HomeMy WebLinkAboutRIVER VIEW ESTATES BLK 5 LT 8J Riverview Estates Block 5 Lot 8 #050-792-22 On -Site Water and/or Wastewater System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP151203 Tax Code Number: 05079222000 Work Type: SepticTank Upgrade Permit Effective Dates: July 02, 2015 to July 01, 2016 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: RIVER VIEW ESTATES Site Legal Address: RIVER VIEW ESTATES BLK 5 LT 8 G:0357 Owner/Address: FITZPATRICK CHARLES E III & MARIA H 7411 WILDWATER CIRCLE EAGLE RIVER AK 995779421 Site Mailing Address: 7411 WILDWATER CIR, Eagle River Lot Size in Sq Ft: 40026 Total Bedrooms: 3 This permit is for the construction of: N Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received BI Issued By: MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 1050-792-99 RUSH Property owner(s) Charles & Maria Fitzpatrick Day phone Mailing address 7411 Wildwater Circle, Eagle River, AK 99577 Site address 7411 Wildwater Circle Legal description (Sub'd., Block &,Lot) River View Estates, Block 5, Lot 8 Legal description (Township, Range & Section) Lot Size 40,026 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) ❑X (w/wo ADU) Septic Tank ❑x Upgrade ❑X Duplex (D) F-1Holding Tank ElRenewal F]Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ ILU8,14 Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: certify that the above information is correct. I further certify that this is in accordance with applicable Muyk4pal Bodes. , property owner or Permit/Rush Fees: al5 Date of Payment: 2115 Receipt Number: 63e;_9 �1 Permit No. 05 P I S oz 3 Permit App_::. :L:c, Waiver Fees: Date of Payment: Receipt Number: Waiver No. Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steveOoaneneakxom July 2, 2015 Subject: River View Estates,Block 5, Lot 8 Emergency Tank Replace Permit Request RUSH, Design -Narrative This is a design narrative for a permit to install an upgrade 1000g Septic Tank to be issued for this property. The existing tank has collapsed exposing sewage to the environment and placing the house out of service. The proposed systems will serve an existing three (3) bedroom house. Currently the lot is developed. The proposed system will utilize a replacement 10008 septic tank that will be connected to the existing drain field. This lot and the surrounding lots are served by private wells. There are no wells within 100 feet of this system. 1. Upgrade Tank Design. a. See Sheet 1 of the design package. 2. Surface Water: There is no surface water within 100 feet of the proposed septic tank. The proposed septic tank upgrade will maintain at least 100 feet from all surface water and drainage ditches. 3. Topography: The existing topography slopes from the south to the north at approximately 10% in the area of the septic system. The proposed installation will not affect the future development of the surrounding or existing lots. There are no surrounding wells within 100 feet of the proposed septic location. Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 /M Ah �M 3 yy. WELL (E) \h7 w WELL (E) I / wT W— 3BR HOUSE \ (E) GY\ w—_ W_� \� DRAIN FIELDS (E) I COLLAPSED 10008 SEPTIC TANK (E) DECOMMISSION PER CODE INSTALL 10008 SEPTIC TANK (P) WITH DOUBLE CLEAN OUT WELL (E) LOT UNDEVELOPED \�G NO WELLS OR SEPCITS �__ W—� W NOTES: PANNONE ENG SVC, LLC TANK REPLACE P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 RIVER VIEW ESTATES, BLOCK 5, LOT 8 CHARLES FITZPATRICK 7411 WILDWATER CIRCLE PLAN EAGLE RIVER, AK 99577 / LOT UNDEVELOPED NO WELLS OR SEPCITS Steven Rei PFc. CE 8149 s . ll 7/2/2015 Scale I 1"=50' I� P.I.D. NO 050-792-22 ane / PERMIT NO. Ospxxxxxx Sheet - 1 OF 1 Municipality of Anchorage Development Services Department Building Safety Division .. .. On -Site Water and Wastewater Program. 4700 S. Bragaw St P.O. Box 196650 Anchorage, AX 99519-6650 Page I of 2 www.d.anchorage.ak.us (907) 3417904 —+ ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SI.JOyOIg�{ PID Number. OSO'%q:?—Q?.) Nam: er' H Wastewater System: [I New Upgrade AE n.: l 5DO /Ac a 57R ABSORPTION FIELD Fnon.: �_ / lAntw a D.troetc V.W T..h O sway. Twnal O R.o D Mbl.w O orw .. LEGAL DESCRIPTION solRaa.F O,g caost Taatkp ftm- pelWa , j F I. Bb<A: Lot:o twre T '}1 S UieuJ 5s Ir4e—< Dapelbpp OaMmfvnogj�ul Gael: J.. Ft. ti MerFFl ear(aFlppa: 67,' FI. TrR+wlap: R.r'pr SRCawI: Fe seoee aewe paac // n.