HomeMy WebLinkAboutGLENN VIEW ESTATES NORTH BLK 1 LT 9Glenn View
Estates North
Biock 1
Lot 9
#051-821-22
• municipality of Anchorage
Development Services Department.._
Building Safety Division
On-Site Water & Wastewater Program, 4700 South Bragaw St.
=°
—�=
"
P.O. Box 196650 Anchorage, AK 99519-6650 SA
www.ci.anchorage.ak.us (907) 343-7904 Page 1
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number. SW030369 PID Number. 051-821-22
"' "
of 3
Name:
LEROY ALDERMAN
Wastewater System: ■ New • Upgrade
Address:
P.O. BOX 45 * CHUGIAK, AK 99567
ABSORPTION FIELD
Phone: No. of Bedrooms:
(907) 688-3403 4
O Deep Trench ■ Shallow Trench O Bed OMound ElOther
LEGAL DESCRIPTION
Soil Rating:
0.6 GPo/sc. rt.
Total Depth from original grad.:
4.5 (MAX) n.
Block: Lot: Subdivision:
1 9 GLEN VIEW ESTATES NORTH
Depth to pips bottom from original grad.:
SEE DWG. R.
Grovel depth beneath pip.:
1.5 Ft
Township: - Range: - Section: -
rID added above original grad.:
SEE DWG. r,.
Gravel length:
158 (2 ® 79+) R
WELL: 0 New 0 Upgrade
Cb..ification
Gravel width:Number
5 R
of ..:
Mohnen
Distance b.f.n Mac:
15+
n'
(Privet.. A.B.C):
wP�R
Total De
rt.
Cased To:
rt.
Total absorption ansa:
1013+
Plps oe bb
D 3034/
F-810
Driller:rS��
so. R.
PVp
Date Drilled:
Static water Level:
PI
Installer:
SOUTH FORK CONSTRUCTION
Dat. Petab.d:
10/6/2003
Tem
GPM
Pump Set At:
n.
Casing Height Above Ground:
rt.
TANK
SEPARATION
DISTANCES
■septic OHolding OS.T.E.P. OOther
To
From
Septic
Tank
Absorption
Field
Lift
Station
Holding
Tank
Public/Private
s.".r LI..
"'mu'nr.
ANCHORAGE TANK
�Pau4 k, gallons:
1250
Well
200'+
200'+
—
—
25'+
Material: STEEL
Number of comportments:
2
Surface Water
100'+
100'+
—
—
—
LIFT STATION
Lot Line
5'+
10'+
—
—
—
Size to gallons:
Yonufaatunr.
Foundation
5'{
10'+
—
—
—
*Pump on' level at
Pump oft' a<
High stater Morns of
Curtain Drain
PumpMaks `
Electrical I*p.ction. Performed by:
NONE KNOWN
Remarks:
BENCH MARK
Location end Description:
TOP OF CMU FOUNDATION ® POINT "B"
Assumed Elevation:
98.08 Ft
ENGINEER'S SEA
v,110
Inspectionsperformed b • AKWWC, INC.
P Y Dates: 1st 10/6/2003
.••I ,-O
��:' 4':
*.:. �Q
2nd 10/6/2003
.
VA
3rd 10/7/2003
ff
QQQ
Development Se ices Department Approval
Reviewed and approved by: Date• /2/? for
�1 �0
Ca 795, s. v*:,
Op°CIp CO'
(Rev. 12/01)
fesston.
DO00000a
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Initial
Permit Number: SW030369
Legal Description: Glenn View Estates North Block 1 Lot 9
Design Engineer: 0041 AK Water & Wastewater Consultant
Owner Name: Leroy Alderman
Owner Address: P.O. Box 45
Chugiak , AK 99567-
1tJx/03 II ,ie))
1 Co u3- q tad
- � JV
lel
Date Issued: Sep 09, 2003
Expiration Date: Sep 08, 2004
Parcel ID: 051-821-22
Site Address: Unknown
Lot Size: 44458 SQ. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of:
❑✓ Disposal Field Q✓ Septic Tank ❑ Holding Tank 0 Privy 0 Private Well 0 Water Storage
All construction must be In accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ).
