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HomeMy WebLinkAboutEAGLE RIVER VALLEY RANCHETTES LT 17DEogle River Vail Y Ranchettes Lot Z7D #050- 222-13 ,1\GV VJIVG/IVB Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP221058 PID Number: 050-222-13 Dwelling: A Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 9 Upgrade Name Matthew and Gail Laver SORPTION FIELD Elp Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 18547 Man O War Rd ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 D/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from origina ade Gravel depth beneath pipe Ft. Subdivision Block Lot EAGLE RIVER VALLEY RANCHETTES LT 17D Fill added above original gradeel Ft. length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Dis ce between lines Ft. SEPARATION DISTANCES To Septic I Absorption I Lift Station � Holding Sewer Total absorption area Number of trenches Dist. between chesFrom Tank Field Tank Line Ft2 Well >100'I NA I >100' I NA NA TANK ❑ Septic ❑e S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage tank Capacity 1500 Gal. Surface Water >100' NA I >1 00' NA Material steel/epoxy Number of compartments 2 Lot Line >10' NA I >10' NA NA Foundation . . > 10' I NA. I > 10' { NA 1 LIFT STATION Manufacturer __ _r__ Capacity I t Remarks A anchorage tank 1500 Gal. Alarm location inside house Electrical installed by reused old panel PIPE MATERIAL House to tank 3034 Tank to 3034 drainfield Installer J Rs Drainfield CO/MT 3034 Inspector Curtis Townsend BENCH MARK (Assumed elevation) ft Inspdection 15' 4/11/2022 4/12/2022 Location and description 3'd 4/16/2CC3 2nd 411 bottom of siding near point B ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date�'�5�?)� J L. Tumsend . •.�\;"`� Septic S step A pproved � � Date "20 c�fl • <. ���®. . • •.' h` Note: this approval does not include well permit requirements. ,1\GV VJIVG/IVB 1 THIS PROPERTY AND SURROUNDING PROPERTIES ARE / SERVED B, 4 PUBLIC WATER SYSTEM AND THER[ ARE / NO WELLS V0Tn|N 200. | � VACANT L4ND| | - ------ ------ |-----' -----' ------ ------ ------ ------| /0f 17A | {Df 17A | 10' UTILITY EASEMENT ' ------ -----' ----------- ------ ------ -----' --r/--- o / �] 3 BEDROOM HOME EXIST IN 24' x 35' x | 5' EFFqCTIVE DEPT* / BED -�NT | NEIGHBORING SEPTIC IS > PROPERTY LINE |0f 1 7/` |Of 16C __________ - - - - - - - - - - SCOPE OF WORK l� PLACED NEW 1.508 GALLON TWO-COMPARTMENT STEEL STEP TANK A MINIMUM OF 10' AWAY MAN O WAR RD FROM HOUSE FOUNDATION AND TIED INTO EXISTING ABSORPTION SYSTEM. TANK WAS PROVIDED WITH A MINIMUM 20^ DIA RISER SERVING THE FIRST COMPARTMENT. PRESSURE PIPE IS l 1/2^ DIAMETER PVC. 2. ALL CONSTRUCTION WAS IN ACCORDANCE WITH ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65� ----------- T ----------------------------- T ----------- |Of 8A I |Of ��� / |Of 7� | Lot `^^� Lot ' ' ` { | Record Drowi^gPrepared for Matthew and Gail Laver 18547 Man 0War Road Eagle River, Alaska qq577 EAGLE RIVER VALLEY RANCHETTES LOT 17D OGP221058 [- r\LL/ / /VA [/VG//VEER/N[, LLC ( . 4/16/2022 19162 muum /mm xUAU CLT CHUGIAK, ALASKA 99567 SCALE: (907) 406-10581=30 Pla 3 SHEET 2OF3 MUNICIPALITY OF ANCHORAGE On-Site Water & Wastewater Program PO Box 1 96650 4700 Elmore Road Anchorage, Alaska99519-6650 Phone: (907) 343-7904 Fax (907) 343-7997 http ://www.muni.org/onsite On-Site Wastewater Permit Number: OSP221058 Work Type: SepticTank Upgrade Tax Code Number: 05022213000 Disposal System Permit Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: 312312022 .3t23t2023 17955 ? Site LegalAddress: EAGLE RIVER VALLEY RANCHETTES LT 17D G:0054 Site Mailing Address: 18547 MAN O WAR RD, Eagle River Owner: LAVER MATTHEW M Design Engineer: EKLUTNA ENGINEERING, LLC* This permit is for the construction of: n Disposal Field M Septic Tank fl Holding Tank fl Privy ! Private Well E Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343.7904 (2417). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Date: Date: ePirfIrnerrt ON-SITE SEPTICM(ELL PERMIT APPLICATION Parcel I.D. 050-222-13 Property owner(s) LAVER MATTHEW & GAIL Day phone Mailing address 18547 Man O War Rd Eagle River AK 99577 Site address 18547 Man O War Rd Eagle River AK 99577 Legal description (Sub'd., Block & Lot) EAGLE RIVER VALLEY RANCHETTES LT 17D Legal description (Township, Range & Section) Lot Size 17,955 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (N all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) 0 Septic Tank El Upgrade x pg (w/wo ADU) Holding Tank El Renewal ❑ Renewal (D) ❑ Privy ❑ Multiple Dwellings ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable MurNcipal Codes. � I (/—, / (,/, '1 � �7 (Signature of property owner or authorized a ent) Permit/Rush Fees: $Z2 5 Waiver Fees: Date of Payment: 3%I� �d 2.9 Date of Payment: Receipt Number: 6-L Receipt Number: Permit No. 05P9:? f 05 y Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\FormsUient Forms\Permit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221058, Rebecca Carroll, 03/23/22 vACANI_!4\D Lot 17 A THrs pRopERTy AND suRR NG pRoptRTrts ARt I SERVED By A puBLrc wAT srEN/ AND tHlnt nRt I NO WILLS WITHIN 200,. WATER LINE IS SHOWN AS I AppRoxtMATE. vERrFy LocATotN PRIoR To IcONSrRUCroN i Lot 1 64 Lot 7C <1% SLOPE | _': l:: \/V- w- -w10, UTILIry EASEMENT \ OL BED EXISTIN 24'x36 x DTPTHCTIVE ---> NEIGHBORING SEPTIC IS > 1O' FRON/ PROPERTY LINE MAN WAR RD SCOPE OF WORK1. PLACE NEW 1,500 GALLON TWO-CON/PARTMENT STEEL STEP TANK A MINIMUM OF iO' AWAY FRON/ HOUSE FOUNDATION AND TII INTO EXISTING ABSORPTION SYSTEM. TANK IS TO BT PROVIDTD WITH A N/INIIVUIV 20" DIA RISTR SERVING THt FIRST COIVPARTMENT. PRESSURE PIPE IS REPORTED TO BE 1 1 /2'' DIAMETER PVC.2. ALL CONSIRUCTION TO BE IN ACCORDANCT WITH ALL RIQUIREMENTS SPICIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15 55 AND 15.65. Lot 8A Lot Lot 7A ---T88 | I I Septic Design Prepored for Matthew and Gail Laver 18547 Man O War Road Eagle River, Alaska 99577 EAGLE RIVER VALLEY RANCHETTES LOT 17D osP221058 EKLUTNA ING/NTIR/NG, LLC 19162 IvIOUNTAIN ROAD CHUGIAK, ATASKA 99567 (e07) 406- 1 OsB DATE: 312212022 DRAWN: CLT SCALE: 1" = 30' PID:050-222-13 SHEET 1 OF 2 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221058, Rebecca Carroll, 03/23/22 -, \J] l-n -z_z_<I Lr-i I LLU 99.4 Z. LIJ () )<z_r {=r- \- Z- L.I.J -lr) )<z_ls:l- \-/ 90.9 INVERT OF TXISTING 125 PROPOSTD 1 50 +0,, B ELOW GRADT IN N/AY GAL TAN K GAL TANK IXISTNG 1,250 GALLON STEEL TANK IS BURIED 3,6,. THE TOP OF ANY NEW STEP TI DEPTH AS THE EXISTING. THE I' REQUIRE 2,, OF INSULATION GROUNDWATER WAS MEASURED JUNE AND WAS STABLE AT 40, ACCORDING TO A LETTER FROM SERVICES DATED JUNE 10, 198' GROUNDWATER IS REPORTED TC TANK. TWO-CON/PARTMENT STEP .NK WILL BT AT THE SAME ]EW SIEP TANK WILL IN THE N/ONTH OF MAY AND BELOW GRADE. THIS IS EAGLT RIVIR ENGINEERING / ) BE 3,, ABOVE TOP OF Septic Design Prepored for Matthew and Gail Laver 18547 Man O War Road Eagle River, Alaska 99577 EAGLE RIVER VALLEY RANCHETTES LOT 17D osP221058 EKLUTNA TNGINTIR/NG, LLC 19162 MOUNTAIN ROAD CI_]UGIAK, ALASKA 99567 (e07) 406 1 058 DATE: 312212022 DRAWN: CLT SCALE: 1" = 5' PID: 050-222-13 SHEET 2 OF 2 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221058, Rebecca Carroll, 03/23/22 ~ MUNICIPALIT, Y OF ANCHORAGE ' ' ' DI~TMENT OF HEALTH AND HUMAN SER~S Environmental Health Division 0 825 "L" Street, Anchorage, Alaska 99502, Telephone 2~-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name A~d~ ~ SEPTIC ABSORPTION Lot LEGAL ~ESCRIPTION LOT LINE ~5- Township. Range, Section T/~ ~/~ ~ ' ~ driveway, wa~e, bodies, etc.) ~ SEPTIC ~ HOLDING TYPE OF SYSTEM '~epth ,o pipe bottom from T~ta, depth from o,,gmal grade II "dladdedaboveorlgmalorade G,aveldepth~ne.thplpe ' ,,~ II l~'Y Graver lenglh Gravel w~dth Number o, lines SOl, .atln~0 Pipe material .