®FI. crar loop[ Well: 13New ❑ Upgrade Gerawore[ wnorsalawc Oaano nel.e.n Inn: R Ft r} ps Cw fi bon iPna1R. A. R ck TaMI Da: GW b: �k151`i FL TaMI aeeorgonarec O© 0 Meanal: g�Q DrRr. ora sumwale Laa: n , tie Fjer4 uA , art Dau Lso,ea —111- all Y.": saxIAIwwC.wK TANK GPM FI. iL SEPARATION DISTANCES 10 Septic ❑ Holding 0 S.T.EP. ❑ Otber. To From Septic Tank Absorption Field Litt Station Holding Tank Irate Sewer Line �/ �J _X1,4,1/1 Ara/ TA, ^,M l� Gal. W« a.�t I..X), '�. S wle,r: 57t!C aA.e.ra Cw.V.ln.nu: swwce Wa1w �00 LIFT STATION La Lbw D„ Faneaop CU 76 Mp.wc' k H/ h C~1 OW1 ani , gown Aunt/ MYwe ElamclaiipaowrpertonaC ty Rar : BENCHMARK Looaan micnmFbw: O r /' O 1" 0141 V I AlW..IY VN.Um O r n 100 FL 1n OFF 17074 E,pl• Rivw toep ROW,2N Inspections performed by: $ a ates: 16 ly-mf �.:. r. -f' l ROBERT C. COWAN �4, Development Services DepartmentApproval �'C'* CE -8801 �y Reviewed and approved by: Al. emit� Date: 7 PERMIT NO. SW040184 PACE 2 OF 3 Municipalit of Anchorage DEPARTMENT OF HEATH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Te�l'ephone 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT S, BLOCK 5, RIVER VIEW ESTATES P.I.D. No. 050-792-22 \� LOT 12 LOT 11 14 � I U � / CRAV1; DRIVEWAY �� CO2 C MT2 —100' WELL RADIUS DOUBLE CLEANOUT -\,&T r A Pi^ c^Z CO Z MTI DV 01 IIJ EXISTING 1000 FCO GALLON SEPTIC TANK N LOT 7 °Gs�° " IWA' R.QO/US SCALE: 1' - 40' I ;ate` ROBERT C COWAN / �'- 4 PERMIT NO. SW040184 PACE 3 OF 3 Municipalit of Anchorage DEPARTMENT OF HEATH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 8, BLOCK 5, RIVER VIEW ESTATES P.I.D. No. 050-792-22 A I B DV 58.5 82.5 CO i 80.0 116.5' MT1 80.5 117.0 CO2 81.5 9 7. 5 MT2 81.5 99.0 C01=94.0' CO2=91.1' FINAL GRADE C01=137.2' SR CO2=87.2' MT1=130.9 N. T. S MT2=81.0' EOEr�q +. 1 r NO WATER FOUND M 74.4' B.O.H. ROBERT C. COWAN� ' �l `mac\• CE - 8801 �`r � l���.. , ...✓`ALV= Municipality of Anchorage Page I o11_ DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 0 Anchorage, Alaska 99519-6650 • Telephone: 3434744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SLk19'107-23 PID Number: 050-792 -Z7; Name: ZACFO ' Wastewater System: IR New O Upgrade DIF.a6 S Address:520 GLA4FL BA GRi:w}B A.IcLt 'hso� ABSORPTION FIELD kv,Deep Phone: No. of aedrooms: s Trench O Shallow Trench O Bed O Mound O Other LEGAL DESCRIPTION soli Rating: I .� Total Depth from original grade: GPD/$ F Lot: Block:Subdivision: Depth to pipe bottom limWilmer grade Gravel depth berropth pipe S IrJER�I1EwJ EST. SI F Ft. Township: Range: Section: FIII added above originalgnde: Gravel length: 'j 38 OI — 1, Ft. Ft. WELL: I�NBW ❑Upgrade Gravel width: 5 Number Ditlannlines:belweanlines:Ft Ft. Classlllcatlon (Private, A,B,C): total Depth: Cased To: Total absorption area: Pipe material: Arran �-Ho3w P a 140 FL 3L-5 FL .F Driller. " � ea"iJAal ( AIIII&LIJEUS DateD illed: 97 Static Water Level. & rt. Installer. Eco L1LLAVATIN6 Date Installed: q -13-411 Yield: Pump Set at: Coding Haight Above Ground: TANK 3 GPM U•k. Ft. Zl+ FL SEPARATION DISTANCES Is septic 0Holding OS.T.E.P. To Septic Absorption Lm moldhgkmrtnte Manufacturer. Aae Capacity In gallons: 1000 From Tank rum Station Tank Sewer LMue viail&V Welt Ill± /yr�lf — — �I+ Material: STeI-L. Number Of Compartments: 2. Surf88e1 r — — — LIFT STATION Water top + too LotSize Line S$I+ _%'4- — '-' In gallons: Manufacturer. Foundation al bet ^ �•, —� 'Pump on" level at: "Pump oft' High water alarm at: CurtainIW tiaalE Pump Make6 Electrical Inspections performed by: Drain Remarks: AaOASEc Te gE00bpc BENCH MARK Unallon and Description: 'nor of Cow O polir B Assumed Elevation; 100.0 Ft E 4�qF �ghit Sj j •9 Inspections performed b HRINO Dates: Ist 1'I�-tt p y17M i� < 9111114 River Loop R . �• 2nd 1 -13 - 91 g&& River, Al11ske"S" 3rd I -IC -41 / r \ ROSERT c COWAN ; �e�o,1 CE -8601 Department of Heal .and Human ervices approval �t�+' \=C . Reviewed and approved by: Date: 72013 (Rw. 9/111) MOA 25 PERMIT NO. SW970223 PACE 2 OF 2 Municipalityof Anchorage DEPARTMENT OF HEATH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone, 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 8. BLOCK 5. RIVERVIEW ESTATES P.I.D. NO. 050-792-22 GRAVEL DRIVE NEW TRENCH ALT. SITE CO2 \ 0 ow \\ \\ Cr TH \\n \\ J ST %> J \ 3 fC0 NEW 1000 CAL. goJg6 SEPTIC TANK A B WELL FCO 10.5 .5 STI 46.5 72.5 ST2 52.5 77.5 DBL1 55.0 79.5 SCALZ V • 40• DBL2 56.0 80.5 COI 65.5 98.0 CO2 73.0 84.0 COt - 93.1' CO2 - 91.8' Cot STI 92.4 5f2 FINAL CRADE MT1 CO2 !N C 6 A .r Gid ' •''e �•9y r NEW 87. ' 1000 CAL Cot a 87.8' SR SEPTIC 87.7' CO2 - 87.4' _ _ • TANK �� A� f� ROBERT C. COWAN ��Q «•8801 f�� MTI - 82.4' g. NO RATER FOUND `i• 78.4 B.O.H. JAN - 2 2- 9 8 T H U 1 0: 3 9 P 0 1 .. ...... 