3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by catling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By: p"1/.s-,rvl
Date. 9/0/01
Issued By:
Date: q/7AT
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. p�7 �— ' \-- 2D Permit Number
Property owner(s) LEROY ALDERMAN Day phone 688-3403
Mailing address (1) P.O. BOX 45 * CHUGIAK. AK
Mailing address (2) Zip Code 99567
GWovy\ Vtu EMa s NOr-A41
Legal description (Lot, Block & Sub d.) LOT 9. BLOCK 1:
Legal description (Section, Township & Range) N/A
Lot Sizeu�
_ ,`i 5 0 _ Acres/Sq.Ft. Number of Bedrooms 4
THIS APPLICATION IS FOR:
Sewer Only a Well Only 0
Sewer and Well 0 Water Storage 0
Sewer Upgrade 0
THIS PROPERTY CONTAINS:
Hot Tub ❑ Jacuzzi
Swimming Pool ❑ Water Softening Unit
Therapy Pool ❑
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.
ALASKA WATER & WASTEWATER CONSULTANTS, INC.
Permit Fees:
Waiver Fees'
Date of Payment: ?I 26- 5 Date of Payment*
Receipt Number: Lk 0711-17 Receipt Number:
ALASKA WATER & WASTEWATER
.na.atsosoairn.:.aseaaask.osswey,a„e,w„aao
CO N S U LTAN TS, INC. ewe..+®..wc.,d....aa.
August 25, 2003
Municipality of Anchorage
Development Service Department
Building Safety Division
On -Site Water & Wastewater Program
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Proposed Septic System for Lot 9, Block 1; Glenview North Subdivision
To whom it may concern:
The proposed 4 bedroom house will be served by a public water system and a private septic
system. We are proposing to install a 1250 gallon septic tank and dual 5 -wide trench type
drainfields. One test hole was excavated on the property by Toben Spurkland and two test holes
were excavated by our firm. The drainfields will be designed around the 30 foot radii of our test
holes. Comments regarding the design are summarized as follows:
1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring,
and the percolation test results. We are proposing to use and averase between the two percolation
rates. It is our opinion that an application rate of 0.6 gallons/day/112 should be used.
2. TRENCH DESIGN:
a. Percolation Rate: 5 & 40 minutes/inch
b. Proposed Application Rate: 0.6 gallons/day/ft2
c. Number of Bedrooms: 4
d. Design Flow: 600 gallons per day
e. Minimum Absorption Area: 1000 ft2
f. Total Depth: 4.5 feet (max.)
g. Effective Depth: 1.5 feet
h. Width: 5 feet
i. Reduction Factor: 0.78
j. Minimum Length: 2 @ 78 feet long. each (156 feet total length)
k Effective absorption area = 100011
3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com
3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic
system.
4. TOPOGRAPHY: The area around the proposed drainfields is relatively flat. In short, there
are no slope concerns.
We are unaware of any adverse impacts this installation would have on adjacent wells or septic
systems. If you have any questions, please contact us at 337-6179. Thank you for your
assistance.
S. erely
effr amess, P.E., M.S.
Pres
NOTE: A site plan drawing, a design drawing, a detail drawing, a soils logs, and a 7 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
Ph: (907) 337-6179 * Fax: (907) 338-3246' Website: akwwc.com
GLENN VIEW NORTH S/D;
LOT 11. BLOCK 1,
•
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GLENN VIEW NORTH S/D;
LOT 10, BLOCK 1.
•
•
•
•
•
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♦
GLENN VIEW NORTH S/D;
LOT 15, BLOCK 1.
GLENN VIEW NORTH S/D;
LOT 14. BLOCK 1.
TOBEN SPURKLAND
TEST HOLE
PROPOSED
4 BEDROOM
HOUSE
•
\
•
ALTERNATE SITE
GLENN VIEW NORTH S/D;
LOT 13, BLOCK 1.
PROPOSED SEPTIC SYSTEM
(SEE DESIGN PACE 2 OF 2)
GLENN VIEW NORTH 5/0;
LOT 2, BLOCK 1,
•
•
•
•
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-----•
45. y
At
.4,.
TH/2
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GLENN VIEW NORTH S/D;
LOT 8. BLOCK 1,
GLENN VIEW NORTH S/D;
LOT 7. BLOCK 1,
NOTE: ALL PROPERTIES
ARE SERVED BY A
PUBLIC WATER SYSTEM
ALASKA WATER 8; WASTEWATER
CONSULTANTS, INC.
