❑
Public Water System ❑ Public Sewer
WaiverNariance request for N/A Distance: -
Received by:(/ op Date: aitk
COSA to be released to the engin:'r unless otherwise requested by the engineer.
COSA Fee $ 524 Waiver Fee $
Date of Payment 5/I'1i1 Date of Payment
Receipt Number Q Receipt Number
COSA# 5OCiSrg tO 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 GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179
Address 3701 E. TUDOR ROAD, SUITE 101 *ANCHORAGE,AK,99507 1
Engineers Printed Name JEFFREY A. GARNESS, P.E. Date 7 i�Ii'( (
r 1
Engineer's Comments:
In conducting this evaluation,GEG provided an engineering evaluation of the well and/or septic system in accordance with the .look\\\ii,Iii
guidelines and regulations established by the Municipality of Anchorage and industry practices.The reported resulls describe the ,i OF ,44p7,! **
condition of the system/s on the date/s of the evaluation.Separation distances were measured to readily identifiable features. .I.1��•, •• ••.•1f� *,
Hidden defects or encroachments may exist that were not identified during the evaluation.The operational life of all wells and septic \r , J• .
systems depend on a variety of variables including,but not limited to,soil conditions,groundwater levels(that may fluctuate during11/4C-7.--
'
the year),quality of construction(materials and workmanship),and the water usage of the family utilizing the system/s.These v I i N * •,
conditions can vary,and are outside the control of GEG.Satisfactory test results do not guarantee future performance of the ....'1• . ..4.. :_—f
system's:therefore,GEG makes no warranty(express or implied)regarding the future performance of the well or septic system. •
ii
GEG makes no representation whether an alternative well or septic system can be installed on the properly in the event either of the 0 •;,;, ' ,1 i_ \ . ,,.:.,:vi
current systems fail.The content of this report is for the sole benefit of the person/party who retained GEG.Reliance upon the f'- f i+
Jeff ey.AarAess ii,./.
information provided in this report by any other person or party,including but not limited to subsequent property purchasers,is not ♦ 0 I / • 4v i
•
authorized.In short,GEG disavows any legal duty to anyone other than the person/party who paid for this report. �� '•• CE 7953 '' �
6. DSD SIGNATURE � •
.♦.1'�O•p �'I"�'�P�-��.
i LICENSE 1,�1\\\S\���• ••
K �7 #AECC884
System #1 Approved for ( bedrooms.
System #2 Approved for bedrooms.
Disapproved. 'N'..6 U.- tilvtc,,
Conditional approval for bedrooms, with the following stip atlonns:-S\�E G)
\f\1RO-ER A Dt.R
•v WFs"E" a
`� Pip c
J •
1' tlIT c,n0"t��
r
By: ��-1 l Original Certificate Date: ( `CO I
The Municipality or Anchorage Develop,emt Services Division (DSD)issues Certificates of On-Site Systems Approval(COSA)based only
upon the represenatations 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. ATTCHMENTS: ' r-'.,
COSA Checklist Nitrate Advisory �...� yi�.=. ,
C
1 .
Septic System Advisory i`
Arsenic Advisory,..,:zit,-,-.,.
Well Flow Advisory Other . ' ` `
(Rev.10112/12)
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: MOUNTAIN MANOR S/D; BLOCK 2, LOT 2 Parcel ID: 050-671-19
A. WELL DATA
Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES
Date completed 4/28/1978 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES
Total depth 77.25 ft. Cased to UNK. ft. Casing height (above ground) 12+ in.
FROM WELL LOG AT INSPECTION
Date of test 4/28/78 4/25/2018
Static water level 64 ft. 68 ft.
Well production 10 g.p.m. 4.3 g.p.m.
WATER SAMPLE RESULTS:
Coliform NEG. colonies/100 ml. Nitrate 5.02 mg./L. Collected by: GEG, Ltd.
Arsenic: <5 ug./L. Date of sample: 4/24/2018
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC/STEEL Date installed 7/27/2007
Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) YES
Foundation cleanout(Y/N) YES Depression over tank(Y/N) NO High water alarm (Y/N) N/A
Date of pumping 5/14/2018 Pumper JR'S PUMPING
C. ABSORPTION FIELD DATA 'BELOW EXISTING GRADE
1) 7/11/1978 1) 195 1) DEEP TRENCH
Date installed 2) 5/11-12/1993 Soil rating (S p.d./ 3'or /bdrm 2) 1.2 System type 2) DEEP TRENCH
1) 66 1 -2. 1) 6
Length 2) 45 ft. Width 2-3 ft. Gravel below pipe 2) 6 ft.
*1) 8.17 1) 792
Total depth *2) 9.6+ ft. Eff. absorption areal) 540 ft2 Monitoring tube YES Depression over field NO
Date of adequacy test 5/8/2018 Results (Pass/Fail) PASS For 4 bedrooms
Fluid depth in absorption field before test-35.5 in. Water added 503 gal. New depth "56 in.
Elapsed Time: 815 min. Final fluid depth-39.5 in. Absorption rate >_ "600+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N &type) NO-SEE QUESTIONNAIRE If yes, give date -
"NOTE:THE 1993 TRENCH IS COMPLETELY FULL TO THE BOTTOM OF THE INVERT.A NEW 2"MONITORING TUBE WAS INSTALLED IN THE
1973 TRENCH AND GEG TESTED THIS DRAINFIELD ONLY.PRIOR TO TEST,THIS MONITORING TUBE WAS DRY.719 GALLONS WAS ADDED TO
CLEANOUT NEXT TO THE MONITORING TUBE WHICH CAUSED A LIQUID RISE OF 39.5".THE DRAINFIELD WAS THAN ALLOWED TO RECOVER
FOR 195 MINUTES AND FOUND LIQUID LEVEL HAD DROPPED TO 35.5".AN ADDITIONAL 503 GALLONS WAS THAN ADDED TO CLEANOUT AND
THE LIQUID LEVEL IN THE MONITORING TUBE WAS BROUGHT TO APPROXIMATELY 1/2"BELOW THE INVERT OF THE DISTRIBUTION LINE.
