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BEAR VALLEY BLK 2 LT 3
Bear Valley Block 2 Lot 3 #020-431- 16 A If ®1b la MR.— - Municipality R.wm— Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of ON-SITE WASTEWATER INSPECTION REPORT AUG 0 6 2018 Permit Number: OSP191242 PID Number: 020-431-16 Dwelling: 01 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 0 Upgrade Name Robert Whittier ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 9221 Honey Bear Lane ❑ Other Phone Number of Bedrooms Soil Rating Totfrom depth fron grade 3 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gr I depth beneath pipe t. Ft. Subdivision Block Lot Bear Valley 2 3 Fill added above originalgrade Gravel length Ft. Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total abs ion area Number of trenches Dist. between trenches From Tank Field Tank Line Ft2 Ft. Well 93.4. TANK 0 Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Infiltrator Capacity 1060 Gal. Surface Water 100'+ Material Number of compartments Lot Line 5' } NA plastic 2 Foundation 10, 11",LIFT STATION Manufacturer Capacity Remarks Gal. Alarm location Electrical installed by Installer PIPE MATERIAL House to tank 3034. Tank to 3034 drainfield A+ Home Services Drainfield CO/MT3034 Inspector Pannone Engineering Services BENCH MARK (Assumed elevation) 1600.0 ft Inspdectio ase 7/2/19 7/29/19 Location and description 2nd 3`d 4th NE Bottom House Trim ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineers Stamp Conditional Approval: Date����� 49 !H— r 5 e:en R Pannor•e '. `Q E Q 1 ,9 4�® Septic System %�I� Approved ml 4 Date ?15117 V Note: this approval does not include well permit requirements.`���� kmev u0/uz/ 10) CLEAN OUT CLEAN OUT CLEAN OUT m i D o ' CLEAN OUT CLEAN OUT >�CLEAN OUT rn mm N Zm NOTES: RECORD DRAWING DRAWN I ACP SITE PLAN ��-,cnc)0pv �-m l 0 t vooomxm(A aI o -�oZ: rm�m�05 m m C O-4 0 m O Zm�c�o (n 0 Z m m m D C Z r M — 0m AX r ' D yD 0 Z n cm z \� \ o co o Op cn I \ f ( / \ \ \ \� 1 \ \LQ o I a 1 \\ CA '1 \ \ 01 \ \ Io 1 tin \ m 1 \ I 1 \ 1 LSI \ 1 1 z f 1 ! z+> \ 1 >>0n :0m I z = w I D ul \ \ CO - --n �-1 11 NJ mZ 1 \ 01 Ln 'LLS's o \ o cr• cr 15' UTiLIIY EASEMENT I PANNONE ENG SVC LLC REVISIONS DATE P.O. BOX 1807 PALMER. AK X39645 PHONE 907 745-8200 FAX 907 745-8201 /�% BEAR VALLEY B2 .L3 BOB WHITTIER" 9221 HONEY BEAR LANE l�+' ANCHORAGE, AK 99516 OF .. .. .... .n ann CE Sta9Arr `ROFTSA�'� 8/2/2019 SCALE 1 " = 50' � P.I.D. NO -431-16 020RMIT �— O PE NO. OSP191242 O N O \ \ m 1. '�o >1 � FTI \1 \ z \� \ o co o Op cn I \ f ( / \ \ \ \� 1 \ \LQ o I a 1 \\ CA '1 \ \ 01 \ \ Io 1 tin \ m 1 \ I 1 \ 1 LSI \ 1 1 z f 1 ! z+> \ 1 >>0n :0m I z = w I D ul \ \ CO - --n �-1 11 NJ mZ 1 \ 01 Ln 'LLS's o \ o cr• cr 15' UTiLIIY EASEMENT I PANNONE ENG SVC LLC REVISIONS DATE P.O. BOX 1807 PALMER. AK X39645 PHONE 907 745-8200 FAX 907 745-8201 /�% BEAR VALLEY B2 .L3 BOB WHITTIER" 9221 HONEY BEAR LANE l�+' ANCHORAGE, AK 99516 OF .. .. .... .n ann CE Sta9Arr `ROFTSA�'� 8/2/2019 SCALE 1 " = 50' P.I.D. NO -431-16 020RMIT �— PE NO. OSP191242 SHEET OF 2 Nsno Lot 5 v� a I 1 Lot 4 I LOT 3 SCALE: 1 "= 40' `tip' S, az Septic vent (typ) W " Septic tank o ( �, h CP I— o� �� I :D I aeo�� 2.0 OH co �y/2Sf� v3.9 a 3 jNooz U n a°' W090I o Well `� _ '` f- __ ~•- -~Gravel driveway �_ ..___.. -•"-- �- Wood fence O { 10' Utility Easement — — R=� HAY BEgR 047.07 L-264.99 — LINE AS -BUILT OF t .�y�'•° 49th �'fie,........,......f,. A- A Elizabeth L. Walatko ; ,o s�F • , 8036 – LS • •.J� AWr EASEMENTS OF RECORD, OTHER THAN p or'Esslot*- THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. I – dy " BE UNLESS OTHERWISE NOTED JKD, S4, FB 19-4, pg 47-48 0 M 0 0 tri M N N d' 0 O O M4 NO CORNERS SET THIS DATE Lot 2 I hereby certify that I have performed a Mortgagee's inspection of the following described property: LOT 3. BLOCK 2, BEAR VALLEY SUBDIVISION Anchorage Recording Precinct, Alaska, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this 10th day of JULY 2019. FRED WALATKA & ASSOCIATES, L.L.C. 907-248-1666 Engineers and Surveyors r I � I r �J . I I I HAY BEgR 047.07 L-264.99 — LINE AS -BUILT OF t .�y�'•° 49th �'fie,........,......f,. A- A Elizabeth L. Walatko ; ,o s�F • , 8036 – LS • •.J� AWr EASEMENTS OF RECORD, OTHER THAN p or'Esslot*- THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. I – dy " BE UNLESS OTHERWISE NOTED JKD, S4, FB 19-4, pg 47-48 0 M 0 0 tri M N N d' 0 O O M4 NO CORNERS SET THIS DATE Lot 2 I hereby certify that I have performed a Mortgagee's inspection of the following described property: LOT 3. BLOCK 2, BEAR VALLEY SUBDIVISION Anchorage Recording Precinct, Alaska, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this 10th day of JULY 2019. FRED WALATKA & ASSOCIATES, L.L.C. 907-248-1666 Engineers and Surveyors MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP191242 Work Type: SepticTank Upgrade Tax Code Number: 02043116000 Site Legal Address: BEAR VALLEY BLK 2 LT 3 G:3242 Site Mailing Address: 9221 HONEY BEAR LN, Anchorage Owner: WHITTIER ROBERT S JR Design Engineer: PANNONE ENGINEERING SERVICES This permit is for the construction of: ❑ Disposal Field RI Septic Tank ❑ Holding Tank ❑ Privy Effective Date Expiration Date: Lot Size in Sq Ft: Total Bedrooms Department 6/24/2019 6/23/2020 46283 ❑ Private Well ❑ 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 (24/7). 