5701 F TIMOR ROAD, SUITF 101 • AFCHOPAGF. AK 99507 • PHOPF (907)357.6179 • FAX (907)139-3746
PREPARED FOR
LEROY ALDERMAN
PHONE NUMBER:
(907) 688-3403
DATE:
8/25/2003
DRAWN BY:
C.J.G.
SCALE:
1" = 100'
LEGAL DESCRIPTION:
GLENVIEW NORTH SUBDIVISION; LOT 9, BLOCK 1
PAGE NUMBER:
1 OF 2
TYPE OF WORK:
SITE PLAN FOR PROPOSED SEPTIC SYSTEM
4
A.
.•
NOTE: THE CONTRACTOR SHALL HAVE THE
NORTH LOT UNE FLAGGED BY REGISTERED
LAND SURVEYOR PRIOR TO CONSTRUCTION
PROPOSED DRAINFIELDS. EXCAVATE TWO TRENCHES
THAT ARE 4.5 FEET DEEP MAXIMUM BY 5 FEET WIDE
BY 78 FEET LONG EACH (158 FEET LONG TOTAL).
ADD 1.5 FEET OF CLEAN, WASHED SEWER DRAINROCK.
APPROXIMATE
LOCATION OF KEYBOX
APPROXIMATE LOCATION OF
PROPOSED WATER LINE
ALTERNATE STTE
NEW 1250 GALLON
SEPTIC TANK
INSTALL FOUNDATION
CLEANOUT
TOBEN SPURKLAND
TEST HOLE-�
CO
1
69
NSTALL DOUBLE
CLEANOUTS
PROPOSED
4 BEDROOM
HOUSE
40'+
21 1 I I
1 11 11 1 612
co
NSTALL FLOW
SPLITTER
10' UTTUTY EASEMENT
NORTHWOODS CIRCLE
ALASKA WATER & WASTEWATER
s , F CONSULTANTS, INC.
T4�0R ROM anTF I01 • AN[wnoA,P AK QOM" • F"r*r (007x17 -A170 • FAX (on7)1.•-17,,A
PREPARED FOR:
LEROY ALDERMAN
PHONE NUMBER:
688-3403
DATE:
8/25/2003
DRAWN BY:
C.J.G.
SCALE:
1"=40'
PAGE
NUMBER:
2 OF 2
LEGAL DESCRIPTION:
GLENVIEW NORTH SUBDIVISION; LOT 9, BLOCK 1
TYPE OF WORK
DESIGN OF PROPOSED SEPTIC SYSTEM
0�0
ALASKA WATER & WASTEWATER
CONSULTANTS, INC.
J701 E. TUDOR ROAD. SURE 101 • ANCHORAGE. AX. 00507 • PHONE: (007)337-8179 • FAX: (007)336-3248 • WEBSRE: okrnrc.-.
(SOIL LOG - PERCOLATION TEST
LEGAL DESCRIPTION- GLENVIEW NORTH SUBDIVISION. LOT 9, BLOCK 1
PERFORMED FOR:
DEP
(feet -- ORGANICS
LEROY ALDERMAN
1
5—;
•
•
6-:
10
11
12- j
13 I}
14—
15-
16-
17-
18-
19—
•
,
•
•
•
B.O.H.
SM/ML
W/ SOME
GRAVEL
20
SOILS LOGGED BY:
COMMENTS.
TEST HOLE #1
SOIL CLASSIFICATIONS
o0 `40•0•
FEiriEtRi
Mite
GW
GP
GM
GC
SW
SP
SM
SC
DATE: 8/14/2003
ORG
ML
CL
OL
MH
CH
OH
DEPTH TO
GROUNDWATER
DATE
DRY
8/14/2003
DRY
8/21/2003
.y00
VA
A. •mess:' 41
—7953 • ticP`GOO
.'Fo4
dProfessiolQ .
0
4000��0
}T.S TH�THJjt
+TH#2
NORTHWOODS CIRCLE
-----�� �� SITE PLAN,
1".100'
DATE
READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
8/14/2003
1
2:28
—
6"
—
2
2:58
30
5 1/4"
3/4"
3
2:58
—
6"
—
4
3:28
30
5 1/4"
3/4"
5
3:28
—
6"
—
6
5:58
30
5 1/4"
3/4"
PERCOLATION RATE
TEST RUN BETWEEN 3.5 FT. AND 4.0 FT.