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SEWERS WATEn LME%TENSK" .SEWER s WATER INSPECTION ENCRIEENNOsiums "REPORTS WELLNSPECTPON S FLOW TEST SIZE PLANS SOIL TEST Pe1COLA110N ZEST STRUCTURALS MCNANICAL INSPECTIONS ONSITE msmwwn OISPOSALSVSTELI OE"I Date: /0 -a -S—`77_7_ Municipality of Anchorage DEPARTMENT OF BEALTB AND HUMAN SERVICES 025 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 REFERENCE: ZO-T pl ISL TOBEITT C. COWAN, P.E. nOBERTA. SFIAFER PE. CIVIL ENOINEEnS (907)694-2979 FAX(907)694.1211 RECEIVED OCT 27 1997 Municipality of Anchorage Dept. Health & Human Services The septic inspections for the referenced property were performed on 9-/ 9 and q -O- 7 . Prior to submitting the On-site Wastewater Disposal System nd/or Well Inspection Report we are waiting for the sHryey to be completed. -11 If we may be of further service please contact us. Sincerely, �2 Robert C. be t Cowan P.E. , I 17034 NORTH EAGLE RNER LOOP • SUITE 204 • EAGLE TIIVER ALASKA 99577 IN 11G Date: 1��� 71 RODERT C. COWAN. P.E. RODERTA. SHAFER, P.E. CMLENGINEERS (907)694.2979 FAX(907)694.1211 14K,NAIRIiDIt,Y RECEIVED AI'P,IOJK9 SEP 16 1997 Municipality of Anchorage Municipality of Anchorage SEWER&WATEn DEPARTMENT OF HEALTH AND HUMAN SERVICES Dept. Health &Human Services ►WNEXIENSKM 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 SEWER & WATER INSPECTICN GoT So QtacK 5� RzTrERL�Ew Gsr s/J REFERENCE: ENCINEERINO9IUDIE3 NMREORTS The septic ins a tions for t e referenced property were 9.71-71,?7 9 7,S Prior to submitting performed on and . the On-site Wastewater Disposal System and/or Well Inspection Report we are waiting for the Fmtno�r�.� to be ION LELOWTEST� completed. & If we may be of further service please contact us. SITEp,A„S 'Sincerely, II0ADOESX'✓1���� Robert C. Cowan, P.E. SOILTESI PERCOLATION TEST STRUCTURAL& &KCNAMCAL INSPECTIONS ONSITE WASTEWATER DSPOS481'STEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER. ALASKA 99577 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 6 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Issued: Jun 11, 2004 Expiration Date: Jun 11, 2005 Permit Number: SW040184 Parcel ID: 050-792-22 Legal Description:*, RIVER VIEW ESTATES BLK 5 LT 8 e Design Engineer: 0003 S & S Engineering Site Address: 007411 WILDWATER CIR Owner Name: Sheri Hutchinson Lot Size: 40027 SO. FT. Owner Address: 520 GLACIER BAY CIRCLE UNIT B Total Bedrooms: 3 Permit Bedrooms: 3 ANCHORAGE. AK 99508-2579 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 dosed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By. Date: 61 1 11 Issued By. rTl I r�t� Date: _t'Al�tl_ Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci. anchorage. ak.us (907)343-7904 -ON-SITE SEWERIWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. ) O - 7 efZ - ZZ Permit Number SW Property owners) Stie I I �% IG�'t rnSDi'1 Day phone O RZ%- X759 Mailing address (1) Ittl k/i lid w 1- �1 Mailing address (2) 1a��er L /// 1 T Zip Code 12577 Legal description (Lot, Block & Sub'd.) O / � gloek �• PryP.ly ew T 5t 4T1e-S Legal description (Section, Township & Range) Lot Size Yo, d a % -Acre Number of Bedrooms 3 THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for Single Family Dwelling and is in accordance with applicable Municipal Codes. S & S ENGINEERING � ���{17034 Eagle River Loop Road No. 204 ��'Q�"_/%�� 7 rar Aladca 44577 (Signature of property owner or authorized agent) Permit Fees: Date of Payment: Receipt Number: (Rev. 12100) q co. ° (o f / o lo'/ O s- 3 5-C 3 /I -sly, weiver Fees: 7 r- Date of Payment: Receipt Number: S 3 S 6 3 N L �'$V 201 V4 S& June 10, 2004 ROBERT C. COWAN, P.E. CML ENGINEERS (907)694-2979 FAX(907)694.1211 HEALTMALKNOR" MUNICIPALITY OF ANCHORAGE AP"WALS Development Services Department P.O. Box 196650 Anchorage, AK 99519 SEWER& WATER MANEXTENSIONS REFERENCE: Lot 8, Block 5, Riverview Estates Subdivision SEWER WATER It is requested that you issue a permit to install a new drainfield upgrade to serve the 96PEMION existing three bedroom dwelling on the referenced property. A test hole was excavated and a percolation