BASED UPON THIS ADEQUACY TEST,THE DRAINFIELD WILL ABSORB 600+ GPD WHICH MEETS THE 4 BEDROOM REQUIREMENTS.AT NO
POINT WAS WATER OBSERVED BACKING UP INTO THE 1993 DRAINFIELD DURING THE ADEQUACY TEST.
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N)
"Pump on" level at in. "Pump off' level at .• a er alarm level at in.
- . •• Cycles tested Meets alarm & circuit requirements?
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 100'+ On adjacent lots 100'+
Public sewer main 75'+ Public sewer manhole/cleanout 100'+
Sewer/septic service line 25'+ Holding tank 75'+
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 10'+ Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
****PER INSPECTION REPORT
Property line .*5' Building foundation ****10' Water main 10'+
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage ***0'
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
*5'+TO BUILDING FOUNDATION.DECK PILES ARE NEXT TO TANK AND 1 OF THE DECK PILES HAS A SMALL PORTION THAT IS OVER THE RADIUS
OF THE TANK. **WAIVER GRANTED.SEE WAIVER#OSV131111. ***THE 1978 TRENCH IS LOCATED UNDER PORTION OF A PARKING AREA.
SEE 2013 COSA.SEE ATTACHED STATEMENT FROM OWNER REGARDING SYSTEM HAS NOT FROZEN. 00,11x11%i I 1
G. ENGINEER'S CERTIFICATION 4�.` ♦♦♦
... )/ffc46*-- �) ' ♦1
I certify that/have determined through field inspections and ;9 u; .,it •
review of Municipal records that the above systems are in •
conformance with MOA COSA guidelines in effect on this • • • ; it•
date. ♦c^ : fr; A. ar ess
Engineer's Printed Name JEFFREY A. GARNESS ♦♦•�5>• CE—/I795 A. :�:�
Date 1/ b,)/ '6 ♦♦� PROF...... �P��.
LICENSE ,�IIIs„`*%'
#AECC884
(Rev. 10/12/12)
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT • ' �t 907-343-7904
On-Site Water and Wastewater Section \ `'' Fax: 343-7997
www.muni.org/onsite
Nitrate Advisory,
Certificate of On-Site Systems Approval # 0SC18121O
Subdivision: Mountain Manor, Block: 2, Lot: 2
A water sample revealed a nitrate concentration of 5.02 milligrams per liter (mg/L).
The Environmental Protection Agency (EPA) has established a maximum
contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While
private wells are not subject to this regulation, EPA standards are based on existing
health information and can therefore be used to gauge the relative quality of water
from private wells. Please see the attached "Nitrate Fact Sheet" for important
information regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On-Site
Systems Approval.
Mailing Address: P.0. Box 196650* Anchorage,Alaska 99519-6650 *www.muni.org
Nitrate Fact Sheet
From Northern Testing Laboratories, Inc.
Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate
is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells.
SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of
ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the
oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners,
food solids,and bacterial cells. It may also result from the breakdown of organic matter buried in the soil.
TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is
associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of
young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood
stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry
oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the
concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered
from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization.
TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home
water treatment systems such as softening or iron filtration does not readily remove nitrate. The best
method for limiting nitrate in well water is source control. This can include avoiding overdosing of
fertilizer near the well and maintaining good separation distances between septic tank leach fields and
the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged
ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate.
TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a
spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect
the activity of nitrate in water. This laboratory uses several different wet chemical methods approved
under the public water supply laboratory certification program. They also have test kits available, which
the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can
monitor the change in nitrate levels from their well. They recommend comparing the test kit results
against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend
using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples.
Mailing Address: P.O.Box 196650*Anchorage,Alaska 99519-6650 *www.muni.org
June 4,2018
Municipalities of Anchorage
Departments of Health and Human Services
P.O. Box 196650
Anchorage,Alaska 99519-6650
Fax 249-7847
Re: Deck support over septic tank
Legal: Mountain Manor Blk 2, LT 2
To Whom it may concern:
Per the request from Garness Engineering a structural inspection was done at the above address to assess the
deck support located near the septic tank. After reviewing the site,a new Laminated Veneer Lumber(LVL)
beam 1.75 x 14" was installed under the deck to bridge-over the single deck pad which is too close to the
tank. This new LVL beam will remove any deck loading onto the septic tank and keep it from failing in the
future.
This structural repair has been done under my direction and will not impact the current structural deck
support in anyway.
Please call me if you have any questions.
Sincerely A
Michael N.Anderson,P.E.
Structural Engineer
4661 Natrona
Anch,Ak 99516
Ph 727-8864
•
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`� w REVISED 5-11 18,Addedseptk;venfsl K/
OF ,q �.+ AS-BUILT • NO CORNERS SET THIS.DATE
../�P•' • •S.�#*
� t hereby Certify that I have performed a Mortgagee's inspection
j:• h::�j,. •-v. ,/• of the following described property: LOT 2. BLOCK 2.
• • • 49' I\ . MOUNTijtN.MANOR SUBDIVISION .
/ .. . Anchorage Recording Precin• ct,Alaska .and that the . .
o••�fzabet L 1 Ctko �. rnproyements situated thereon are within the property lines
f %, e :ow and do not overlap or encroach on the property Lying'
vm" •..ES'.:.•
w / adjacent thereto,thaYno improvements on the propertytyfrtg
,adjacent thereto encroach on the premises in question and • .
•• : � sstow .`� that there are no roadways,transmission lutes or other
1 \\�Ni� visible easements on said property except as indicated • - .
-- .E•
: -SCA : 1 50' .• 5./4.. - '.Dated at Anchorage,Alaska
EASEMENTS OF RECORD,OTHER THAN . th•
is 17th day of APRIL ;2018.
THOSE SHOWN ON THE RECORDED FRED WALATKA&ASSOCIATES
PLAT:ARE NOT SHOWN HEREON REJ BE • Engineers and Surveyors
. ' UNLESS OTHERWISE NOTED, g02 248..1886
Municipality of Anchorage
• a,..