40 (MIN./INCH)
PERC. HOLE DIA.
6 (INCHES)
A FOUR HOUR PRESOAK WAS PERFORMED: • YES ❑ NO
JODY MAUS PERCOLATION TEST PERFORMED BY: JODY MAUS
PERFORMED BY AKWWC, INC. I. JEFFREY A. CARNESS, CERTIFY THAT THIS WM PE FORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 2.5703
ALASKA WATER & WASTEWATER
CONSULTANTS, INC.
3701 E. TUDOR ROAD. SUITE 101 • ANGWRACE. AX. 99607 • PHONE (907)337-6179 + FAX: (907)338-3446 • WEHSRE: ob.c. om
ISOIL LOG — PERCOLATION TESTI
LEGAL DESCRIPTION. GLENVIEW NORTH SUBDMSION; LOT 9, BLOCK 1
PERFORMED FOR:
'rpm
feet== ORGANICS
1
LEROY ALDERMAN
2—Z
3
4-4
•
5—
•
6
SM/ML
SM/ML
W/ SOME
GRAVEL
•
8 ;
9
10-4
11
12—;
•
13-0
14
15-
5-
16-
16-
17-
17-
18-
18-
19—
19—
20
SOILS LOGGED BY:
COMMENTS.
TEST HOLE #2
SOIL CLASSIFICATIONS
rain
lanza
atm
GW
GP
GM
GC
sw
SP
SM
SC
1)
DATE: 8/14/2003
ORG
ML
CL
OL
MH
CH
OH
DEPTH TO
GROUNDWATER
DATE
DRY
8/14/2003
DRY
8/21/2003
o%e
Profes810noao
��D�000��d
•}•TH# 1
*T.S.TH
+TH#2
NORTHWOODS CIRCIE—
SITE PLAN
1"=100'
DATE
READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
8/14/2003
1
2:30
—
6"
—
2
3:00
30
0"
6"
3
3:00
—
6"
—
4
3:30
30
0"
6"
5
3:30
—
6"
—
6
6:00
30
0"
6"
PERCOLATION RATE
TEST RUN BETWEEN
5 (MIN./INCH)
4.0 FT. AND
A FOUR HOUR PRESOAK WAS PERFORMED:
JODY MAUS PERCOLATION TEST PERFORMED BY:
PERC. HOLE DIA.
4.5 FT.
• YES ❑ NO
JODY MAUS
6 (INCHES)
PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WWq,,Ss P RFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDEUNES IN EFFECT ON THIS DATE: S/2-5701
Performed For;
LegalDescnpoon;
Municipality of Anchorage
Development Services Department
Bending Safety Oiviston
On -Site Water and Wastewater Program
4700 South 8ragaw S6
P.O. Box 198650 Anchorage. AK 99519-5650
WV•W.d,anchoraoe.atyus
(907)343-7904
Soils Log - Percolation Test
LENV,ffW Nn TH Date Performed: f %t
Loi KI
GOmmENTS
Slope
WAS GROUND WATER
ENCOUNTEREO1
Township, Range, Section:
NO
s
IF YES. AT WHAT DEPTH? L
Depth to Water After C
Nemtamic
. f
Ore: I1i2Y/oz
Reading
FILL
5 '/z.
b IA -
Dale b 1Z
Date
"P2
'/17/0
Gross Time
SDA•.
Net Time
ve7...._1
3O 3O w -(IN
3 . oc, o
:3o • o
Depth to Water I Ne: 3707% I
9IY/
3y
9°
9p
PERCOLATION RATE 9
M+MefMrnl FERC HOLE DIAMETER
TEST RUN BETWEEN „_ SFT ANO � FT
PERFORMED BY
PERFORMEDrr A� CERTIFY THAT THIS -ES' ;::5
COROANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE
`%r Si
•
•
•
•
Municipality of Anchorag
On -Site Water & Wastewater Program
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPR
Parcel I.D. 051-821 —22
1. GENERAL INFORMATION
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Real Estate Agent
Expiration Date:
GLENN VIEW ESTATES NORTH; BLOCK 1, LOT 9
23501 NORTHWOODS CIRCLE *CHUGIAK, AK
SCOTT & BONNY STARK Day phone 230-3635
23501 NORTHWOODS CIRCLE *CHUGIAK, AK
DONNA ALDERMAN
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS:
4. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class Well
Public Water System
WaiverNariance request for
Received by:
COSA to be released to the eneer, u -ss otherwise requested by the engineer.