test performed. The approximate location of ENGRNEERPNOSTUMS the test hole is located on the attached site plan. At the time of excavation 5/21/97, no ANO REPORTS water was found. After monitoring, ground water was not found. We do not anticipate any adverse effects on neighboring wells, septic systems, reserve WEU NNSPEOTIC N areas or drainage patterns by the installation of the proposed septic system. The & FLOW TEST construction of this system will not prevent any future development on any of the adjacent properties. UTE PLANS If you require additional information, please contact us. Sincerely, ' ROAD DESNGN Robert C. Cowart, P 8O1'TEST RCC/bjj Enclosure PERCOLATION TEST STRUCTURAL& MCNANCAL S6PECTIONB ONSITE WASTEWATER QSPOSALSYSTELL DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER ALASKA 99577 1" = 50' 0 y m E>1E DESIGN SITE—PLAN O � A N cn c0 !� �L OCn 'M ro��v >. ZO�rr, 0 rrlM-0 Cr °'Oo CN C WILDWATER % CIRCLE L �= 17 0 1-3 n v c CA r 0 '� W r 0 �a -P- (A CN 1� ----- NO O O N • A O n m O off' 4 A r,. Ln CO Cr r 0 '� W r 0 �a -P- (A CN 1� ----- NO O O N • U/ C" m o r,. Ln CO Cr °'Oo CN 1�1 O C) 17 L', A LV l�J * 0 a (� M Z D 0 JJ ~~ OCy Vl ti Dcp n � O n r,. 1�1 A LV l�J von aAmo Z D JJ ~~ OCy Vl ti Dcp <.v, O '✓1 T XO u A v o =Nn Z O O .�Municipality of Anchorage !\i / DEPARTMENT OF HEALTH 8 HUMAN SERVICES e 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST COWAN p, RO!(RT G fOWAN P•rot cons F55 PERFORMED FOR:yLAA M Z,teFOS DATE PERFORMED'' 1// LEGAL DESCRIPTION: 07 O SLDCk, S Township, Range, Section: C L e xvezJS'6 Lj FZr. 1 �J 2 V 3 01 4 rl 6 to L-kL,,0-r SILT 7 e 8 9 U / 10 11 0 12- 13- 14- 15- 16-- 17- 18- 19 213141516 171619 20 WAS GROUND WATER ENCOUNTERED? IF YES. AT WHAT DEPTH? ge;th to Water Atler Monitoring? _lc_ N1 , ■■.■...■■■ ' .■■.■■■■■■ ■■.■..■.■■ ■■.■■■■■■■ so I I Ll ' PERCOLATION RATE (minuievmiich) PERC HOLE DIAMETER TEST RUN BETWEEN � FT AND - , FT COMMENTS 1;9 S ENGINEERING PERFORMED BY: ZrgeeMY FcsseQ II re,LwpRT Ja SHAT THI$ITESJ WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINE94612 �IWOONgjl\ B93£7 DATE: Y04 / 1, 72-008 (Rev. 4x85) Date Grost Time Net Time Depth to Water Net Drop LFteading 3 .• Ir14 11,4 A. I ' ., a ,• 01 IM 1% 11ja Is 15 1n .. yJVq0 11sk ., � I r 1 O 1. •• I w so I I Ll ' PERCOLATION RATE (minuievmiich) PERC HOLE DIAMETER TEST RUN BETWEEN � FT AND - , FT COMMENTS 1;9 S ENGINEERING PERFORMED BY: ZrgeeMY FcsseQ II re,LwpRT Ja SHAT THI$ITESJ WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINE94612 �IWOONgjl\ B93£7 DATE: Y04 / 1, 72-008 (Rev. 4x85) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 ^L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW970223 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:ZARFOSS DIANE OWNER ADDRESS:520 GLACIER BAY CIRCLE #B ANCHORAGE, ALASKA 99508 PARCEL ID:05079222 LEGAL DESCRIPTION: RIVER VIEW ESTATES BLK 5 LT 8 LOT SIZE: 40026 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 2.Om Ll'. &I) q- \vc�1 PAGE 1 OF 1 DATE ISSUED: 7/29/97 EXPIRATION DATE: 7/29/98 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 DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: DATE: ISSUED BY: 'LtL(ll DATE :- 2 / 7 July 11, 1997 WEALTHAUTHORITV APPROVALS ROBERT C. COWAN. P.E. ROBERTA. SHAFER, P.E. CIVIL ENGINEERS (907)694-2979 FAX(907)694-1211 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 �NSbNS Anchorage, AK. 99519 L REFERENCE: Lot 8, Block 5, Riverview Estates Subdivision SEWER& WATER NSPECTION Request you issue a permit to drill a well and install a septic system to serve the proposed three bedroom house on the referenced property. ENGINEERING STUDIES A test hole was excavated and percolation test performed. The approximate location of the M10 REPORTS test hole is located on the attached site plan. The monitoring tube within the test hole has been checked and found to be dry. WELLINSPECTION &PLowTEST This property has enough area for a future septic upgrade which can be seen on the attached site plan. SITE PLANS We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic system. FOADDESIGN There are no points of contamination within the proposed well radius which can be seen on the attached site plan If you require additional information, please contact us. SOILTEST Sincerely, PERCOLATION TEST / --X'/A. Robert C. Cowan, P.E. RCClm STRUCTURAL& MECHANICAL Enclosure INSPECTIONS ONSITE WASTEWATER DISPOSALSrSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER, ALASKA 99577 1" = 60' SITE -PLAN DESIGN SCALE WNtI�`�AVIW C VN "O O Al, m [rJ �rom m CZ is II ^� /�m�°"— "' J 0 o — -- W ILDIYATER CIRCf r. 9 n y o m• NO A"z• o � A 0 ry v 6_ IN L x s 0 w�pedo�a N i° ; p�Sp n 04 � 5-10 z 11 rl ►110 1- H Z �1 11 Z [�l s -moi>nN NFn D fly 11 /0-15% �+In�m*c �� m P p o�O Z->i>umir�iN I �xM 5-10% OL _.at. AWE b y vu-'im Kni V 6 m- CyOoyy ci �O� Z r SDK AN ZoM m CCOrZ i 41En ' �-0.'O.