On -Site Water &Wastewater Program
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 050-671-19 Expiration Date: 9-3L,13
1. GENERAL INFORMATION
Complete legal description MOUNTAIN MANOR; BLOCK 2 LOT 2
Location (site address)
Current Property owner(s)
Mailing address
Real Estate Agent
2. TYPE OF DWELLING:
18746 ROADS END CIRCLE *EAGLE RIVER AK 99577
MIKE ENSCH Day phone
18746 ROADS END CIRCLE *EAGLE RIVER AK 99577
0 Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4
Day phone
231-2999
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well
N
Individual On-site
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
Received by: ! Date:,-` z {`
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ 4901 `p
Date of Payment 6x413
Receipt Number Q'
COSA# 0 5013101
Waiver Fee $ % o(i)Q, 'ro
Date of Payment 5/ag j�3
Receipt Number &1011
Waiver #_ ase -/a1 IS 0131111
�jwmvtf)T
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, 1 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. Phnna 337-6179
Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date 5 2 l'3
Engineer's Comments:
In conducting this evaluation, GEG, UD. 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 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 tight whatsoever.
6. DSD SIGNATURE
L-"� System #1 Approved for 4—
System #2 Approved for
Disapproved.
Conditional approval for
bedrooms.
bedrooms.
bedrooms, with the following stipulations:
t(f!
OF
ON-SITE
WATER AND
WASTEWAT D,
Original Certificate Date:.`
The MLy17cipV)fyXA,0§h6rage Develop,emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only
upon the represenatations 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. ATTCHMENTS:
COSA Checklist
Septic System Advisory .
Well Flow Advisory
(Rev. 11105)
Nitrate Advisory
Arsenic Advisory
Other
10 �—V,s� _0I/a
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: MOUNTAIN MANOR: BLOCK 2, LOT 2 Parcel ID: 050-671-19
A. WELL DATA *BASED UPON SURROUNDING WELL LOGS
Well type PRIVATE If A, B, or C provide PWSID# N/A
Date completed 4/28/78 Sanitary seal (YIN) YES
Total depth 7725 ft. Cased to *40+ ft.
FROM WELL LOG
Date of test 4/28/78
Static water level b4 ft.
Well production 10 g,p,m,
WATER SAMPLE RESULTS:
Well Log (YIN) YES
Wires properly protected (YIN) YES
Casing height (above ground) 12+ in.
AT INSPECTION
4/15/13
70 ft.
1.89 g.p.m.
Coliform 0 colonies/100 mi. Nitrate 4.45 mg./L. Collected by: GEG. Ltd.
Arsenic: NO ug./L. Date of sample: 4/16/13
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC/STEEL Date installed 7/27/07
Tank size 1250 gal. Number of Compartments 2 Cleanouts (YIN) YES
Foundation cleanout (YIN) YES Depression over tank (YIN) NO High water alarm (YIN) N/A
Date of pumping 4/24/13 Pumper JR'S PUMPING
C. ABSORPTION FIELD DATA *BELOW EXISTING GRADE
7/11/78 195
Date installed 5/11-12/93 Soil rating( .p.d./ft r /bdrm 1 2
66 2.
Length 45 ft. Width 3 ft.
System type
TRENCH
TRENCH
6
Gravel below pipe 6 ft.
792
Total depth *9.50+ ft. Eff. absorption area 540 ft2 Monitoring tube YES Depression over field NO
Date of adequacy test ***5/17/13 Results (Pass/Fail) PASS For 4 bedrooms
Fluid depth in absorption field before test 26 in. Water added 797 gal. New depth **58.5 in.
Elapsed Time: 120 min. Final fluid depth544 in. Absorption rate >= 600+ g,p.d.
Any rejuvenation treatment (past 12 mo.) (YIN & type) SEPTICLEAR If yes, give date 4/19/13
**2.5 INCHES INTO INVERT
***TESTING DATE APPROVED BY JAY CREWDSON (<30 DAYS)
TESTED THE 1993 TRENCH ONLY.
C/0 -SUMP AT END OF 1978 TRENCH IS NOT FUNCTIONAL.
D. LIFT STATION
Date installed Size in gallons Manhole/Access
"Pump on" level at in. "Pump off
E. SEPARATION DISTANCES
water alarm level at in.
Cycles tested Meets alarm & circuit requirements?-
E.
equirements
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100'+ On adjacent lots 100'
Absorption field on lot 100'+
Public sewer main N/A
Sewer /septic service line 25'+
On adjacent lots 100'+
Public sewer manhole/cleanout N/A
Holding tank
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 53+ 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 **5' Building foundation 10'+ Water main_ N/A
Water service line 10'+ Surface water 1001+ Driveway, paridng/vehtcle storage *0'
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
**PORTION OF 1978 TRENCH IS UNDER PARKING AREA. **SEE ATTACHED WAIVER REQUEST.
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.
Engineers Printed Name JEFFREY A. GARNESS
Date 5J 3 113
4.,.L�e .......
SS'.
Municipality of Anchorage
P.O. Box 196650 • 4700 Elmore Road
Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997
http://www.muni.org/Onsite
Development Services Division
On -Site Water and Wastewater Program
Ment .S
"A H
C,
Department
**** VARIANCE/WAIVER REVIEW ****
Waiver#: osp131111 COSA#: osc131219 Permit#:
PID#: 050-671-19
Legal Description: Mountain Manor B-2 L-2
Engineer: Garness Engineering Group
Applicant: Mike Ensch
Your request for a waiver of the required 10 feet horizontal separation from the absorption field
to the property line has been approved. The approved separation distance is 5.0 feet.
This waiver approval applies to the existing absorption field only. Any future upgrade to the on-
site wastewater disposal system will require all separation distances be met or another approval
from this department.
❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this
waiver.
❑ Notarized letter(s) of nonobjection have been received from the owner(s) of the affected
adjacent property.
® Adjacent properties are not affected by this waiver.
...............................................................................
Waiver is Granted: X Waiver is not Granted: J
Date: —� ` 3 1—) Approved by:
G(/ • �`
Na ewer
............................................ ... ......................