N/A
•
4
Day phone
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
Individual Holding tank
Community On-site
Public Sewer
Date: 6/84
•
Distance: —
COSA Fee $ J
Date of Paymentt
Receipt Number CAOL1 / o GI
COSA # 05(-1A0/261
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, t 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
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Engineer's Comments:
In conducting this evaluation, GEG provided an engineering evaluation of the well and/orseptic system in accordance with the
guidelines and regulations established by the Municipality 0!Anchorage and industry practices. The reported results describe the
condition of the systems on the date/sof the evaluation. Separation distances were measured to readily identifiable features.
Hidden defects orencroachments may exist that were not identified during the evaluation.The operational life of all wells and septic
systems depend on a variety of variables including, but not limned to, soil conditions, groundwater levels (that may fluctuate during
the year), qualtyof construction (materials and workmanship), and the water usage of the family utilizing the system's. These
conditions can vary, and am outside the control of GEG. Satisfactory test results do not guarantee future performance of the
system's! therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system.
GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either ofthe
current systems fail. The content of this report is for the sole benefit of the person/party who retained GEG. Reliance upon the
information provided in this report by any other person or party, including but not limited to subsequent property purchasers, isnot
authorized. In shod, GEG disavows any legal dutyto anyone otherthan the personlparlywho paid forthisreport.
6. DSD SIGNATURE
System #1 Approved for 7' bedrooms.
System #2 Approved for bedrooms.
Disapproved.
Conditional approval for
Date
•
•
•
J/rftit
f rn 0 iffrey A. Gayness e 4�i sr
#I S, tv CE -7 53i
le it PROFESS \ kr 4.
bedrooms, with the following stipulations:
By few..
Original Certificate Date: G 1
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:
COSA Checklist
Septic System Advisory
Well Flow Advisory
(Rev. 10112112)
Nitrate Advisory
Arsenic Advisory
Other
11 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: GLENN
A. WELL DATA
Well type
Date completed
Total depth ft
VIEW ESTATES NORTH; BLOCK 1,
LOT 9
PUBLIC
Parcel ID: 051-821-22
If A, B, or C provide PWSID# _ Well Log (YM)
Sanitary seal (WN) _ Wires properly protected (Y/N
Cased to ft. Casing height (abo - round)
ATI CTION
FROM WELL LOG
Date of test
Static water level ft.
Well. production
WATER SAMPLE RES
Coliform colonies/100 ml.
enic: _mug./L.
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC/STEEL
Tank size 1250 gal. Number of Compartments 2
Foundation cleanout (Y/N) YES Depression over tank (YIN) NO
JR'S PUMPING
gpm.
Nitrate mg./L.
Date of sample:
ft.
g.p.m
Date of pumping 5/25/2016
C. ABSORPTION FIELD DATA
Date installed 10/6-7/2003
Length 1335 75 ft.
Total depth *36+ ft Eff. absorption area 1013 ft2
Pumper
Soil rating
Width
m
Collected by:
Date installed
10/6-7/2003
Cleanouts (Y/N) YES
High water alarm (Y/N) N/A
f*BELOW EXISTING GRADE
rft2/bdrm) 0.6
System type SHALLOW TRENCH
5 ft Gravel below pipe 1.5 ft.
Monitoring tube **YES
Date of adequacy test 5/25/2016 Results (Pass/Fail) PASS
c H INC.u£Q Pecow reprEn"r-
Fluid depth in absorption field before test 4_7 in. Water added 1232 gal.
celd
Elapsed Time: 870 min. Final fluid depth 110.7 in
Depression over field NO
For 4 bedrooms
New depth ***14.7 in.
Absorption rate >= 600+ g p d
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date —
TESTED WEST TRENCH ONLY; LIQUID LEVEL MEASUREMENTS WERE TAKEN FROM MT1
(SOUTH END OF TRENCH), EAST TRENCH WAS 100% FULL UPON INSPECTION AND
COULD NOT BE TESTED
**NORTH MT IN WEST TRENCH EXTENDS 22" BELOW INVERT. SOUTH MT IN WEST
TRENCH EXTENDS 15.7" BELOW INVERT.