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 Received By:/ Issued By: Date:0149—VI14? Date: b 7 3 Municipality of Anchorage P.O. Box 196650 e 4700 Elmore Road Anchorage, Alaska 99519-6650 ® (907) 343-7904 e Fax (907) 343-7997 http://www.muni.orq/Onsite Development Services Department On -Site Water and Wastewater Section r l)eparrmcnt * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: WR890059 COSA#: Permit#:OSP191242 PID#: 020-431-16 Legal Description: Bear Valley Block 2 Lot 3 Engineer: Pannone Engineering Services Applicant: Robert Whittier Your request for a waiver of the required 100 feet horizontal separation from the septic tank to the private well has been approved. The approved separation distance is 90.0 feet. This waiver is being reissued because the condition has existed since 1983 and well water samples from 2011 showed no coliforms or nitrates. This waiver approval applies to the proposed septic tank only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ............................................... ■ ............................. ■ r Waiver is Granted: X Waiver is not Granted: Date: y Approved by: �l/ v�i�� 6tt'o-0 Name of Reviewer ............................................... ■ ............................. ■ t **** VARIANCE/WAIVER REVIEW **** Ep%inlS 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. 020-431-16 Property owner(s) Robert Whittier Day phone Mailing address 9221 Honey Bear Lane, Anchorage, AK 99516 Site address Same Legal description (Sub'd., Block & Lot) Bear Valley, Block 2, Lot 3 Legal description (Township, Range & Section) Lot Size 46,283 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) ❑X Septic Tank ❑X Upgrade ❑X (w/wo ADU) (D) ❑ Holding Tank ❑ RenewalDuplex ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Septic tank to well Distance: 90 1 certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees:/025— Waiver Fees: Date of Payment: &/a C2 /(!? Date of Payment: Receipt Number: d /A W4 Receipt Number: Permit No. _ 05P191 2q.1 Waiver No. Permit App__ ::...:c Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191242, Rebecca Carroll, 06/24/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191242, Rebecca Carroll, 06/24/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191242, Rebecca Carroll, 06/24/19 Development Services Department Building Safety Division On -Site Water & Wastewater Program *AK 4700 Elmore RoadP.O. Box 196650Mark 8e9ich Anchorage, AK 99507 Mayor www.mumorg/onsite (907)343-7904 Pump Installation Log Well Drilling Permit Number: SW_ Parcel Identification Number: Legal Description 13�U'o 6C z �,t3 Pump Installation Date: Pump Intake Depth Below Top of Well Casing: ZV feet Pump.Manufacturer'sName: RjFb9MCK1rj— Pump Model: ?S'C911 g$/6 Pump Size 31y hp Pitless Adapter Burial Depth: /O feet Pitless Adapter Manufacturer's Name: Date of Issue: erty_Owner Name & Address:_ 6's W14'r IEg 009) 14cm *y fl ei t Rc 14,7fh61tAgtt •OK - - r Pitless Adapter Installer: [Y' Well Disinfected Upon Completion?'Yes ❑ No Method of Disinfection: C MLoJet q ief 1019ULITS Comments: Pump Installer Name: /9✓! C Mt a P �t tt✓l �L Anchorage Well & Rump Service, Inc. 330 East 76h Avenue Anchorage. AK 99518 Fix, 907-243.0742 Attention: The pump installer shall pram pump installation log to the DSD within 30 days of pump installation. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH &ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE NEW �/ 1-1 1 ),c A yr4 A) C1— S-6 I `1'q ?-I ❑ UPGRADE MAILING ADDRESS 0 • __T-_ ^- RNA7 ► ON A L A ITR` ORT ANcH, LEGAL DESCRIPTION A' o -f L A R c 1. E LOCATION GE CLl1(�' K �, ON PONEY BEAK LANE NO. OF BEDROOMS vY DISTANCE TO: Well " ��(� i Absorption area IC) Dwelling mgr PERMIT NO. H Z W F Manufacturer 61 R L k Material No. of compartments✓ STEE P_ Cn Lic. capacity in gallons IF HOMEMADE: Inside length 'A` Width Liquid depth I r VA ^_ DISTANCE TO: Well Dwelling PERMIT NO. .JOZ O Z < ManufacturerMaterial Liquid capacity in gallons = DISTANCE TO: Well Qf Foundation i Sg Nearest I t lineact. PERMIT N.O.w ¢ �j%a Z Z w No. of lines Length of�� line Total I t of lines TrencD vyidth Distance between lines FJ-- Jar DO inches H Top of tile to finish Material beneath grade D tile / Total effective absorption area 525w M�/� � o . z_ 4" Vicks k gravel ll J Sig. '1� t. w Bd+� Length Width Depth PERMIT NO. w 0 Qa F wa Type of crib Crib diameter Crib depth Total effective absorption area Lu DISTANCE TO: Well Building foundation Nearest lot line J Class Depth Driller p i Distance to lot line PERMIT NO. J W DISTANCE TO: Building foundation Sewer line Septic lank Absorption area(s) OTHER PIPE MATERIALS " CA R L,)nI 432 -1 -5 - SOIL TEST RATING /25 C— INSTALLER P t I EXcAVATING- REMARKS cover 'iVN s . -ISE PT C 3 Rvcic covev"� fel VJ. ; RX F910,AF4It IV, o�sE r� 7 RO OSE b ©JOHN E. SWANSON � MUNICIPALITY OF A CH RA E. 17 F ENVIRONMENTAL P - — --..