Rec#: 046716 Amount: $200.00 Date Paid: 5129/13
**** VARIANCEIWAIVER REVIEW ****
T�S00
3
HOUSE6 _
ly
R
UNDER NO CIRCUMSTANCES SHOULD AN AS—BUILT BE USED FOR CONSTRUCTION OR FOR ESTASIJ"G BOUNDARY OR FENCE ONES.
THE SURVEYOR TAKES RESPONSIBILITY FOR THE INITIAL TRANSACTION ONLY AND ASSUMES FINANCIAL LIABILITY ONLY FOR THE COST OF THE SURVEY,
UF= DISTANCES PREVAIL OVER SCALING. REPRODUCTION MAY CAUSE ERRORS IN SCALE.
LOTstww SURVEY TYPE SYMBOLS
FOMFeIAL ASRCIDIURE AII-SILT "SET REBAR 7=' � DRAINAGE ASPHALT
O FOUND ❑ RESAR .pis WOW FENCE CONCRETE PLOT PUW ... A8-SIR.r ... 40T jEM .. , 1014 ASAMY ® ASSUMED M. * * III. METAL FENCE ® WOW DECK
-DlIlLT... � COFAM2
IT 15 THE RESPONSIBILITY OF THE BUILDER OR OWNER, PRIOR TO
CONSTRUCTION, TO VERIFY PROPOSED BUILDING GRADE RELATIVE
ONLY THOSE IMPROVEMENTS ABOVE GROUND AND VISIBLE WILL BE
SHOWN. FENCES, VIEWS. SEPTIC CLEANOUTS, SIDEWALKS. DRIVEWAYS,
TO FINISHED GRADE AND UTILITY CONNECTIONS AND TO DETERMINE
ETC., ARE SHOWN IN THEIR APPROXIMATE LOCATION, ONLY. SNOW
THE EASTENCE OF ANY EASEMENTS. COVENANTS OR RESTRICTIONS,
MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATED.
WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT.
ALL DISTANCES ARE RECORD UNLESS OTHERWISE; NOTED.
SURVEY CER71FICA71ON�
o
Prepared by
Robert E. Johns, Jr. & Assoc.
PLOT PLAN
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Professional Land Surveyors
A.e��N� M iaMi1 `al�ww �:
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ANCHM04L ALASKA 89001
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Boole: 50,
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Rm PW R* No.
FUt NDA104 AS-BIM.r
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Drape e .e4��lAK
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Data DIeNM:
05/21/13
NW254
W.G. 13-197
FINAL sRIucILmE A6�IIILrg�.,
;•�',���
•'•a.
Legal De1MPDoA:
Lot 2 BLOCK 2
4_MoI L AMS e. IIeMr aYy r I
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h•ti�i�w��k-
MOUNTAIN MANOR
May 24, 2013
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 Elmore Rd.
P.O. Box 196650,
Anchorage, Ak 99519-6650
(907)343-7904
Ref: Lot Line Waiver Request for Mountain Manor; Block 2, lot 2,
To whom it may concern:
We request that your department issue a 5 -foot lot line waiver from the north property line to the
existing drainfield. The existing drainfield on Lot 2 has a separation distance of approximately 5
feet to the north property line, which borders Roads End Circle. In short, there are no drainfields
on adjacent properties for at least 50 feet. We are unaware of any adverse impacts this waiver
would have on ad'acent wells or septic systems. If you have any questions, please contact us at
337-6179. Than�you for your assistance.
P.E., M.S.
3701 E. Tudor Road, Suite 101 *Anchorage, AK 99507-1259
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com
May,23 2013 10:48RM HP LRSERJET FOX P.1
M TIA
NON -OBJECTION TO EASEMENT ENCROACHMENT DOCUMENT
By this document Matanuska Telephone Association, Inc. (MTA) declares that it has no objection to the
encroachment of a portion of a septic system within the 10' utility easement Iocated upon and within Lot 2,
Block 2, Mountain Manor, Anchorage Recording District, Third Judicial District, State of Alaska, situated in
Section 6, Township 14 North, Range 1 West, S.M., Alaska.
Please be advised that MTA through the issuance of this document does not forfeit any of its rights to the use
of the area cited. In the exercise of these rights MTA will, if needed, upgrade, maintain, repair, and/or replace
buried or aerial telecommunications facilities within the easement. Any repairs that may be required to the
encroachment as a result of utility construction will be borne by the property owner of record. This document
does not authorize the placement of any additional encroachments within the easement area. Property owners
are required to obtain utility locates before doing any kind of work in the utility easements and will be liable
for any damages caused by their construction work in the easements.
This document is, in no way, an agreement to vacate any Rpition of the utility easement and should not be
interpreted as such
Issued for Matanuska Telephone Association, Inc. this 29th day of May, 2013, by,
Ze4�_
Real Estate & Properties Supervisor
THIS IS TO CERTIFY, that on this 29th day of May, 2013, before me the undersigned, a Notary Public in and for
the State of Alaska, duly commissioned and sworn as such, personally appeared Bonnie Bailey known to me
and to me known to be the individual named in and who executed the foregoing instrument and acknowledged
to me that he signed and sealed the same as a voluntary act and deed for the uses and purposes therein
mentioned.
IN WITNESS WHEREOF, I have hereunto set my hand and official seal the day and year first above written.
,„',Notary Public in and for
My commission expires:
GRANTTOR:
Matanuska Telephone Association Inc.
PO Box 3550
PWtr Alaska 996463650
800.746.95/0
907.761.2510
907-761.2648 {}a>Q
WWW Mumolutions.00rn
Local
Long Distance
Wireless
Business Solutions
Internet
Directory
DN
from aPS STORE EAGLE RIVER ALASKA To:3383248
tl4- LUt7 L:'F9[m uL1 vor
May 24, 2013
W1i1W Bnsch
10744 Roads End Circle
Fi& 1bve , Alaska
I3earMilce £Hach:
05/29/2013 08:43 #586 P.001/001
60m==42ftoUC4XP,h&t= . 1 - -.. \. the 5BPdcpipe,ewroacbmg into the, .
tty
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BY .1 below,YOU J3Ww . ,.. w.l1 m ,. i aCommunicistim .,.11:..1.