***ONE(1) INCH BELOW INVERT.
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N)
"Pump on level at In. "Pump off" level at in. High water alarm level at
Datum Cycles tested Meets alarm & ' <• requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot On adjacent lots
Absorption field on lot On adjacent Tots
Public sewer main Public sewer manhole/deanout
Sewer/septi - Mceline
containment areas
Holding tank
Manure/animal excrete storage areas
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 51+
Water main 10'+ Water service line 10'+
Wells on adjacent lots 100'+ PVT & 200'+ PUBLIC
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO:
Property line 101+ Building foundation 10'+ Water main 101+
Water service line 101+ Surface water 1001+ Driveway, parking/vehkfie storage 10'+
Curtain drain NONE KNOWN Wells on adjacent Tots 1001+ PVT & 200'+ PUBLIC
F. COMMENTS
Surface water 100'+
G. ENGINEER'S CERTIFICATION
1 certify that 1 have determined through fled inspections and
review of Municipal records that the above systems ere In
conformance with MOA COSA guidelines in effect on this
date.
Engineer's Printed Name JEFFREY A. GARNESS
Date 5)31 J/h.
(Rev.11/05)
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AUL ILT
I HEREBY CERTIFY THAT I HAVE SURVEYED THE
FOLLOWING DESCRIBED PROPERTY:
a:edr 'Y/s7//Err4JI4TiM later 019. f /
AND ATHAT NO ENCROACHMENTS EXIST EXCEPT AS
INDICATED. IT IS THE RESPONSIBILITY OF THE
OWNER TO DETERMINE THE E ISTENCE OF ANY
EASEMENTS! COVENANTS, OR RESTRICTIONS
WHICH DO NOT APPEAR ON THE RECORDED SUBDI-
VISION PLAT. UNDER NO CIRCUMSTANCES SNDIA.D FB'nt-ere)
ANY DATA HEREON BE USED FOR'CONSTRUCTION
OF FENCE LINES, OR FOR ESTABLISHING BOUND-
ARY LINES. t
SENARO & ASSOCIATES LAND SCR
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Municipality of Anchorage .
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 051-821-22
1. GENERAL INFORMATION
Complete legal description
Es-te-i'es
4
GLEN VIEW NORTH SUBDIVISION; LOT 9, BLOCK 1
HAA# O O 1,2 -5 -
Expiration
Z.5Expiration Date: 14. ` / G - 0 ,-
Location (site address or directions)
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
NORTHWOOD CIRCLE * CHUGIAK, AK 99577
LEROY ALDERMAN
Day phone 223-8100
P.O. BOX 670045 * CHUGIAK, AK 99567
Day phone
Day phone
Unless otherwise requested, HAA 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
•
4
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
Individual Holding tank
Community On-site
Public Sewer
•
0
0
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer
of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or
water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority
Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may
be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid
water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water
system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's
work.
Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $ at, or prior
to closing for the engineering services provided.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, 1 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. 1 further verify that based on the
information obtained from the Municipality of Anchorage files and from my investigation and inspection, the
on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal
and State codes, ordinances, and regulations in effect at the time of installation.
Name of Firm GARNESS ENGINEERING GROUP, Ltd.
Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Engineer's Comments:
In conducting this evaluation, GEG, Ltd. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & 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 right whatsoever.
5. DSD SIGNATURE
Approved for I+ bedrooms.
Disapproved.
Phone 337-6179
Date
4(r 44-
Conditional approval for bedrooms, with the fllowing stipulations:
•ON-SITE • ?i
WATER AND
WASTEWATER
: PROGRAM •
O.••
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
Manitenance Agreements
Supplemental Engineer's Reort
Other
,•. .
C"q-
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Original Certificate Date: /
Municipality of Anchorage
Development. Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
HEALTH AUTH,ORITY.APPROVAL,CHECKLIST
E9� .I
•
SAI LTV
Legal Description: GLEN VIEW NORTH'SUBDIVISION; LOT 9, BLOCK 1 Parcel ID: 051-821-22
• A. WELL DATA �.
B.
n
Well type' If A, B, or C provide'PWSID# Well Log (Y/N)
Date completed Sanitary seal 1(Y/N)'Wires proper y protected (Y/N
Tota depth ft Cased to ft • Casing height (abo = •round)
FROM WELL LOGAT INSPECTION
Date of test
Static water level
Well production
.m.