� Imilos�K = ti f J� NO y •O tail On Ivo �o 9>ZO Zn r^ �n F o .4 10 s to m IC ch to s n v OJ v C �3•ny 0y -10 O r _� 0� �< -1 o ; r ooyy z wfi 7, n m Cc = foc+ aWOoo FALLING in OD a v Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 (� SOILS LOG — PERCOLATION TEST PERFORMED FOR: VlAMM GiIQF05 DATE LEGAL DESCRIPTION: 1 or O &OCX 5 Township, Range, Section: 1 / 2- 3- 4- 5- 6- 7 3 a56 7 s 9 � / 1D it 0' 12 13 /r 14 u 15 / 16 71819 17- 18- 19 20 C; L 1?rv0PjM uJ F5r, a V�0.0. WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water After Monitoring? *M111 G COWAN ■■■■■■■■■■ ' ■■■■.■■■.■ Reading Date Gross Time Net Time Depth to Water Net Drop PW - 0AK f •x-1*7 1 .. 1t 1:15 s •• •' .. :4 a/• .. .q.. of 144 .. ov My•• 'r •e G . •ll t. 7 of 1:y .e $7 •' 4z r .• t o is •• t �• la/ •t G'y'' a v" PERCOON LATIRATE 1 (mmutevmcn) PERC HOLE DIAMETER S� TEST RUN BETWEEN FT AND 5 6/7 FT COMMENTS -� _ITeFea1Y F S & 5 ENGINEERING PERFORMED BY: - 057@lc� I� TIFYIHAT THIg TES WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINEgMILIFRblii.(AIMh& MU DATE: TUi � 9 7 72-008 (Rev. 4/8.5) t t�tUt� I C I�HL I T'r' iC?F r=�haCF-+�Fs:Rr�E � V DEPARTMENT HEALTH AND ENVIRONMEFJTAL ?OTECTIGPJ JI 825 'L' STREET, ANCHORAGE, AJ:. 99501 ( �// raP 264-4720 WELL Huta ON—� I TE 5 E4JEFR F}ERM I T PERHIT NO. C £30587 ) APPLICANT LYON= CONST PO BOX 1913 0945993 LOCATION LEGAL L 8 B 5 RIVERVIEW EST. LOT SIZE 30000 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TREPJCH MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING CSO FT/BR)= 125 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: L7EFTH= LENGTH= 47 GRHk'EL C?EFJTH= 4 THE LENGTH DIMENSION IS THE LENGTH CIN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GP.OUND AND THE BOTTOM OF THE EXCAVATION CIN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION CIN FEET). RE:QU I REO �EF''T I C THNK- � I zE= 1 C-10 GHLLONS PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DUPING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER. OF RESIDENCES THAT THE I -JELL WILL SERVE. --- TW G C :2 7 I t+1SF''EC:T I QN'S HRE REG!U I AEC] --- BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A I -JELL 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. MINIMUM DISTANCE FROM A PRIVATE I -JELL 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 THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER. REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. t�ER11 I T E}SF" I RES} DECEMJ= ER :3:1. 1.S_G2: 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 IPJ ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SEI4EP SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. SIGNED APPLMANT LtVAKS CONST ISSUED BY��C-------------DATE�l_��� V4.0 MUNICIPALITY OF ANCHORAGE \i DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street. Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERFORMED LEGAL )N: 1—O✓ V �/`-Je R,co Lo .-I 197- SOILS LOG (((❑��- PERCOLATION TEST L,5 1 - - 2 3 4 :5.,z -r y 5s ,O y SAE d6ti 5 �e W.'r74 �6 Gt 6 l 7 9 ' 10 D J �•� WAS GROUNDWATER S 11 ENCOUNTERED? OL P 12 IF YES, AT WHAT DEPTH? 13- 14- 15- 16- 17- 3 bi it PLAN 20t_j PERCOLATION RATE ' ` (minutestinch) TEST RUN BETWEEN FT AND FT /z,5 Fr, ja;c B�nl2oor-r PERFORMED 72-006 (6/79) IED M Gross Net Depth to Net tnReading Date Time Time Water Drop 1617 a4 NO?il^c 8 18- 19 19 20t_j PERCOLATION RATE ' ` (minutestinch) TEST RUN BETWEEN FT AND FT /z,5 Fr, ja;c B�nl2oor-r PERFORMED 72-006 (6/79) IED M Gross Net Depth to Net tnReading Date Time Time Water Drop .f J 20t_j PERCOLATION RATE ' ` (minutestinch) TEST RUN BETWEEN FT AND FT /z,5 Fr, ja;c B�nl2oor-r PERFORMED 72-006 (6/79) IED M Municipality of Anchorage u PAGE BLI�O -� Development Services Department Building Safety Division .. On -Site Water and Wastewater Program 4700 Elmore Road sA E,, P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 050-792-22 COSA #_ Expiration Date: 7/2- 1. GENERAL INFORMATION Complete legal description RIVER VIEW ESTATES BLOCK 5 LOT 8 Location (site address) 7411 WILDWATER CIR., EAGLE RIVER AK 99577 Current Property owner(s) IAN IVES Day Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 7411 WILDWATER CIR.. 