-..-_-_ ----_-_.. __� __ _-_ _._ p•�....p®�°mow<,0� 0 ,.. of ; Chi APPROVED DIZECEIWD 72-013 (Rev. 3/78) WATER WELL RECORD STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES Division of Geological a Geophysical Surveys Drilling Permit No. _ LOCATION OF WELL (Please complete either lo, Ib or Ic.) A.D.L. No. la. Borough Subdivision Lot Block Ib. 1/4 gtrs. Section No. TownshipNQ Range EQ Meridian Anch 3 2—of_of_of— SQ WQ Ic. DISTANCE AND DIRECTION FROM ROAD INTERSECTIONS 3. OWNER OF WELL: Bear Vally Address: Horizon Homes Street Address and Area of Well Location 2. WELL LOG Feet Below Surface Material Type Top Bottom 4. WELL DEPTH: (final) 280 it. 5. DATE OF COMPLETION _ _� ;ravely 0 �Q 6 Q Cable tool MXotory Q Driven Q Dug Q Auger —]Jetted ❑Bored Other: brn till dam - bedrock gray 35 235 7. USE: QXomestic Q Public Supply Q Industry Q Irrigation Q Recharge Q Commerical Q Test Well Q Other: -- 1851 225' seepage 2301 ` to 3 4 gpm 8. CASING: Q Threaded :�D Welded diam.__6__in. to 41 ft. Depth Weight Ibs./ft. diom. ,in. to ft. Depth Stickup_ ft. gray rock w lenses of white L 3 5 280 �- 6X'8034 f,—aG 4Pe4 1 9. FINISH OF WELL: Type: _ Diameter: Slot/Mesh Size; _ Length: Set between ft. and ft. Backfilling -- Gravel pack 2 R - rm of rICII WPOPALITY QEPT• of o-iECTION - 10. STATIC WATER LEVEL: ft. Q Above or Q Below land surface Dote Equipment used: ff� ut t✓`. �A� I I . PUMPING LEVEL below land surface and YIEL.D 280 _tt. after hrs. pumping 2? g.p.m. ft. of ter hrs. pumping g.p.m. 12.GR0UTING Well Grouted: Yes -r No Material: Q Neat Cement Other: 13. PUMP: ( if available) HP Length of Drop Pipe �--ft. capacity g.p.m. Q Subm. Q Jet Q Centrifical Q Other 14. REMARKS: 16. WATER WELL CONTRACTOR'S CERTIFICATION: This well was drilled under my jurisdiction and this report is true to the best Alaska Now-Well-Vern's Drilling & i.'nt Registered Business Name Contract Address: 1224.1 Avion Ste SRA Box 1 X560 Aneh 15. Water Temperature _—_° Q F Q C of my knowledge and belief; _ AA 3327 License Number .Ak 99507 _ Signed : L24� -¢f[ f% Date:�— �. Authorized Representatives —�- Form 02-WWR (11/81) Copy Distribution: WHITE-Stote DGGS, PINK -Driller, CANARY- Customer ���I C:: I F::, F-1 L_ I IF a -e CA F= ���" CA F..-' F-1 C3 F ---- DEPARTMENT HEALTH AND ENVIRONMENTAL ROTECTION �(0 825 STREET, ANCHORAGE, HK. 9>j01 '~ 264-4720 U W E= L_ L_ FA FJ E> CA V" I IF F= FE L4 F:-, ��F:;:-, t-1 I IF � PERMIT NO. ( 830552 ) APPLICANT PYRAMID EXCAVATING 7125 OLD SEWHRD HIGHWAY 99502 349-6561 LOCATION LEGAL L3B2 BEAR VALLEY S/D LOT SIZE 999999 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = ] SOIL RATING (SQ FT/BR)= 125 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: I> K F01 IF ki= E3 L_ K KI(A -lF 41= -t 0" C3 FQ Fl It E= L_ E> E= F" IF VA= .04 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD. THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). ����I F:;: -'E= El On E= FF'"T I C--; ��Ir-4 :1 2: EF= JL C- I NZ3 �3 F=1 [-. I— K-3 t' -A '-:3 PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. ��r-:K ��� 1E 1'4 F:E-- I--- lF 1 CA lr-4 F:� FK E= FQ E= CA- NJ 1 F" EE C.'" BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR H PRIVATE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM H PRIVATE WELL TO H PRIVATE SEWER LINE IS 25 FEET AND TO H 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. �FE F..., 1w] I -F E-:.":-. F- I F?E-E in E> Eo CD Eo Ul E3 EO FQ 71 "L" AL��w_3l.: I CERTIFY THAT i: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ]: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ] BEDROOMS. SIGNED: HPPLICHNT PYRAMID EXCAVATING V4�0 ISSUED BY___ _DHTE__ _ S & S ENGINEERS, INC 7125 Old Seward Hwy. Anchorage, Alaska 99502' 349-6561 SOILS LOG — PERCOLATION TEST SOILS LOG PERCOLATION TEST �33edroom75 PERFORMED FOR:_R4Y_a��%�.VA rl N ---_- __-- _ OA FE PERFORMED:.---0/Q._._._------- LEGAL DESCRIPTION. Lot 3 B o C lC 2- BLA )�- "AL - Q H Sl(ll'F SITE PLAN 0'-2-0' ©�:G/HN1C SIt�T I 2 2 3 (� 2, b - ia. 0 ' &MAvE c C'( SAA10 SCAT-TERED CrJr n' SW rho W/ T r AG L .�71 T ,. r Y 7k,4 r 10Cr P y. 11 I rl WAS GROUND VVATFH ENCOUNTERED? 12 1 IF YES, AT WHAT 13 P" DEPTH? r2.0 F-- --- --- .. 14 - #1000 0/ l.ni A0 P., di �t OFA ,4 Lq�•�•••s•e :••� e v 17 18 / s JOHN E. SWANSON : Q ®mss • 1834-E ; ° 20 - COMMENTS PERFORMED [3Y yV, ��Ja y t ' »..nnu (6//Q) Reading 1 Date 1 :Q 1 W G PERCOI.-A [ION RA i E V-..5_._a—l_----_..--------_.__Irninutes/inchl TEST RUN W-IVVI-E-N —A. FT AND — FT DATE Consttuation gest -Lag "One test is worth A •thousand npininns" 3919 SPENARD ROAD, ANCHpRAGE, ALASKA 99503 o TELEPHONE 277-0231 Hole Pia. 1 Location -Ijot 3 B ock Top JileV Existinp- YM iwrriwsrw rrlr DEPTH CIASSIPICATION FE= SYSTEM itw Organic Overburden RMedium YCoarse Brown Gravelly 3-40 ' 0 p Medium Coarse Brown Sandy Silty Gravel, moist 5 r ( these soil types are fairl 6 R { uniform thruout the depth ? 