WATER SAMPLE RES
Coliform colonies/100 ml. Nitrate mg./L.
Date of samp e:
•
enic:
SEPTIC/HOLDING TANK DATA;
Tank Type/Material STEEL/SEPTIC
mg/1
Tank size 1250 gal Number of Compartments _2
Foundation cleanout (Y/N) YES Depression over tank (Y/N)
Date Iof pumping NEW Pumper i'
l .
C. ABSORPTION FIELD DATA
1 •
�� _
Date installed
10/67/2003 Soil rating
ft.
g.p.m.
in.
'Other bacteria colonies/100 ml.
'Collected by:
Date insta led
Cleanouts (Y/N)
NO High waterlalarm (Y/N) N/A
10/6-7/2003
YES
I'BELOW ,FINAL GRADE'
Length (2079')158 TOTAL ft. Width
r ft2/bdrm) 0.6
15.0
Total depth •4A6s daft. Eff. absorption area1013+ ft2
Date adequacy test NEW SYSTEM : Results (Pass/Fail)
Fluid depth in absorption field before test, in: Water ad
Elapsed Time:
System type SHALLOW TRENCH
ft. Gravel below pipe 1.5 ft.
YES
me: min. • • . epth
venation treatment (past 12 mo.) (Y/N, & type)
Depression over field NO
New depth in
in Absorption rate >= g.p.d.
'' =If yes, give date
D. LIFT STATION
Date installed Size in gallons
"Pump on" level at in. "Pump off'
Datu Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot
Absorption field on lot
Public sewer main
p is service line
'Manhole/Ac'
High water alarm level at
Meets alarm & circuit requirements?
PUBLIC WATER
'On adjacent Tots
On adjacent lo
Public sewer manhole/cleanout
Holding tank
in.
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 200'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:...
Property line
101+ Buildingfoundation 101+• Water main 10'+
Water service line
10'+ Surface water 100'+
Curtain drain NONE KNOWN
F. COMMENTS
Wells on adjacent lots 200'+
Driveway, parking/vehicle storage 5'+
G. ENGINEER'S CERTIFICATION
1 certify that 1 have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA HAA guidelines in effect on this date.
Engineer's Printed Name
Date 4 f i 2104,
JEFFREY
f 4 -
JEFFREY A. GARNESS
�s000
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ess•:
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'a ,, fessloc.ate''
ooa��'
HAA Fee $
Date of Payment Li /Pi Ioq
Receipt Number CAO '-1(
(Rev. 12101)
'Waiver Fee $
Date of Payment `
Receipt Number
04/13/04 TUE 08:23 FAX 6896499
VISTA REAL ESTATE ER
LOT 8
LOT 13
LOT 9
44,458 s.f.
SEPTIC CLEANOUTS
N
0
eV
10
N
0
10t1
t0
N
LOT 10
1002
NOtRTHWOODS CIRCLE
1
[•)
PLOT PLAN
/
X04-055
AS BUILT SCALE = 40'GRID _NW1560 Pro)ecl No.
Lang & Associates, inc.
Registered Land Surveyors
www.langsurveyors.com / lnfo®Iangsurveyors.com
11500 Daryl Avenue. Anchorage,
(907) 522-6476 Phone
(907) 522-4625 fax
hereby certify that 1 have surveyed the following described property:
LOT 9. BLOCK 1. GLENN VIEW ESTATES NORTH SUBDIVISION (PLAT 2003-9)
%nchorage Recording District. Alaska, and that the improvements situated thereon are
vithln the property Tines and do not encroach onto the property adjacent thereto. that
to Improvements on the property lying adjacent thereto encroach on the surveyed
premises and That there are no roadways, transmission lines or other visible easements
m said property except as Indicated hereon.
)aced this the 1Z Day of WO -AL S°OtiA�
Alaska
1 Is the responsibility of the owner to determine the existence of any easements,
...___ ...►.�.,� a„ not nnnear on the recorded subdivision plat.
•
, 01 Anchorage,
[2)
Alaska 99515-•3049
—Q40 A L °off
o fp/ 49TH .y.OQO
p � V 0
QO• r, KENNETH G.
•.
0s LS -5202
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