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 Individual Water Storage Community Class Well Public Water System Day phone Day TYPE OF WASTEWATER DISPOSAL: ® Individual On-site ❑ Individual Holding Tank ❑ Community On-site ❑ Public Sewer E 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 sample results. (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 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 868-3792 Address 20441 PTARMIGAN BLVD., EAGLE RIVER AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 02/16/2012 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 fife 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 occupants or can ArcTerra guarantee that no unseen encroachments, deficiencies or discrepancies exist. i 5. DSD SIGNATURE Approved for 3 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By - Original Certificate Date: (Rev. 11105) Municipality of Anchorage • '� Development Services Department Building Safety Division On -Site Water and Wastewater Program s ^ E 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: RIVER VIEW ESTATES BLOCK 5, LOT 8 Parcel ID: 050.792-22 A. WELL DATA Well type PRIVATE If A, B, or C provide P WSID # Well Log (Y/N) Y Date completed 8/1997 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 160 ft. Date of test Static water level Well production Cased to 36 ft. (Into Bedrock) Casing height (above ground) 24 in. FROM WELL LOG WATER SAMPLE RESULTS: 8/1997 ft. 9 - p.m - AT INSPECTION 2/7/2012 Coliform NEG colonies/100mL Nitrate ND mg/L Arsenic: ND mg/I Date of sample: 2/7x2 Collected by: ArcTerra B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 9/12/199 Tank size 1000 gal. ft. Number of Compartments 2 Cleanouts (YIN) Y Foundation cleanout (YIN)Y Depression over tank (y/N) N High water alarm (Y/N) N Date of pumping 712 Pumper yRs C. ABSORPTION FIELD DATA Date installed 0114/04 Soil rating (g.p.d./flz or efbdrm) 0.8 System type Deep Trench Length 50 ft. Width 3 ft. Gravel below pipe 6 ft. Total depth 13.5 ft. (Measured 2/7112) Eff. absorption area 600 ftz Monitoring tube Y Date of adequacy test 2/7/2012 Depression over field N Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 36 in. Water added 570 gal. New depth 52.5 in. Elapsed Time: 1170 min. Final fluid depth 36.6 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date --- D. LIFTSTATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at _in. High water alarm level at in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAift station on lot 100'+ Absorption field on lot 100'+ Public sewer main 751+ Sewer/septic service line 251+ Animal containment areas 50'+ On adjacent lots 1001+ On adjacent lots 1001+ Public sewer manhole/cleanout 100'+ Holding tank 100'+ Manure/animal excrete storage areas loo'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 51+ Property line 51+ Absorption field 51+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 1001+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 101+ Building foundation 10'+ Water main 101+ Water Service line 101+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ 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 de review of Municipal records that the above systems are in jil" 1 conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name KENNETH M. DUFFUS Date 2/16/2012jl COSA Fee $490.00 Date of Payment��I Jo� Receipt Number 0�3 (Rev. 11/05) Waiver Fee $ 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.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL .-f FOR A SINGLE FAMILY DWELLING Parcel I.D. �J` D' 'f��"o� COSA# r7 tggiD Expiration Date: 11-6-07- 1. 1-6-O.7 1. GENERAL INFORMATION Complete legal description Lot s; Biotic 5; Riverview estates Subdivision Location (site address) 7411 Wddwator Cir. Current Property owner(s) Chris strait Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 2591 South 2310 East St. George, Utah 84790 Rick Jarvis Unless otherwise requested, COSH will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well❑ Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone 435656.1947 Day phone Day phone 276.2761 TYPE OF WASTEWATER DISPOSAL: Individual On-site❑ 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 sample results. (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 seat 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 s a s Engineering Address 15861 S. Birchwood Loop pd. jak, A!