0of this test hole) TI Y e ''0 Percolation test performed 9 '' in this test hole. We observed a four inch drop 10 "of 0 in the water level during th 11 40'Q first hour and a total of 12,, eight inches after three hours duration. 13-4 1Z 16 c 1? 1 Limit of Subsurface Znvestig 19-- 20- 22. 9 2®22 23-- 24-- 25 32425 26 . z Y Sheet of. ; W,0, No« Operator Ji Mack Date -2, , 1975 Client Alaska Land Development ProjectBear Vally Subdivision SAMPLE DATA (ML) (GM) Split Spoon Sampl( taken at followinj depths: 5 -6.5 ft. 10-11.5 ft. 15-16.5 ft. Samples visually examined by CTL and retained by Alaska Test Lab. ion LEGE ND Gravel � Sand s D Silt Clay Organic Content Peat Prost Water TrLble E, av��__ CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 020-431-16 1. GENERAL INFORMATION Complete legal description Bear Valley Subdivision, Block 2, Lot 3 Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address COSA # 0 JC.- 11 I 115t7) Expiration Date: S— 1:7— // 9221 Honey Bear Lane Anchorage, AK 99516 Michael Rabideau P.O. Box 112655 Anchorage, AK 99511 Real#Estate Agent v = Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2.' NUMBER OF BEDROOMS: Three (3) Day phone Day phone Day phone 3:°,TYPE OF WATER SUPPLY: Municipality of Anchorage f� Development Services Department j 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 FOR A SINGLE FAMILY DWELLING Parcel I.D. 020-431-16 1. GENERAL INFORMATION Complete legal description Bear Valley Subdivision, Block 2, Lot 3 Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address COSA # 0 JC.- 11 I 115t7) Expiration Date: S— 1:7— // 9221 Honey Bear Lane Anchorage, AK 99516 Michael Rabideau P.O. Box 112655 Anchorage, AK 99511 Real#Estate Agent v = Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2.' NUMBER OF BEDROOMS: Three (3) Day phone Day phone Day phone 3:°,TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: IndividuaC Well ✓❑ Individual On-site ✓❑ Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private.or Class C well and may be reissued with new water 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. 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 Anderson Engineering Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Benjamin Schiller, P.E. 5. DSD SIGNATURE Approved for bedrooms Disapproved. Conditional approval for Phone 522-7773 Date 5/12/2011 A4 11111140 r 4 00 +`�p�=•Ben;.qmin Icc e�,tA�•� ed„iller:" , s C. - fp I25 ?w.,a& • . , ,�r� dao �.. •^.� bedrooms, with the following stipulat o�i%�`�� (i ((w(, VP / ,-;;J to %/1\ -kit l L. -. X : WATER AND WASTE Attachments: COSA Checklist X Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report Nitrate Advisory Other By: Original Certificate Date: (Rev. 11/05) Municipality of Anchorage • Development Services Department u Building Safety Division On -Site Water & Wastewater Program s . C1 Y 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 3, Block 2, Bear Valley Subdivision Parcel ID: 020-431-16 A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed 6/26/83 Sanitary seal (Y/N) Y Total depth 280 ft. Cased to 41 ft. FROM WELL LOG Date of test 6/26/83 Static water level 54 (10/5/89) ft. Well production 2.5 g.p.m. . WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate N/D mg/L Arsenic: N/D mg/I Date of sample: 4/22/11 B. SEPTIC/HOLDING TANK DATA Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) >18 in. AT INSPECTION 5/2111 61.4 ft. .91 g.p.m. Other bacteria colonies/100 mL Collected by: A. Harala Tank Type/Material Septic/Steel Date installed 6/24/83 . Tank size 1,000 gal. Number of Compartments TWO Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping 5/10/11 Pumper Isaac's Pumping C. ABSORPTION FIELD DATA Date installed 6/24/83 Soil rating (g.p.d./ft2 or ft2/bdrm)125 GPD/BDRM System type Deep Trench Length 50 ft. Width 2.5 ft. Gravel below pipe 4 ft. Total depth _8_ft. Eff. absorption area 400 ft2 Monitoring tube YDepression over field N Date of adequacy test 5/2/11 Results (Pass/Fail) Pass For. 3 bedrooms Fluid depth in absorption field before test 41 in. Water added 457 gal. New depth 44 in. Elapsed Time: 1,440 min. Final fluid depth 41 in. Absorption rate >= Ll S' 99.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed Size in gallons "Pump on" level at in. "Pump ofr level at in Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot W— Absorption field on lot Public sewer main N/A >100, Manhole/Access (Y/N) High water alarm level at in. Meets alarm & circuit requirements? On adjacent lots >100' On adjacent lots >100' Public sewer manhole/cleanout N/A Sewer /septic service line >25' Holding tank N/A Animal containment areas >50' Manurelanimal excrete storage areas >100' SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line ?5' Absorption field >5' Water main., N/A Water service line >10' Surface water Wells on.adjacent lots >100 - SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: >100' Propelrty line >10' Building foundation >1V Water