.•n FAd arty, a Ir .z <. 1a �Yvi.. ... m-.0
Y • v AngiWdT4WaiU943i3.00 ..
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Anchorage Water & Wastewater Utility
Engineering Division
Mayor
Dan Sullivan
May 28, 2013
Mike Ensch
18746 Roads End Circle
Eagle River, AK 99577
Board Chair
Timothy M. Sullivan, Sr.
Re: Mountain Manor BLK 2 LT 2 (Grid NW254)
Request for Letter of Non -objection to Encroachment (Tax ID# 050-671-19)
The Anchorage Water and Wastewater Utility received a request from you on May 23, 2013
in regards to an existing on-site septic system pipe encroaching into the utility easement
along the north property line of Mountain Manor BLK 2 LT 2.
AWWU is currently not using this utility easement and has no objection to the
encroachment. AWWU hereby issues this letter with stipulations to allow the encroachment
of an existing on-site septic system pipe into the utility easements, the property owner(s)
agrees to the following:
1. AWWU will be held harmless, now and forever, for any damages or injury to any
person as a result of the encroachment;
2. The property owner(s) shall call for utility locates before excavation in the
easement;
3. All applicable codes and regulations will be observed and maintained within the
easement;
4. This letter will in no way preclude AWWU from full use and enjoyment of its rights
within any portion of the easement;
5. The property owner(s) shall pay any additional and/or extraordinary costs incurred
to accommodate the encroachment during any future required construction or
reconstruction of AWWU facilities;
6. AWWU's non -objection does not imply other approvals that may be required for this
encroachment; and, -
7. AWWU does not provide a position for any other parcel or utility impacted by the
encroachment.
Should you have any questions, please calf the AWWU Planning Section at 564-2739.
Respectfully,
Shawn Odell
Engineering Technician
Anchorage Water & Wastewater Utility y Clearly
•rte
3000RmicBoulevard • Mchorage,Alaska 99503
Phone 907-564-2774 • Fax 907-562-0024 • wwwaw rabh ,.�^-.✓-ti�,`�
Fron:Enstar Marketing
May 28, 2013
Jeffrey A. Gamess, P.E., M.S.
Gamess Engineering Group, LTD.
3701 E. Tudor Road, Suite 101
Anchorage, AK 99507
Grid: NW254
Re: Letter of Non -Objection
To whom it may concern:
9073347737 05/28/2013 14:29 #642 P.001/001
ENSTAR Natural Gas Company
A DIVISION OF SEMCO ENERGY
Engineering Department
Right of Way Section
401 E. International Airport Road
P. O. Box 190288
Anchorage, Alaska 99519-0288
(907) 334-7753
FAX (907) 334-7798
ENSTAR Natural Gas Company has no objection to the proposed septic pipe encroachment four (4) feet
into the ten feet (10 FT.) utility easement situated adjacent to and coincident with the northeast boundary
line of Lot 2, Block 2, Mountain Manor Subdivision, Records of the Anchorage Recording District, Third
Judicial District, State of Alaska.
Acceptance and use of this letter of non -objection by yourself, your heirs, your assigns, or your
successors, will constitute agreement to the following stipulations:
• landowner/Contractor working near ENSTAR gas facilities shall contact the Alaska Digline, tic., (907)
278-3121 or 811 for line locating two (2) business days prior to any related excavation.
• ENSTAR will be held harmless, now and forever for any damages or injury to any person or property as a
result of this encroachment.
• Any ENSTAR facility damaged or destroyed, as a result of this encroachment will be repaired at no cost to
ENSTAR.
• Any costs incurred by ENSTAR for special construction necessitated by this encroachment will be home
by the land owner.
• All applicable safety code regulations will be observed and maintained.
• This letter of non -objection will in no way preclude ENSTAR from full use and enjoyment of its rights
within any portion of its right-of-way.
Sincerely, L-0/ �
Tom Arminski
Manager, Right of Way & Permitting
ENSTAR Natural Gas Company
cc: Fite
MATANUSKA ELECTRIC ASSOCIATION, INC.
June 20, 2013 LETTER OF NON -OBJECTION
Marta D. Freitag and Joe M. Freitag
18766 Roads End Circle
Eagle River, AK 99577
Re: Lot 2, Blgck.2„LMo Dt@l0. ? M,,$ubdivision.(Plat 77-23, Anchorage Recording District)
Dear Marta and Joe:
MEA has no objection to the encroachment of a septic system located in the utility easement as depicted on
the attached as -built survey drawing, subject to the following conditions:
1. The improvement will In no way restrict or limit the current or future ability of MFA to fully enjoy the
benefits of the easement for any and all utility purposes that it presently enjoys under the easement.
2. MEA will be held harmless by the landowner from liability for any and all damages or injury to any
person or property that may result from the existing and future use of the easement by MEA, its
contractors, or assigns,
3. MEA will be held harmless by the landowner for any and all liability arising out of or relating to any use
of the easement by others under a Letter of Non -Objection.
4. The landowner will be liable for any damages caused to MFA facilities by the improvement in the
easement.
5. The landowner will be responsible for any special construction costs incurred by MEA due to the
improvement in the easement.
6. The landowner will assure compliance with all applicable safety codes relating to the improvement in
the easement.
7. Use of this letter by the landowner, their successors or assigns will constitute acceptance of these
conditions.
8. Alteration of these conditions shall invalidate this letter.
9. This letter is not effective unless it is recorded in the Anchorage Recording District before ownership of
the referenced property is changed from the above named landowner.
Sincerely,/
&04 .
Keith Quintavell
Right -of -Way Administrator
STATE OF ALASKA),SS-
THIS IS TO CERTIFY that on this 20 day of:June , 2013 before me, the undersigned, a Notary Public in
and for the State of Alaska, duly commissioned and sworn as such, personally appeared
<<)f4 aL,.;rfgivtI/
Known to me and to me known to be the individual(s) named in and who executed the foregoing instrument
and acknowledged to me that he/she/they signed and sealed the same as a voluntary act and deed for the
uses and purposes therein mentioned.