~ WELLS ~ PRIVATE ~ OTHER (Iden~fv) . ' Municipal and Sim guidelines in dfect on this date: ~ ~ Health Depa.ment Approval: Date' ~ - 22 72-013 {3/85) MU~II C :[ PAL_ I TY OF ANCHORAGE DEPARTMENT OF HE:ALTH AND ENVIRONMENTAL PROTECTION 825 L STREET, ANCHORAGE~ AK 99501 264.'-4720 [}b~---S ][ TE SEIcJER F'ERM I T PERMIT NO: DATE ISSUED: 8, U. _ = UPGRADE 01/02/87 APF'J_ ICAN T: JAMES KULtEZAW ADDRESS: P. 0. EO^ 1966 - EAGLE RIVER, AK 9957'7 CONTAC'I PHONE: ~_77 ~ol- ..... /~:..1 LEGAL DESCRIP: ~¢~iJ~I~IO~ 'EAGLE RIVER.VALLEY R LO~:, 17D . SECf~ON: ~" ' TOW~BH~P. T14N RANGE= RI'¢ LOT SIZE= 1,9~,~ (SQ.PT. OR ACRES) certify_ that: 1. I am £amiliaf· with the requirements for' on-site sewers and wells as set forth by the Municzpa].itv o~ Ar;chef-age (MOA) and the State of Alaska. 22. I will install the system zn accordance with all MOA cedes and regulations, and in comol~ance with the design cr].terza o£ this permit. :5. I will adhere to ail MOA and State o¢ Alaska requirements fop the set. back distances from any existing well, wastewaten disposal system or pubizc sewerage system on this mr any adjacent or nearby lot. IF A LIFT STAT10N IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES~ ]"HEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS WILL NO'¥ BE APPROVED WI]'HOOT AN ELECTRICAl_ INSPECTION REPORT; AND (..3) THE ELECTRICAL WORK MUST BE DONE BY ~ LICENSED ELECTRICIAN. APF'LICAN'F: JAMES KUI_IEZAW ~ ISSUED BY DEPAF(Ti~IENT . HEALTH AND ENVIRONMEI'4TAL .~OTECTION .. ~... L ,:>TREE F., ANCHORAbE.~ Al'::: 99501 ,=64 4.7,: ,~ PERMIT NO: DATE[ 1,,SJED. S6 ')430 UF E RADE 1~:,/1~./86 APPL. I CANT: ADDRESS: CONT~qCT F'HONE: LEGAL. DESCR I F:': LOT StZE~ JAMES KULtEZAN P. 0,. BOX ].966 E:AGLE RIVER, Al<: 99577 :2.77-5551 '-'-'72 ;[ SUBDIVISION: EAGLE; R. VALLEY RANC LOT: 17D SEC"f ION: 7 '[OWNSHIF': T lz1.1'4 RANGE: R 1W 17955 (SQ. FT. OR ACRES) BLOCK: I c:eptify tha-L: ].. t am fam:i.i~.a'p with the requirements For' on-site sewers and wells as set. forth by the Muriicipality oF Anchor, age (MOA) and the State of Alaska. I will 'install the ~ysi:.em in acc~r-danc:e with all MOA codes and regulations, and ir'~ compliance with the design critepia of this pepmit, I will adheF, e to all MOA and State of Alaska requipements for' the set back distances fr'om any exist:ing well, wastewatep disposal system or public sewer'a.',,~e system on 'Lh~s or' any adjac, ent or near'by lot. :I:F:' A [...IF"]' ST'A"FION IS INSTALLED IN AN AREA COVE:RED BY M[IA BLJILI)ING CODES., THEN (J] AN E]JECTRICAL PERMIT AND INSPECTION MU!:]T BE OBTAINED; (2) AS-BUlL. TS WIL. L. NC)T BE' APPROVE:D WITHE)UT AN ELECTRICAL INSPECTION REF'ORT; AND (J) TNE ELECTF;:ICAL WOFd< IdUS]' BE DONE BY A L. tCENSED ELE:CTF:~IC',EAN. CAN, . SSLIED BY DA'I"E: JAMES I....,JL I E.,~AN LEGAL: A. GENERAL EAGLE RIVER ENGINEERING SERVIOES P.O. 80X 775294 EAGLE RIVER, ALASKA 99577 SPEOIFIOATIONS FOR ON-SITE SEPTIC SYSTEM Lot 17D Eagle River Valley Ranohettee The well and septic plan are for a single family residence only,, 2. The drawln9 and or site plan shall be a part of thie speoifieation~ 5. All materials and workmanship shall meet the requirements of the Anchorage Department of Health and State D.E.C. 4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer. 5. All excavations and depths are advisory and are to be verified or modified in the field by the contractor to meet MOA, D.E.O require- ments. 