main >10' Water Seryice line 5,10' Surface water >100, Driveway, parking/vehicle storage >26 Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS: *"See Well to Septic Tank Waiver. G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Michael E. Anderson, P.E. Date 5/17/2011 COSA Fee Date of Payment .7 3 Receipt Number (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number 01 AW AW rr * 49� �Ii�,� ♦ st •; �.aG AW Municipality of Anchorage • Development Services Department L Building Safety DivisionX. On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www. ci. anchorage. ak.us (907)343-7904 Water Well Advisory Certificate of On -Site Systems Approval (COSA) # 111155 During a recent COSA on-site inspection and test of the potable water supply well on Block 2, Lot 3 of Bear Valley subdivision, the well's productivity was determined to be .91 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 -bedroom residence is .31 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. 0 SGS SGS Ref.# 1111532001 Client Name Anderson Engineering LeT 3, 13Loe4,_ L Project Name/# BEAR VALLEY SUBD, Client Sample ID private ww drawn from hose bib Matrix Drinking Water PWSID 0 Sample Remarks Printed Date/Time 04/29/2011 15:11 Collected Date/Time 04/22/2011 16:28 Received Date/Time 04/22/2011 16:55 Technical Director Stephen C. Ede Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals by ICP/MS EP200.8 Arsenic ND 5.00 Waters Department NRB Total Nitrate/Nitrite-N ND 0.100 Microbiology Laboratory (<10) E. Coli Negative I Total Coliform Negative 1 ug/L EP200.8 C (<10) 04/25/11 04/26/11 NRB mg/L SM20 4500NO3-F B (<10) 04/28/11 AYC I OOmL SM20 9223B A IOOmL SM20 9223B A 04/22/11 DLC 04/22/11 DLC r'r Lot 4 n 6 CD Honev— Bear Lore r A 7"N 49id A ............................ Thomas H. Dreyer, x LS -7625 a i 5 W � Ordered by: Barbara Michelsohn Legal Description; �'_ sbliilt Lot 3, Block 2, Bear Valley Subdivision `purvey Certification: l hereby certify that a Mortgagee's inspection was performed on the described property. Nates: it is the owner's responsibility to determine the existence of any easements, covenants, or restriction which are riot on the recorded subdivision plat. This asbuilt small not be used for construction or for establishing property lines. Checked by: THD Drawn by. cB Scale 1" = 40' Job 2011--28 Field Book: 101/47-49 Piot m76-209 Iv C4 cf� 0 `o+ 2 L egenrd: Reber with Cap*1 AL. Monument Rebar 0 Monument Well Septic Pavement Overhang Wood Deck" Concrete Fence_.._....._._.__ _... Grid 3242 Date: 5/2/2U11 ISAACS PUMPING SERVICE 6218 Quinhagak Street Anchorage, Afaska 99507 (907) 563-3300 CUSTOMER'SORDER.:� UT'!. UcSCRIP ilO.'l MIN PHICC _NO; MAN ANN "am i, - mi, m 3._ TOTAL m AI;L CLAIMS ANDTh RETURNED GO00S a k., Tou MUST BE ACCOMPANIED BY THIS BILL N MUNICIPALITY OF ANCHORAGE • '� DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section cam P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel 1. D. # o '-� _-_ )-/ 3 1 - / C- 1. GENERAL INFORMATION HAA #'G`', Complete legal description Lot 3; Black 2; Beat Vattey Location (site address or directions) 9221 Haney Bean. Lane, Ancha Daae. AK Property owner Jahn & Shan.an Bak.ek Day phone 345-5070 Mailing address 9221 Hone,u, Bean, Lane Anchan.age, AK 99516 Lending agency Day phone Mailing address Agent _ Jack Btain/ Remax P-tapen.ti.ea Day phone 257-0159 Address 9221 Haney Bean. Lane Anchotage, AK 99516 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well XXX Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XX Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and reggl&tgrfXdtNeff tAGn the date of this inspection. 17034 Eagle River Loop Road No. 204 Name of Firm Eagle River. Alaska 99577 Phone Address Engineer's signature 6. DHHS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for Additional Comments By: It ]TIC Date c /-/ — 9- q 7 -/ ROBERT C. COWAN CE -8801 N bedrooms, with the following stipulations: Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91 ) Back MOA N21 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825"L" Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744 Health Authority Approval Checklist Legal Description: L O ` 3 f3 L 2 a 9.Al,''y91-1"Xparcel, ib,: 09-0 —. l/ '31, A. WELL DATA Well type f P ,Y4 1` L Log present &N) Total depth Sanitary seal (F�/N) Date of test 4, S *If CS If A, B, or C, attach ADEC letter. ADEfC water system number Date completed G r 8 3 Cased to -11 Casing height (above ground) FROM WELL LOG /W3 Static water level U IK Well production WATER SAMPLE RESULTS: Coliform a Q.9 Date of sample: 3/ v7 /c/ 6 11.19KEOHOLDING TANK DATA Date installed G/9 3 Tank size Nitrate I ' -+- Wires properly protected (9N) Y 4 s AT INSPECTION 3 / 30 7 S Xj C`" ua T erA 0.1 Other bacteria Collected by: S & S ENGINEERING 17034 Naole River Loop Read No. 204 Eagle River, Alaska 99577 /000 Number of Compartments -� Cleanouts 0/N) Ye -5 Foundation cleanout i t- J Depression (Y/& High water alarm (Y/o ^� Date of Pumping '�'OI A G, Pumper A