O�e��iGCR srk'f.
IN WISNEEASS WHEREOF, i have hereunto set my hand and official seal d qa ygatifirs�t: a written
Notary Public in and of Alaska My commission expires
p ,
Return to: MEA, PO Box 2929, Palmer, AK 99645 u" `
q�
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of'Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage, Alaske 99519-6650
343-4744
Parcel I.D. #
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
1. GENERAL INFORMATION
Complete legal description
Location (site address or directions)
Property owner
Mailing address
Lending agency
Mailing address
Agent
Address
Day phone
Day phone
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS:
TYPE OF WATER SUPPLY:
individual well
Community well
Public water
NOTE:
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
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 (Rev. 1/91) Front MOA #21
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~,ou s! @beJoqou¥ ~o X~!iBd!o!unlAI eH.L 'penss! s! eleo!~!~Jeo ~ 9Jojgq elep eZXleUe JO suop, ogdsu! ~onpuoo
~ou op SHHQ ~o see4Oldu~3 'S)~UDLUGJ!FIb9J @),eT, s pUB leJepeJ u!~Jeo ~,sp, es o~, J@pJo u! suop, n]]:~su! 5u!puel J!eql pue
lu@puedepu! ue /~q @AOqe g qdeJbeJed u! UeA!~ SUOp, BJUeB~)Jd~)J eql uodn Xluo p@seq se]~13o!J!~J9~) leAoJdd¥
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sluawwoo leUO!~!pPV
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I:lqqNION=l AE] NOIJ. O=IdSNI dO .I.N~IN=I.I.Y.LS
Municipality of Anchorage
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description:
A. Well Data
Well type ~£~ v/~1-~ If A, B, or C, attach ADEC letter. ADEC water system number
Log present (Y/,J~') o~ F'f~.7- Date completed ~/'~7/7 ~/ Driller
Total depth 7 ~' ' Cased to ~ ~' ' Casing height
Sanitary seal (Y/N) ~ Wires properly protected (Y/N)
FROM WELL LOG
Date of test
Static water level
Well flow
Pump level1
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot )..h--~
Absorption field on lot / o ?
Public sewer main ~,J/3-
Sewer service line /~"D f--
g.p.m.
AT INSPECTION
; On adjacent lots
¢o. ~.: r"rl
g.p.m. ':7-.. o ""'
; On adjacent lots
Public sewer manhole/cleanout
Petroleum tank
WATER SAMPLE RESULTS:
Coliform C)
Nitrate 'z, 5 ?
Date of sample: / o//~/~ ~ Collected by:
Other bacteria
B. SEPTIC/HOLDING TANK DATA
Date installed ~¢} ) ~" Tank size / -z..
Cleanouts (Y/N)
High water alarm (Y/N)
Date of pumping
Foundation cleanout (Y/N)
/J///~ Alarm tested (Y/N)
'7//¢/~"?..~ Pumper
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Compartments
Depression (Y/N)
Well(s) on lot I ~C)
To property line :bo
Surface water/drainage
On adjacent lots
Absorption field
/
Foundation ~ ~
Water main/service line ~,~-~
72-026 (3/93)* Front CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Size in gallons
Vent (Y/N)
High water alarm level
Meets MOA electrical codes (Y/N)
"Pump on" level at
Manufacturer
Manhole/Access (Y/N)
"Pump off" Level at
· Cycles tested
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot
On adjacent lots
Surface water
D. ABSORPTION FIELD DATA
Date installed ,~oo, r/~,~ t
Lengt~~' ~ Width
Total absorption area ~
Date of adequacy test ~
Water level in absorption field before test
Peroxide treatment (past 12 months) (Y/N)
Gravel thickness
Cleanout present (Y/N) y
Results (pass/fail)
o,~, ~,.~..-~ s¥~r~,, le:¢>~/'*'~
Soil rating (GPD/FF) &~1~',~,~ ), ~- System type
6' Total depth
Depression over field (Y/N)
for
Bedrooms
After test
If yes. give date
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot
To building foundation
On adjacent lots
Surface water
Curtain drain
On adjacent lots ! '~o +- Property line
To existing or abandoned system on lot
Cutbank ~ Water main/service line
Driveway, parking/vehicle storage area :S ' -
E. ENGINEER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA
Signature
David R. Dayton P.F..
20210 Donalar St.
Chu~jiak~ Alaska
Engineer's Name
Date
HAA Fee $
Date of Payment
Receipt Number
72-026 (3/93)* Back
Waiver Fee $
Date of Payment
Receipt Number
MUNICIPALITY OF 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. p tC', 4C 1-1 `'1 HAA If
GENERAL INFORMATION
Complete legal description �'f Z �c� 2 4^'rn�^� ihNoa SSS.
Location (site address or directions) /0 03 6;U,5) e";Za`-6
t4ALfs M. � �o��r°'7Tz<' l�t7ut Da h G9�--�Y33
Property owner Cy phone ssi—�s�u c�riro
Mailing address I K 74J,
Lending agency
Mailing address.
Agent
Address
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 4-
3. TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
Day phone
Day phone
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
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.
72-0261Nn. 1911 Front UOA4t
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. l 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 r��oBs�y(b�(ct on the date of this inspection.
Name of Firm20210 Donalar St. Phone �9G ��5�/7
- kta3, 9936
Address
Engineer's signature
Date 10 ) z319 I_
+ 7,rc.� AoEo.
1_�Q\•4CST �rJ�1-7'10n1A� XfvQov A,— Wrf2F Fkk2PS
E-_-,C2.ow D 'P;. e— c.Rwor< . IPz SPR1k1ti ,t 493
6. DHHS SIGNATURE
Approved for bedrooms.
Disapproved. c
Conditional approval for bedrooms, with the
...t.�1..• .N • 1/ I ..-
COYW R. 0eytx
NO. 2205-C P
Additional Comments Lei/k/V
�G'/•T/L/r'�IY �•"'4 .?G'J /n �.r i:C1e.-cl% v✓ < �G ,G'ir/'l� �I' L�'ei,.•
By: ryt, I A. j Date
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.