6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi-family wells~ 7~ The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. 8, It is always recommended that a surveyor locate the nearest lot line position and the location of any easements. DRAINFIELD The bottom of the septic gravel is to be at ~/' above the water table level. A sandy Gravel it run material can be used to bring up grade after topsoil is excavated. 2. The bottom of the bed shall be level, plus or minus 1.5". The total depth of the bed excavation is not to exceed 2' at any point. The sewer line is to replace the existing sewer" line that leads to the existing trench. 5. The bed gravel is to be covered with typar or fabric material. 6. Soil Or' combination of soil and extruded beard insulation to a depth of 4~ cc equivalent is to be placed over the drainf~eld. 7~ The area over the trench is to be finish graded to prevent poeding of surface water runoff. 8. The septic tank and leaohfield must; no~ be closer than LO0 feet to any existing private well, 150' to any Class "C' well, or 200 feet to any community well. C. LIFT STATION 1. The lift station is to be a pre-approved combination septic tank and lift station~ 1250 gallon. 2. Lift station is to be wired by a licensed electrician to MOA Electrical Code requirements for outdoor use. 5. The existing tank may be retained. 4. The alarm and controls are to be mounted inside residence. RECOMMENDED LEACHFIELD DIMENSIONS TOTAL DEPTH= .0~ GRAVEL DEPTH= BED LENGTH= 56' BED WIDTH= 24~ Absorption Area = 864 Soil Rating = i90 Bedroom Capacity z 5 Septic tank size= 1000 + lift station This septic system will require~e×oavation and~replaeement of the topsoil layer with a soil rated GP by engineer. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOl LS LOG PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: go SLOPE 1 / 3 DATE PERFORMED: SITE PLAN 10 11 12 13- 14- 15- 16- 17- 18- 19- 2O COMMENTS WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Gross Net Depth to I Net Reading Date Time Time Water Drop PERCOLATION RATE ! ~' ~? ' ? ~/'"'"~-- {minutes/inch) TEST RUN BETWEEN / ~;~,- FT AND ;~ , FT PERFORMED BY: Eagle River Engineering Services ~. U. Box 773294 Eagle River, AK 99577 694-5195 CERT F ED BY:~ DATE: ///'~ ~/~' EAGLE RIVER ENGINEERING SEF =.S P.O, Box 773294 EAGLE RIVER, ALASKA 99577 Phone 694-5195 TO ]VjR. STEVE MORRIS, CIVIL ~GINEER, ON-SITE SVC. MUNICIPALITY OF ANCHORAGE P.O. BOX 196650 ANCHORAGE~ AI~a~SKA qq~19 LETTER Date JUNE 10, 1987 Subject EAGLE Ri~ERVALLEY PJINCHET±'ES: LOT iTD, WATER MONITOPd]~, DEAR MR. MORRIS: WE RAVE DONE .WATER MONITORING ON EAGLE RIVER VALLEY RANCH~±TES: LOT lTD, IN MAY AND JUNE OF !987. ~ WATER IS STABLE AT ~0" BELOW GROUND SURFACE WE ARE P~ING INSTALLATION OF THE SEPTIC S~S~ FOR ~ ~ OF JUNE 15, 1987. I JUST WANTED TO SUPPLY THIS INFOEMATION TO YOU BOR YOUR FILES. [] Please reply [~' No reply necessary Municipality of Anchorage D~EPAR3~I~/IENT OF HEALTH & ENVIRONMENTAL PROTECTION POUCH 6-650 ANCHORAGE, ALASKA 99501 INSPECTION REPORT ON ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL NAME ¢,~11¢,',~-~ ~'~, LOCATION ~7,~,~,,,,~ o t~.~-.,'~,,,~ ~'2,,~;~ LEGAL DESCRIPTIONA /7~ E- ~, PERMITNU~BER SEPTIC TANK MANUFACTURER CAPACITY IN GALS. MATERIAL #OF COMPARTMENTS INSIDE DIMENSIOT LENGTI~ /WIDTH DEPTH SEEPAGE SYSTEM [] TILE DRAINFIELD NUI~SER OF LINES LENGTH EACH TOTAL LENGTt I DISTANCE BETWEEN LINES ITRENCH WIDTH DEPTHS: ' ',:'; TILE T.(~.GRADE [ FILL.BELOW TILE FILL ABOVE TILE .[~EEPAGE TRENCH OR [] PiT W, DT" LENGT. '? '/' ~.