f 116M f Sift - c � S v C. ABSORPTION FIELD DATA Date installed 6 r If 3 Soil rating (g.p.d./ft2 o ft2/bdrm 1 a S" System type T 2 f N C. N Length S O Width 3 0 Gravel thickness below pipe Lt Total depth / Effective absorption area Lf o O Monitoring Tube present(&/1) Ykf Depression over field (Yo n Date of adequacy test 3 30 9 C Results (Pass/Fail) Piss For 3 bedrooms Fluid depth in absorption field before test (in.); 3,9 Immediately after/ 81 gal. water added (in.): 4 � Fluid depth y1 (ins.) Minutes later: 33 Absorption rate = of 9 3 3 g.p.d. Peroxide treatment (past 12 months) (YIN) N o e L e-0 w ^/ If yes, give date D. LIFT STATIONr 5 Date installed Size in gallons Manhole/Access (YIN) "Pump on" level * "Pump off' level at* High water alarm level at* *Datum Cycles t E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: 1 antic holding tark on lot X90 ; On adjacent lots 10 0 f Absorption field of lot /00 f ; On adjacent lots / d o '4 Public sewer main' N 44 Public sewer manhole/cleanout IV Sewer /septic servile line Lift station N 1A r2 - �q oa 3 q SEPARATION DISTANCES FROM11EE10HOLDING TANK ON LOT TO: Building foundation a S �f Property line SO �� Absorption field S Water mam/servi4 line CO t Surface water/drainage 100 �� Wells on adjacent lots /00 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: l Building foundation aS Water main/service line s`0 Surface water 7 0 0 ° f Driveway, parking/vehicle storage area 30 Curtain drain Na c kN ai pi Wells on adjacent lots / o ° 4 Property line o � F. ENGINEER'S (CERTIFICATION 1 certify that 1 hae determined thr u field inspections and review of Municipal records that th tems are in conformance 4th AfOAes in effect on this date. OF A Signature— y+"• •'••,'i,9, Engineer's Names 90 6 fA r Cr Cd w.9,✓ y t }l' •� �, !:! :-n!..• as !Y Date 3 / 6 V •ROBERT ❑yr HAA Fee $ , 73)/ CJ i Date of Payment Receipt Number —sem Rev. 8/95 OSS: haa4k.doc —57 Waiver Fee $ Date of Payment Receipt Number }� - COWAN , ���f� CE -8801 r 04/02/96 14:51 CT&E ESI ANCHORAGE - 9076941211 NO. 931 P09 CT&E Environmental Services Inc. ZROtIL Laboratory Division Drinking Water Analysis Report for Total Coliform Bacteria 200 ch rage• Or AK Drive9518-1605 READ IrYSTRUCTIOrYS ass R,E'YER-SE SIDE BEFORE COLLECTING SAiVPL9 -2343 Fax: 907) 562 5301 ST BE COMPLETED BY WA 0 PUBLIC WATER SYSTEM I,b. # �C PIU VATS WATER SYSTEM i8 Sed Results (X Send invoke S -r F -NC -("V r4 r.V C�- ilN yl-.-`y,WlormPNY- •Me Net M1M one. 7-71 r u. utA eI �lLuns Add -<u !, Wv s ary V p Send Resuttt t3 Send Invoice onYn �, aTou+y p ,U,.nq AUCin, un a ,if SAMPLE DATE: 21. . l otl [.1 N] Month Day Year SAMPLE TYPE: Routine © Treated Water 0 Repeat Sampic (for routine sample of Untreated Water %vith lab ref, no. �) CJ Special Purpose Time Collected SAMPLE LOCATION Collected By LpT 3 URI C ac a 3044 Vf"+'Y S10 9.20 j r,t RV 6 - Please Print Comments: TO BE COMPU, l ti) 0 T 1,ADvrl^ I vr, r Analysis shows this Water SAMPLE to be: Satisfactory C unsatisfactory ❑ Sample over 30 hours old, results may be unreliable O Sample too tong in transit; sample should not be over 4$ hours old at examination to indicate reliable results. Please send new sampic via special delivery mail - Date Received�� Time Received Analysis Beean Analytical Method: C—Membrane Filter C] MMO-MUG " Number ofcolonies/100 ml - Lab Ref. No. Result* Analy t 95.1 L � r - - Sent to A.D:E.C. ACh . Fbks Jun Faxcd Date: Client notified of un$gtisfactory results; ❑ ❑ Phoned Spoke with )`axed Datc: Time: — 13ACTERIOLOGICAL WATER ANALYSIS RECORD tjmmo-MUG Result: Total Coliform rillembrane Filter. Direct Count E. Coli Q Colonies/100 ml ` Verification: LT13 BGB — COLIFIRM� Fecal Coliform Confirmation Final Membrane Filter R It Reported By 6 Date �Colifucm/100 m1 me i6 6 � `-� _— hrs 17 rvrc. r,,,,,vw,CrnU, n, G.ve, on - rues 8•cr,r:e .. J , ,r an* LV 71 a r►s + iY �✓'� ON SGS Member of the SGS Grvup (Societb GAndrale de Surveillance) Acro PAl tcngnnA to narnn t,,,.,n,c A011i ov, 0- A— ••.�N�• ^., .•.ern. p mei., lcvecv nu,n WC CT /Id RtNl6 04/02/96 14:50 CT&E ESI ANCHORAGE -+ 9076941211 NO.831 D07 ME Environmental Services Inc. Laboratory Division ► fI/A21r'K0wAw" rArA—A/�21I►lyl�i�►�I�lr/�.�� Laboratory Analysis Report CUE ReF.N 961050.8464 Client Safttpie ID L3 B2 BEAR VALLEY SIDS 1050-01 Collected Date 03/27196 Matrix Driaking Nater Technical Director MSID 0 Released By " Sample Remarks: Parameter Nltrate-N Results CC PQL Units Method Allowable Prep AnalySIS Init oust Limits Date Date 0.100 U 0.1 ms/L EPA 353.2 03/28/96 Erle 200 W. Potter Drive, Anchorage, AK 99518.16055 — Tele (907) 562-2343 Fax= (907) 561-5301 3180 Peger Road, Fairbanks, AK 99709-5471 — Tel•. (907) 474.8656 Fax: (907) 474.9685 ENVIRONMENTAL FACILITIES IN ALASKA. CALIFORNIA, FLORIDA, ILLINOIS, MARYLAND, MICHIGAN, MISSOURI, NEW JERSEY, OHIO, WEST VIRGINIA Parcel I.D. # MUNICIPALITY OF ANCHORAGE A • Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING 020-431-16-000 HAA # )_� "t C)u L -)a 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 