<r99 7 Engineer's Printed Nt 5. DSD SIGNATURE _AZ Approved for 3 bedrooms. Disapproved. Phone 694-2979` Date / O A •.,9 0- SWAM tv.. 14974 Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report Nitrate Advisory Other By: ��1 zy if Original Certificate Date: 3 — 6r; —Q7 V (R• . 11M) 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 CHECKLIST Legal Description: LOT P3LOUC S 1 ?—\U62.Vtt%W EST ParcelID:DJ;�O - 792-2Z A. WELL DATA Well type EVJ%AAk5,' If A. B, or C provide PWSID # = Well Log (SON) YF -s' Date completed <2 M7 Sanitary seal1�' N) -I&S Wires properly protected J9N)_ Total depthIk—oft. Cased to 5 ft. 'VC0LK Casing height (above ground) IS in. se FROM WELL LOG AT INSPECTION Date of test ��' 7/2%.07 Static water level 3� ft. 3 1 ft. Well production �j. t7 g.p.m. 4j. y g.p.m. WATER SAMPLE RESULTS: p( Coliform J,�f_colonies/100 mL Nitrate Q&& 54ng/L Other bacteria i(J colonies/100 mL Arsenic: _.kb ug/L date of sample: I•` u'l Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/MaterialSE4T1 r�crF Lam_ Date installed i / (2 7 Tank size _Jcya gal. Number of Compartments Cleanouts (b/N) IY66 Foundation cleanout 6YN) g_C Depression over tank (Yo ,yam_ High water alarm (Yoye Date of pumping 0 Pumper ,Q ` 5 C. ABSORPTION FIELD DATA Date installed 6liq JOY Soil rating E d./ r r ft=/bdrm) System type DEEP T?1 EPC* Length SO k. Width 3 ft. Gravel below pipe (_ft. Total depth 2_5 ft. Eft. absorption area 4aLft2 Monitoring tube Depression over field -wL Date of adequacy test — Results as Fail) PA 5-5 For 3 bedrooms Fluid depth in absorption field before lest 6_ in. Water added gal. New depth in. Elapsed Time: kv min. Final fluid depth ly In. Absorption rate >= i56 4 g.p.d. Any rejuvenation treatment (past 12 mo.) (y&& type) N9 If yes, give date �� D. LIFT STATION Date installed A A Size in gallons "Pump on' level at _ in. "Pump off" Datum ycles tested E. SEPARAV06N DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100 'J - Absorption field on lot loo `- Public sewer main _n4.14 Sewer /septic service line 2 S r 'f Animal containment areas SG '4 - High water alarm level at Meets alarm & circuit requirements? On adjacent lots too' On adjacent lots 10 o'i- Public sewer manhole/cleanout IJ14 Holding tank 1140 Manure/animal excrete storage areas too SEPARATION DISTANCES FROM SEPTICM"kH*NG TANK ON LOT TO: Building foundation r Property line 5 L Absorption field 5' 1 Water main A/A Water service line 10 /�- Surface water too ` L —r Wells on adjacent lots 100 ' `= SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'.1 Building foundation I� Water main '114 r Water Service tine 0 J Surface water 106 '1 Driveway, parking/vehicle storage to L Curtain drain Aawr k ypµlnl Wells on adjacent lots 10V'1 F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have dr review of Municipal re conformance with MOA Engineer's Printed Name Dale COSA Fee $ q 30 Date of Payment S - /- 0 % Receipt Number (Rev. 11/05) h field inspections and above system& are A Waiver Fee $ Date of Payment Receipt Number A. *400 iep4 in. 5M SGS ReLN Client Name Project Name/N Client Sample ID histris PWSID Sample Remarks: 1073551001 S R S Engineering L8,115, Rivervicw Est L8, D5, Riverview Est Drinking Natcr All Datmalmes are Alaska Standard Time Printed DateMme 07/312007 14:04 Collected Date/time 07/192007 12:00 Received Datdrime 07/192007 13:33 Technical Director Stephen C. Ede Allowable Prep Analysis pew Results PQL Units Method ContainerlD Limits Date Date Init Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 C (<10) 0724/07 0728/07 M11 Waters Department Total Nitratc/Nitritc-N 0.252 0.100 mg/L SM20 4500NO3-F D (<10) 0720/07 JDS Microbiology Laboratory Total Coliform 0 col/100mL SM209222B A (<I) 07/19/07 SDP Municipality of Anchorage Development Services Department Building Safety Division _ On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel l.D.OsO -"792 — �X HAA#-- — 0 40 29q s• Expiration Date: i' 0 -- G - O J�A GENERAL INFORMATION Complete legal description Lot 8: Block 5: Riverview Estates Location (site address oidirections) 7411 wildwa er Cir. Earle River, AK 99577 Current Property owner(s) Sheri Hutchinson Day phone 694-6958 Mailing address same Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. /Aem, 7 [7/01 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well a 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 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 sample results. (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(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm S b S Engineering Phone 694-2979 Address _17034 N. Eagle River Loop Ste. 204 Eagle Engineer's Printed Name Robert C. Cowan River, AK 99577 Date 64;-9/0y [*. 