~ [] LOG C5~8 FILL MATERIAL DEPTH , [] RINGS- DIA. DEPTR TOTAL EFF'EcTIVE ABSORPTIDN AREA; SQ. F'I' DISTANCES . F R0"'~,~M ~.SEPTIC SEEPAGE SEWER TANK SYSTEM LINE CESSPOOL WELL TION SYSTEM DIAGRAM CLASSIFICATION ,INSTALLER WELL t DEPTN ' PIPE MATERIAL REMARKS o.,,-,:;/¢ o 72-012 {9/77); Lo-~/7 D BLOCK: __ i"IUN T C- 1. PFIL 1' T'Y C~F I-qNC:HClt~. FI~31S DEPARTMI OF HEALTH AND EN¥IRONMEI'iiIIL 811I~'L' STREET, ANCHORAGE., I]t'-,I--S ! T'E SEI4ER F'ISRI-,,1T T APPLICANT FALKINS ENTER. DX 68..~ E. R. LOCATION MAN OF WAR -- LEGAL LT. i?-D E. R. VALLEY RA~,tC:HETTES~ LOT SIZE :1~955 SQUARE F?~' TYPE OF SOIL ABSORBTION SYSTEM IS: TRENL;H MAX'IMUM NUMBER OF BEDROOMS = g SOIL RATING (SQ FT, THE REQUIRED SIZE OF THE SOIL HB_,URFTION SYSTEM IS: E:'EF'-FH= 8 LENGT'H= 50- GRR%~EL DEF"¥H= 5 ]'HE LENGTH DIMENSION IS ]'HE LENGTH (IN FEET> OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCN OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND 8ND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GR8YEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). RE~U lr RE[~ SEPT' I C: 'TI-:INI< $ I ZE= 1~300 C:i PI L L ii l'-,I S F'F-liS~(i:-]GE PLF:INI' OF"T1.1DN PACKAGE PLANT MAY BE INSTALLED AT THE PERMITTEE~S OPTION SUBJECT TO THE FOLLOWING CONDITIONS: 1. EITHER A CLASS I OR II NSF ~PPROVED PLANT HAY BE INSTALLED. 2. A CONTINUOUS MAINTENANCE AGREEHENT IS REQUIRED. AGREEMENT ABSORPTION tF A MAINTENANCEsoiL· IS NOT KEPT CURRENT YOU MAY BE REQUIRED TO ENLARGE THE - SYSTEM AND/OR YOU MAY BE SOBJECT TO PROSECUTION. TI-lO (2) I NSPECTIO~S ARE RE~-.UI BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEEl FOR ~ PRIVATE WELL OR 200 FEET FOR 8 PUBLIC WELL OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F"ERI"'I 1. T E:-'~::P I I:~."ES DECEMBER :gl.. 1977 ISSUED I CERTIFY THAT l: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS BS SET FORTH BY THE MUNICIPRLITY OF ANCHORAGE. 2: I WILL INSTRLL THE SYSTEM IN 8CCORDANCE WITH THE CODES. ~: I UNDERSTAND THRT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS. · ....... . HPPLICHNT CHLKINS ENTER. JNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch 6-650, Anchorage, Alaska 99502 276-222~ SOILS LOG - PERCOLATION TEST [] SOILS LOG [] PERCOLATION TEST PERFORMED FOR: DATE PERFORMED; SLOPE -- j 1 2 3- 4- 5 6 7 8 9 10 11 12 13 14 15 16- 17- 18- 19- 20- WASENCOUNTERED? GROUND WATER SITE PLAN IF YES, AT WHAT DEPTH? Reading Date Gross Net Depth to Net Time Time Water Drop TEST RUN BETWEEN ,'~ FT AND ('~ FT 72-008 (7/76} MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 050-222-13 1. GENERAL INFORMATION Expiration Date: 3 - 1.5— - Z, C9 Z -V Complete legal description EAGLE RIVER VALLEY RANCHETTES LT 17D Location (site address) 18547 Man O War Rd Eagle River AK 99577 Current property owner(s) LAVER MATTHEW & GAIL Day phone Mailing address 18547 Man O War Rd Eagle River AK 99577 Real estate agent Wendy Eringnurst 2. TYPE OF DWELLING: El Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone 907.854.1236 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ❑ Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System I] Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 550 Date of Payment qi 1S a o Q 2 Receipt Number 0 5q I y D COSA # 05G2Z I I `� Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Eklutna Engineering, LLC Phone 907.406.1058 Address 19162 Mountain Rd Chugiak AK 99567 Engineer's Printed Name Curtis Townsend, PE Date Z 6. DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for Disapproved Conditional approval for bedrooms cJ � G'L•a �� bedrooms, with the following stipulations: ,<<ll(t�tttrrr�,. J))))))1)h� B -.