72-025 (A. 1911 &xX MOA •21
Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: ~ ~', ~-¢ ? Parcel I.D.
A, WELL DATA
Well type ~f~¢u.*¢~ If A, B, or C, attach ADEC letter. ADEC water system number
Date completed ,¢,/Z.-~/?~ Driller ~¢~ '~/~'~-'-,"~
Cased to "7~'/ Casing height
Wires properly protected (Y/N) /V'
Log present (Y/~)
Total depth_ 7 ~ '
Sanitary seal (Y/N) y
FROM WELL LOG
Date of test 4-/Z.~,/~
Static water level ¢'4z /
Well flow / O
Pump level ~7~. ~
SEPARATION DISTANCES FROM WELL TO:
Septic/l~ on lot
Absorption field on lot
Public sewer main
Sewer service line
AT INSPECTION
; On adjacent lots
p~¢'-o- ; On adjacent lots
Public sewer manhole/cleanout
Petroleum tank
WATER SAMPLE RESULTS: C ~'~'~" ~
Coliform Nitrate
Date of sample:
Collected by:
Other bacteria
B. SEPTIC/~TANK DATA
Date installed /~) 7,~
Cleanouts (Y/N) Y
High water alarm (Y/N)
Date of pumping
Tank size / ~7::::, Compartments ~-
Foundation cleanout (Y/N) ~' Depression (Y/N)
Alarm tested (Y/N)
,
2-- Pumper ~ J2_.' ~ ,Z~u~,,¢:¢
SEPARATION DISTANCES FR'OM SEPTIC/HCLD;NG TANK TO:
Well(s) on lot
To property line
Surface water/drainage
On adjacent lots
Absorption field
/~ ¢'- Foundation ~' -/c~ /
! ~ ' Water main/service line ~o,~-~
72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Size in gallons
Vent (Y/N)
High water alarm level
"Pump on" level at
Manufacturer
Manhole/Access (Y/N)
"Pump off" level at
Cycles tested
Meets MOA electrical codes (Y/N)
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot On adjacent lots Surface water
D. ABSORPTION FIELDDATA ~'~:::::;d~ -'~'~,~,~'~--uO l-~,~-"L~uL~"t-r'~ '~c~---.~
Date installed / ~ ?~ Soil rating / ~ ~ System type
Gravel thickness ~ /
Cleanouts present (Y/N)
Date of adequacy test
for ~'/'-
Length ~' ~ / Width
Total absorption area
Depression over field (Y/N)
Results (pass/fail)
Peroxide treatment (past 12 months) (Y/N)
If yes, give date
Total depth
bedrooms
SEPARATION DISTANCE
FROM A ...... , ~,,4 FIELD TO:
Well on lot ~ ,-~ c;~
To building foundation
On adjacent lots
Surface water
Curtain drain
On adjacent lots /~ ¢-
Property line
To existing or abandoned system on lot
Cutbank A/~,~¢- Water main/service line
Driveway, parking/vehicle storage area
E. ENGINEER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signature
Engineer's Name
Date /~~
Waiver Fee: $
Date of Payment
Receipt Number
SEATTLE MORTGAGE
Alaska Branch
560 East 34th Avenue
Suite #100
Anchorage, AK 99503
(907) 562-5626
Fax (907) 562-7798
RECEIVED
November 5, 1992
Municipality of Anchorage
Department of Health & Social Services
Division of Environmental Services
P.O. Box 196650
Anchorage, AK 99519-6650
NOV 6 1992
Municipality of Anchorage
Dept. Health & Human Services
RE: Lot 2, Block 2, Mountain Manor Subdivision
Charles M. and Danette S. Ensch
To Whom It May Concern:
Please be advised that in consideration of a conditional
approval, Seattle Mortgage Company will hold an escrow in the
amount of $7,178.00 as assurance of completion of remedial action
to the sewage disposal system serving the captioned property.
~an
Loan Officer
D. R. DAYTON, P.E., R.L.S.
~{~:x~{~l~)~ Chugiak, Alaska 99567
20210 Donalar Street
(907) ~1~~'
696-2417
October 24, 1992
WELL FLOW TEST
Legal Description: Lot 2. Block 2. Mountain Manor Subdivision
Date of Test: September 30, 1992
Well Depth: 78 ft.
Static Water Level: 63 ft.
Requirements: 600 gallons per day for 4 bedrooms
Test:
The well was pumped at 7.5 gallons per minute for 60 minutes
resulting in a drawdown of 6.7 ft.. The flow was then reduced and
pumping continued for an additional 3 hours.
Results:
The well produced a total of 1040 gallons in 4 hours.
Conclusion:
The well is currently producing adequately for a 4 bedroom home.
CHEMICAL & GEOLOGICAL LABORATORY
A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO.
5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562.2343 FAX: (907) 561.5301
ANALTSIS RESULTS for IN70ICE If 60056
Chemlab Ref.t 92.6010 Sample t 1 )L,triz: WATER
Client Saaple ID : L2 12 MOUNTAIN MANOR Client Name :DAVID DATION, P.E.
PWSID : CA Client Acct :DAVIDIA
Collected OCT 27 92 t 08:00 hrs. Spot Pot :NOBZ RECEIVED
Received : OCT 28 92 4 13:53 hrs. Root ;
Preserved with AS REQUIRED Ordered By
Analytic Completed OCT 30 92 Send Reports to:
Laboratory Supervise. STEPHEN C. EDE 1)DAVID DATION, P.L.
Aaleese3 By
l/ jrt,Gr
....................................................................................................................................
Parameter Results Units Method Allowable Limits
------------------------------------------------------------------------------------------------------------------------------------
NITRATE-N 2.37 mq/l Erk 353.2/300.0 10
t
Sample ROUTINE SAN?LE CCLLECTED ST: D.A. DAIION.
Remarks:
....................................................................................................................................