3, Block 2, Bear Valley S6,TllN,R2W Location (address or directions) 9321 Honeybear Drive (b) Property owner Charles Kirschbaum Mailing Address PO Box 110033, Anchor Telephone: (home) 345-3681 Business aqe, AK 99511 (c) Lending Institution Northland Mortgage Telephone 274-5150 Mailing Address 2605 Denali, Anchorage, AK 99503 (d) Real Estate Company and Agent Roger Herrel l , Kruyne & Wendt Address 3333 Denali, Anchorage, AK 99503 Telephone 279-1561 (e) Mail the HAA to the following address: (or check here i7, if hold for pick up.) List contact person and day phone number below: Please hold for P/U by Mark Pearson, Mountain Engineering, 696-1700 2. TYPE OF RESIDENCE f Single -Family I� Number of bedrooms 3 3. WATER SUPPLY Individual Well E� Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DIFOSAL On-site 1� Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 (Rev. 7/88) Page 1 of 2 ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional .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 Mountain Engineering Telephone 696-1700 Address 10251 Crestview East Eagle River, AK 99577 Date 10/10/89 ' 49th ' 7 ........... . MARK W. PEARSON t aj`6'�'• CE - 7760 Engineer's Seal 6. DHHS APPROVAL Approved for J',. bedrooms by Date 147111`3/ Approved — Disapproved Conditional Terms of Conditional Approval AAVA4 CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 7/88) Back Page 2 of 2 QFIVa�'ILITY OF ANCHORAGE (MOA) M F HEALTHalth Authority Approval (HAA) E •NTAL PROTQFI@l$KLIST - FEBRUARY 1984 343-4744 I '} iyaq Legal Description: RECEIVE® Lot 3, Block 2, Bear Valley A. WELL DATA Well Classification Residential If A, B, C, D.E.C. Approved (Y/N) Well Log Present (/N) Y Da completed 6/26/89 Yield 2 - 5 GPM Total Depth 280' Cased t04 Depth of Grouting None Static Water Level 54' (10/5/89)"--' 10/5/89)"--' Pump Set At 280' 'r Casing Height Above Ground 20" / Sanitary Seal on Casing (Y/N) Y Electrical Wiring in Conduit (Y/N) Y Depression Around Wellhead (Y/N) SEPARATION DISTANCES FROM WELL: 11-11 To Septic/Holding Tank on Lot 90' (see wvr app) ;On Adjoining Lots >100' W To Nearest Edge of Absorption Field on Lot 108' ; On Adjoining Lots >100' To Nearest Public Sewer Line None To Nearest Public Sewer Cleanout/Manhole None To Nearest Sewer Service Line on Lot None Water Sample Collected by Mountain Engineering ; Date 10/6/89 Water Sample Test Results PASSED - Coliform & Nitrates Comments Application for waiver of 90' Well/Septic Tank sep. attached B. SEPTIC/HOLDING TANK DATA Date Installed 6/24/83 Size 1, 000No. of Compartments 2 Standpipes (Y/N) Y Air -tight Caps (Y/N) Y Foundation Cleanout (Y/N) Y Depression over Tank (Y/N) N Date Last Pumped 10/5/89 ( see recpt ) Pumping/Maintenance Contact on File (Y/N) N ; for Holding Tank High -Water Alarm (Y/N) N/A Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water -Supply Well 90' To Property Line >10' To Water Main/Service Line None To Building Foundation 20' To Disposal Field 6 To Stream, Pond, Lake or Major Drainage Course None Comments See attached waiver application 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata .125 sq ft/BR Type of System Design Trench Date Installed 6/24/83 Length of Field 50' / Width of Field 30" Square Feet of Absortion Area 400 s Depth of Field Gravel Bed Thickness ft 4' --� Statndpipes Present (Y/N) Y Depression over Field (Y/N) N Date of �pst Adequacy Test 10/5/89 Results of Last Adequacy Test PASSED - 3 bedroom SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well 108, / To Property Line >10' To Building Foundation Lot None To Water Main/Service Line 46' None To Existing or Abandoned System on On Adjoining Lots 86' To Cutback (if present) None To Stream, Pond, Lake, or Major Drainage Course "IUne To Driveway, Parking Area, or Vehicle Storage Area 60' ' Comments D. LIFT STATION Date Installed NONE Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent(Y/N) Pumping Cycles during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Mark Pearson A�,e Company Mountain Engineering Date 10/10/89 CE89-007 MOA No. Receipt No. 2 D q':;_7 ! 6q Date of Payment Amount: $1 Ila tr Engineer's Seal P�ARS `MARK W. *3� <<; CE - 7760 `> Receipt Nol�kaAOFESS ��� Waiver Fee: $ t0 Date of Payment n- Gl 72-026 (Rev. 7/88) Back Page 2 of 2 MVVEU&� CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. g, TELEPHONE (907) 562-2343 5633 B Street Anchorage, Alaska 99518 4 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY�WATER SUPPLIER TO BE COMPLETED BY LABORATORY ( ❑ PUBLIC WATER SYSTEM I.D.