- - (44dOriginal Certificate Date: /_\1 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet Legal Description: EAGLE RIVER VALLEY RANCHETTES LT 17D If more than 1 septic system on lot: COSA Checklist # of A. WELL DA ❑ Well log is filedwith ite (or attached) Date drilled Total depth ft Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Comments B. TANK DATA Age of tank(s) f1 years Tank type/material step steel/epoxy Measured operating fluid level in aseptic tank FOR Standpipes/foundation cleanout per record drawing Date of pumping INSTALLED APR 2022 D. ABSORPTION FIELD DATA Which system tested (date installed) 1987 ❑ ALL standpipes present per record drawing Total measured depth from grade 3.6 ft (max) Measured depth to pipe invert from grade 3.1 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective NO Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: bed insulated with 2" of insulation COSA Checklist yellow sheet Parcel ID: 050-222-13 Structure served by this system Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative itrate mg/L ❑ Nitrate less than MRL (ND) Arsenl ug/L ❑ Arsenic less than MRL (ND) Collected by Date of Sample C. LIFT STATION ❑ Required maintenance completed Age of lift station `1 years Lift station material STEEL Jepoxy Comments: INSTALLED APR 2022 Adequacy test date 3/15/2022 Results ,[�✓ Pass For 3 bedrooms Fluid depth prior to test 0 in Water added 450 gal New depth 0.5 in Elapsed time 1440 min Final fluid depth 0 in Absorption rate ' 450 gpd Any rejuvenation treatment (past 12 months) no If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' E✓ Yes Community Sewer Manhole/Cleanout > 100' ft r Yes if No ft Cf✓ Yes if No ft Neighboring Tank > 100' ED Yes if No ft Private Sewer/Septic Line > 25' F71 Yes if No ft Absorption Field on Lot > 100' (/✓ Yes if No ft Holding Tank > 100' ❑✓ Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' M Yes if No ft 0✓ Yes if No ft _ If septic tank is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' �✓ Yes if No ft M Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' E✓ Yes if No ft Surface Water > 100' Yes if No ft Property Line > 5' ✓Q Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' �✓ Yes if No ft Private Wells > 100' F/ -J Yes if No ft Water Main > 10' ft Yes if No ft Community Wells > 200' ❑✓ Yes if No ft Water Service Line > 10' Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' EJ Yes if No ft If absorption field is under driveway comment below Property Line > 10' 0 Yes if No ft Wells on Adjacent Lots: Water Main > 10' Yes if No ft Private Wells > 100' Q Yes if No ft Water Service Line > 10' Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100' Q Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION l certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformaannngp� h MOA COSA guidelines in effect on this date.„ - ku COSA Checklist yellow sheet rem mow.. OF Ak ,0."' 49 TH* SHANE A. HOLT G LS -6914 0` O °fessiona\ -�o �.,'J(J ,'.nTC: fPLH O i� nEAS r!"AlT RE(�A7DlftE 4VfL.L R.4^ii/.SA MAN 0 WAR ROAD AS-BUILTSURVEY j " =20' NO CORNERS SET THIS DATE i HEREBY CERTIFY THA T I NAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY _0T170 E40LER/VERV.9LLEYFA"-ii:iiETT=SS;B THE INFORMATION HEREON I S FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY ANCHORAGE RECORDING DISTRICT, ALASKA. AND THAT THE CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS: AND IS VISIBLE IMPROVEMENTS SITUATED T r+EREON.ARE WITHIN NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES, THE PROPERTY LINES Ai'iD NO V`SIBLE ENCROACHMENTS EASEMENTS OF RECORD OR OTHER RIGHTS OF WAY, OR ANY ENTITY NOT ON THE RECORD PLAT EXIST OTHER THAN NOTED, ARE NOT SHOWN HEREON. UNLESS NOTED. DATED