5. DSD SIGNATURE Ar \ ROBERT G COWAN f4,t c, CE .8801 Approved for bedrooms. Disapproved. tti ...... Conditional approval for bedrooms, with the following stipulations: Additional Comments Jam: ON-SITE Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other By: 61.� Original Certificate Date: (Rw. 01103) Municipality of Anchorage Development Services Department Building Safety Division On-SRe Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519.6650 www.ci.anchomge.ak.us (907) 3437904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LOT f4 j I -L0C K 'S� ; IGIVn -d I Q CST Parcel ID: d �;P ` 7 97 -Yr- A. 7Y A. WELL DATA S I-� Well type /, If A, B, or C provide PWSID #= Well Log (Y/N) Date completed c /`1 Sanitary seal (YM) Wires properly protected (YIN) ~/ Total depth -LLO ft. Cased to t?eort oc.K Casing height (above ground) In. FROM WELL LOG AT INSPECTION Date of test I ojq 4 14'} '} Static water level 41.4 i 7 ft. Well production 3e0 g.p.m. —1. 4 g.p.m. WATER SAMPLE RESULTS: Coliform 'tom colonies/100 ml. Nitrate ©r 1 mg.A. Other bacteria Q colonies/100 ml. Arsenic: mg./I. Date of sample: 1 1 )n4 Collected by: €iJG rate7Z int B. SEPTICIHOL-OM TANK DATA Tank Type/Material r Date installed Tank size 't 00<) gal Number of Compartments Z Cleanouts (YIN) Foundation cleanout (Y/N) _% Depression over tank (Y/N) _L�_ High water alarm (YIN) IJ Date of pumping� 104 Pumper C. ABSORPTION FIELD DATA Date installed *l*—I#* Soil rating (g.p.d.e or fe/bdrm) _� System type Length 9 0 ft. Width 3 ft. Gravel below pipe R. Total depth 10_ ft. ER. absorption area .&Kft' Monitoring tube Depression over fieldJ, Date of adequacy test "67,1 I,1 Zde ass/Fall) For 3 bedrooms Fluid depth in absorption field before test Water added_ gal. depth_ in. Elapsed Time: _ min. Final fluid in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y If give date D. UFT STATION Date installed ^� R 'Pump on' level at in. Datum E. SEPARATION DISTANCES Size in gallons 'Pump ofr level at _ in. Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: Manhole/Access (Y/N) High water alarm level at Meats alarm Ii circuit requirements? Septic tank/lift.statiew on lot / h C 'a On adjacent lots ren Absorption field on lot 1 t^( r On adjacent lots / r t? ' 4 - Public sewer main A Public sewer manhole/cleanout 4 1A Sewer/septic service line 2 S + Holding tank N AA SEPARATION DISTANCES FROM SEPTIC/HGW*N&TANK ON LOT TO: i Building foundation 5 a- Water main )-J A- � Wells on adjacent lots 1 0n �» Property line 5 * Absorption field 1 J. Water service line 10 '+- Surface water 1 O 0 '+- SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line (� �+ Building foundation _ i n '� Water main A t Water Service line i7 4- Surface water CSC' 14 Driveway. parking/vehide storage oQ + Curtain drain IJ ert e— 1 ;nl v w) Wells on adjacent lots (tx a - 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 HAA guidelines guidelines m effect on this date. Engineer's Printed Name [f/Od'e.,&T C. cowyr.r Date d'. / a. q /n y HAA Fee $ H 3 0 Y Waiver Fee $ Date of Payment c o Y Date of Payment Receipt Number Receipt Number (Rev. tvot) ROGM C. COWAN / �. CE -MI ASBUILT k ,h ell v V JpU1 i o d o� w 70 1t bE I HEREBY CERTIFY -THAT I HAVE SURVEYED THE SCALEI ,,,, FOLLOWING DESCRIBED PROPERTY=++� OF At' oC.f DATE,,!Q� ......•.•,93'x` AND THAT NO ENCROACHMENTSrEXIST EXCEPT AS 6���g/ r''� '•,� 1 INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY GRIDS •••� ••••.•. • ••• * _ EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI-•, 0°°.,° w°n z.ws a VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB! / �'• t5-esle� ANY DATA HEREON BE USED FOR CONSTRUCTION /oz-7� ��•,� OFFENCE LINES, OR FOR ESTABLISHING BOUND= DRAWN hitt s6xtat����" ARY LINES. Off �*nw�Y•