1 Teets Performed See Special Instructiocc Above UA -Unavailable
ND- None Detected See Sample ?,ams. ks Above
NA- Not Analyzed LI -Lees Than, GI -Creator Than
@WN S13S Member of the SGS Group (Socidt6 GAnkale cle Surveillance)
MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
DIVISION OF ENVIRONMENTAL SERVICES
343-4744
Parcel I.D. #
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include 10t, block, subdivision, section, township, range)
Mountain Manor Sub., Lot 2, Block 2 T14N, R1W, Sec.6
Location (address or directions)
18746 Roads End Circle
(b) Property owner Tom Sheets
Mailing Address P.O. Box 770956
(c) Lending Institution
Mailing Address
Telephone : (home) 694-3951 Business
Eaqle River, AK 99577
Telephone
(d) Real Estate Company and Agent Century 21 Lars Ekstrand/Di¢ne tvJa~t'
Address 3401 Denali Ste. 103 Anchorage, AK 99503
Telephone 561-0491
(e) Mail the HAA to the following address: (or check here rq, if hold for pick up.)
List contact person and day phone number below:
Pick-up by Engineer
2. TYPE OF RESIDENCE
Single-Family~ Number of bedrooms 4
3. WATER SUPPLY
Individual Well ~
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 ~ Public [] Community [] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legality and status.
72-025 (Rev, 7/88) Page 1 of 2
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 end 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 Eagle River Engineering SrVS.Telephone 694-5195
Address P.O.B. 773294 Eagle River, AK 99577
6. DHHS APPROVAL
Approved for ~ bedrooms by
Approved ~)/%, Disapproved
Terms of Conditional Approval
Conditional
Date
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 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 (Rev, 7/88) Back Page 2 of 2
Well Log Present (Y/N) '~ ~ Date Completed
Total Depth ~' Cased to
Static Water Level [~ ~ ~-/~
Casing Height Above Ground
Electrical Wiring in Conduit (Y/N)
SEPARATION DISTANCES FROM WELL:
T~'Septic/Holding Tank on Lot
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line
To Nearest Sewer Service Line on Lot
Water Sample Collected by
Water Sample Test Results
MUNICIPALITY OF ANCHORAGE (MOA)
Health Authority Approval (HAA}
CHECKLIST - FEBRUARY 1984
343-4744
Legal Description:
If A, B, C, D.E.C. Approved (Y/N) . _
' '~',,'~"~'?7,P Yield ~',
Depth of Grouting
"~' ~'~'~'~ Pump Set At ~,2./
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N)
; On Adjoining Lots
; On Adjoining Lots
To Nearest Public Sewer Cleanout/Manhole
; Date
Comments
B. SEPTIC/HOLDING TANK DATA
Date Installed 7/?,~' Size
Standpipes (Y/N)
Depression over Tank (Y/N)
Pumping/Maintenance Contact on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK:
To Water-Supply Well /~"~ '
To Property Line ~'/,""
To Water Main/Service Line ~
To Stream, Pond, Lake or Major Drainage Course ~'/"~
Comments
/,.~ .~,~ I. No. of Compartments
Air-tight Caps (Y/N) )" Foundation Cleanout (Y/N)
"'J Date Last Pumped
,~,'/a ; for
Temporary Holding Tank Permit (Y/N)
To Building Foundation
To Disposal Field //
72-026 (Rev, 7/88) Front Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed
Width of Field
Square Feet of Absortion Area
Depression over Field (Y/N)
Results of Last Adequacy Test
SEPARATION DISTANCE FROM ABSORPTION FIELD:
To Water-Supply Well ~-~,~,' '
To Building Foundation
Lot
To Water Main/Service Line //,~
To Stream, Pond, Lake, or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments .
Type of System Design
Length of Field ~'~' /
Depth of Field ?¢ ¢~ z
Gravel Bed Thickness ~" ¢
Statndpipes Present (Y/N)
Date of Last Adequacy Test
To Property Line_ /,,~¢
To Existing or Abandoned System on
; On Adjoining Lots ~%~ /
To Cutback (if present)
D. LIFT STATION /¢/4
Date installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Meets MOA Electrical Codes (Y/N)
Comments
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping 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 in effect on the date of this
inspection.
Signed
Company
Date
Eagle River Engineering Services
P. 0. Box 773294
Eagle River, AK 99577
MOA No. S7~-.2t~ 694--5~95
% .¢~ lgineer's Seal
Receipt No. ~/,._~
Date of Payment
Amount: $
72-026 (Rev. 7/88) Back
Receipt No.
Waiver Fee: $
Date of Payment
Page 2 of 2
AUG -24-89 T"U 10:11 McCt-II-!TOCK LS—ER ENGINEER P.02
..ww.•ow..c
iek
CIIEAfICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
` 5633 B STREET ANC FEDERAL ALASKA TAX ID N9150040 TELEPHONE (907) 5622343
ANALYSIS MOAT B1 SAM?LE for Work Order B 15721
Cate Report Printed: An 11 89 ! 20:30
Client Sample ID:M9CNTAIN MANOR L2 12
PW31D :UA
Collected AUG 8 89 ! 16:00 hcs.
Received ADO 9 89 4 13:00 his
Pieser Yea with :AS FEQUIRED
Client Name EAGLE RIVER ENOR
Client Ace- : EAGLERP
P.O.E NLNE RECEIVED
Req t
Ordered By
Send Reports to:
Analyata Completed :A"G IC 89 1)EAOLE RIVER ENGR
labotatoxy Supervieot :STEPHEN C. WD" 2)
Special
Instruct:
Chea_ab Re: E: 69^.0 Lat Sip! ID: 1 Matrix: WATER
Pa[ais
.star Tested Pesult/u%
------------------------------------------------------------
NITRATE•N 1.9 mq!l
Sample ROUTINS SAI u
Remarks: SAME COLLECTED BY R.H.
Allowable
Mathca Limits
-------------------- -----------
EPA 353.2 10
..• •••••,•••• •••••• •See Spectal`Instructions •Above ••• .•UA•UnaVsilable
1 Tests Performed
NC. None Detected " See Sample Remarks Above
NJ. Not Analyzed LT -Loss Than. OT -Greater Than