AT A,YCHORAGE,ALASKA THIS I' Tti DAY OF NOTE FENCELINES THATMA Y APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE ''i'R# 2022 PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. ANY PAVING SHOWiN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW A,NDiOR ICE. survey ordered by: HOt TZ Afd,'SUF CrIMG 9?p°GHCVGR pRIV£ �INGYOfratle: K 99507 22d-8616 MUNICIPAUTY OF ANCHORAGE ~ ~-~0 ~' ~'' *~/'~ DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY H86-1325 264-4744 Application Date GENERAL INFORMATION /MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 17D Eagle River Valley Ranchettes Subdivision (T14N R1W Section 7) Location (address or directions) (b) (c) (d) Property Owner James Kuliezan Telephone:Home 694-3966 Business 277-5551 X721 Mailing Address PO Box 1966 Eagle River, Alaska 99577 Alaska Mutual Bank Lending Institution Telephone Mailing Address Pouch 4-9003, Anchorage, Alaska Real Estate Company and Agent Address 274-3561 99509 Telephone Mail the HAA to the fotlowina address: or; Check here [~, if hold for pick up. List contact person and day phone number below. Eaqle River Enqineerinq Services (e) TYPE OF RESIDENCE Single-Family r~x Number of Bedrooms three (3) WATER SUPPLY .' / / =. Individual Well [] Community [~x Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4, "SEWAGE DISPOSAL Onsite~:x Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72.025 IRev 8/861 Fron~ 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 an d 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 Servi~hone 694-5195 Address PO Box 773294, Eagle River, Alaska 99577 Date Engineer's Seal This department has received written confirmation from the engineer regarding the Conditional Approval of December 12, 1986. The corrections have been accomplished and an inspection has been completed by the above engineer. The subject property meets with Municipal standards and is now approved. Approved forthree (3) bedrooms by Approved XXXXXXXXXXXoisapproved Conditional Terms of Conditional Approval June 29, 1987 CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approva~ certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska, The D HHS does this as a courtesy to purchasers of homes and their lendin g 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. Page 2 of 2 72-025 IRev 8/861 Back MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL ~--~\~ OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date November 4, 1986 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 17D Eagle River Valley Ranchettes T].4N R}W sec.7 Location (address or directions) ~,~gle River (b) Applicant Name 2Ames ~.~liezan Telephone:Home 694-3966 Business 277-5551#721 . Applicant Address P.O. Box 1966 Eagle River~ Alaska 99577- (c) Applicant is (check one): Lending Institution []; Owner/builder []; Buyer []; Other [] (explain); (d) Lending Institution Alaska Mutual Bank Telephone Address Pouch 4-9003 Anchorage, Alaska 99509 (e) Real Estate Company and Agent , N/A Address (f) 274-3561 Telephone N/A Mail the HAA to the following address: picku~ b,Y engineer TYPE OF RESIDENCE Single-Family[] Multi-Family[] Other Number of Bedrooms 3 WATER SUPPLY Individual Well [] CommunityE'l Public [] Note: If co mm unity well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite [] Public [] Community [] Holding Tank [] Note: If corn munity well system, must have written confirmation from the State Department of Environ mental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11/84) As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Telephone Address ~.~LE R!VER E.~.~!f'!EER!.N~ SE~V!OE~ Date EAGLE RIVER, AK 99577 0. BOX 773294 694-5195 * Requires escrow of funds to replace existing septic system as .per permit application 12/9/86. Approved'fbi' ' 'r ~ bedrooms by Approved Disapproved Conditional Terms of Conditional Ap0roval .~ E' E Date CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work, Page 2 of 2 72-025 (11/84) WELL DATA CO~l~/t~U~/T-y/ ~f~E'Z./ Well Classification ~/4~'5' ~' '~ Well Log Present (Y/N) Date Complete~l Total Depth Cased to Static Water Level Casing Height Above Ground Electri'cal Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results MUNICIPALITY OF ANCHORAGE HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 .~,,V~..al Description: z~/~'/'~ I~A, B,.C, D.E.C. Approved (WN) Yield Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Depression Around .We head (Y/N) ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date Comments B. SEPTIC/HOLDING TANK DATA Size Date installed Standpipes(Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) separation Distances from Septic/Holding Tank: T(~ Water-Supply Well /'~'-,~--~ Air-tight Caps (Y/N) No. of Compartments Foundation Cleanout (Y/N) ./~ Date Last Pumped /~' ; for Temporary Holding Tank Permit (Y/N) To Building Foundation ,/~'~ To Property Line To Water Main/Service Line Course r~/~ Comments To Disposal Field ~ To Stream, Pond, Lake, or Major Drainage Page 1 of 2 72-026(11/84) /'A[Ji,~i¢,'.~.ur Or ANCH'C)RAGE DEFT. OF HEALTH & ENVIRONMENTAL PROTECTION ' DEem RECEIVED C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata //-~'"' Type of System Design "-'/~,',/~,~ D~t' " Width of Field ~ "'~" -'" i Depth of Field " .... ,' Gravel Bed Thickness Square Feet of Absorption Area (:~"~ Standpipes Present (Y/N) y Iv Depression 6vet Field (Y/N) /V/ Date of Last Adequacy Test Results of Last Adequacy Test ~~ ~ ~ ~ ~ ~ Separation Distance from Absorption Field: To Water-Supply Well ~¢ / To Prope~y Line Z~ To Building Foundation ~ To Existing or Abandoned System on Lot .~ ; On Adjoining Lots To Water Main/Se~ice Line /~ ~ To Cutbank (if present) -/. To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments ~~ ~;~ ~~ ~ D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at Dimensions - Manhole/Access (Y/N) "Pump Off" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N):, Vent (Y/N) .... . -.. Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have c~ec k~J, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ~~ Date /'~J~,"~' , ~ ~r'~.~,.~ '~.rcr,-,~ o~'~ . Company ~-5. MOANo. ~T~g~ ~Z ~'~ ~ ~. Page 2 of 2 INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR MUNICIPALITY OF ANCHORAGE MUNICIPALI~ OF ANCHOEAGE ) DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPT. OF HEALTH & 825 L Strut - Anchora~, Al~ka 99601 ENVIRONMENTAL , ENVIRONMENTAL SANiTATiON D'WS ON MAR 5 1 1981 Telephone 2~4720 DIRECTIONS: Complete all pa~s o~ page 1. Incomple~ requ~ will not be proc~d. Please allow ten {10) days for proc~sing. 1. PROPERTY OWNER ~ PHONE PR OPE RTY R ESI D E NT (If different f~om above) P H ON E 2. BUYER PHONE MAILING ADDRESS MAILING ADDRESS 4. REAL~OR/AGENT , - ~ I PHONE & 5. LEGAL DESCRIPTIO~ / O--Z'- STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS [] One [] Four I~ SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY ~ Three [] Six [] Other 7. WATER SUPPLY [] INDIVIDUAL* COMMUNITY [] PUBLIC UTILITY 5. SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON-SITE** [] PUBLIC UTI LITY ATTACH WELL LOG. A well log is required for all wells drilled s~nce June 1975. For wells drilled prior to that date, give well depth (attach log.if available.}~ YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACC~IM~ANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.