# I I PRIVATE WATER SYSTEM ���V'42Q_ r r c 69b-1-700 Name J Whone No. 1 L)—z fi Mailing Address �7�LQ (� �`1� Cj '-c S-7 City State Zip Code SAMPLE DATE: i O U(oe q Mo. Day Year SAMPLE TYPE: Routine ❑ Check Sample (for routine sample with lab ref. no. ) ❑ Treated Water ❑ Special Purpose X, Untreated Water SAMPLE M -Time Collected NO. PYA LOCATION Collected'\ By KI 4 5 READ INSTRUCTIONS BEFORE COLLECTING SAMPLE Anal is shows this Water SAMPLE to be: Satisfactory ❑ Unsatisfactory ❑ Sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. Date Received Time Received__ Analytical Method: Membrane Filter * No. of colonies/100 ml. Lab Ref. No. Result* Analyst FTI m � I m FE BACTERIOLOGICAL WATER ANALYSIS RECORD Membrane Filter: Direct Count Verification: LTB Final Membrane Filte a Its Reported By TNTC = Too Numberous To Count OB = Other Bacteria #666 lo1 q )n Coliform/1100ml BGB Collform/100ml Date `�/j �l 6,/", - Time: C) a.m. p.m. CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. ANCHORAGE INDUSTRIAL CENTER 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 ANALYSIS REPORT MOUNTAIN ENGINEERING 10251 CRESTVIEW EAST EAGLE RIVER AK 99577 ANALYSIS COMPLETED OCT 9, 1989 LABORATORY SUPERVISOR- STEPHEN C. EDE CHEMLAB REF NO. 7910 LAB SAMPLE NO. i CLIENT ACCT NO. MTNENGN WORK ORDER NO. 7910 DATE RECEIVED OCT 6, 1989 RELEASED BY-�l L3� (fi2r�j2 MATRIX - WATER PARAMETER TESTED RESULTS ALLOWABLE LIMITS NITRATE - NITROGEN ND: NONE DETECTED ND(0.1) MG/L 10 MG/L ..•.• ic3 .."7'-7in`a.1."i.(i„�v�:�i.'nat f•Ii:W. •""w i.�1:='r'+ ../ r..7 '.Y,+n� a .ice .v, v.. ✓ a.. ae.t • . .. .xrc ..,..«�......... ..r.-:c1��K�.�.sn.�.4:?r;a+vYJ,-:M1L'in.E_'++.1ti*ai%At_.Mix.:;.:.F�.J.x"a..!�t...Y",.. ., -.�w. h . •�r_..t-».. .a .. . ..,. ... �. � . Municipality of Anchorage Department of Health and Human Services Tom Fink, 825 "L" Street Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 October 13, 1989 Mark Pearson, P.E. Mountain Engineering 10251 Crestview East Eagle River, Alaska 99577 Subject: Waiver Request for Lot 3 Block 2 Bear Valley Subdivision Waiver Request #WR890059, PID #020-431-16, HA890402 Dear Mr. Pearson: Your request for waiver of the required 100 foot separation of a septic system to a.private well has been approved. The approved separation distance is 90 feet from well to septic tank. This waiver approval applies to the existing septic system to well separation only. Any future upgrade to either will require all separation distances be met or another approval from this department. Si/ Jnge ly, 1 Robert W. Robinson Civil Engineer On-site Services RWR/ljm I MOUNTAIN ENGINEERING EERING 10251 Crestview East • Eagle River, Alaska 99577 Anchorage 907-696-1700 Outside Anchorage 800-478-0101 0 October 9, 1989 Municipality of Anchorage Department of Health and Human Services On -Site Services Anchorage, AK 99501 ATTN: Mr. Dan Roth Dear Dan: RE: Bear Valley, Lot 3, Block 2, Waiver Application The purpose of this letter is to request a waiver of the 100 FT well/septic tank separation requirement for the above referenced lot. As you suggested during our telephone conversation of 10/5/89, I have obtained a copy of the well log (attached) from the mortgage company (Alaska USA). The log indicates that the water -bearing strata are located at depths of 185' (little seepage), 2251(seepage), 230'(1/2 to 3/4 GPM), and 240' (1-1/2 GPM). Gray bedrock is recorded from 35' to 235', and gray rock with lenses of white and green is recorded from 235'-280'. We feel the following information indicates that there has been no adverse impact on the well and that no such impact should occur in the future. There has not been any indication that water quality has been compromised. Recent tests (10/6/89) passed coliform and nitrate requirements, and there have never been homeowner complaints regarding water quality. • The well log indicates that the majority of the water is drawn from depths of 230' or greater, and most of the well is drilled through bedrock. • The well is located approximately 20' vertically higher than the drainfield/septic tank, reducing the chances of surface and shallow ground water flow from the drainfield to the well. Waiver Request: Lot 2, Block 2, Bear Valley Page 2 • An adequacy test performed 10/5/89 found the static water level of the well at 54' . Under a flow of 7 GPM, the water level stabilized at 891. No cascading water was detected, which decreases the likelihood that water was entering the well from a higher elevation. • Two soils logs were apparently performed on the lot; one on June 20, 1983 by S&S, and the other on May 2, 1975 by Construction Labs. Neither of the logs (attached) indicate the presence of groundwater. Although both logs rate the soils as rapid percolating, they also indicate the presence of fines in the strata. Based on the above information, I hereby request a waiver on behalf of my clients; Charles and Becky Krichbaum. If I can provide any additional information, please contact me at 696-1700. Sincerely, Mark Pearson, PE enclosures o- T Time APPLIC AT FILLS OUT UPPER HAL ONLY Prcnerty Owner- t ;', !: ' < 'r`.:: f / j : ( i ` ` - Phone MailingAddress `- crf >/l f ] f r' i ;,� % Zip Code '✓' z/ Buyer Date Address Inspector Zip Code Lending Institution Inspector Phone Address % ` r`. - - Zip Code n Realty Co. & Agent Field Notes; + Phone MUNICIPALITY O ANCHO G !` r+ l rEPT. OF H`r'' Tr• I ^: Address -``� �'-,z C� Lam, , Zip Code Legal Description (J +' �- } �_ r. > 1 Street Location _ RECEIVED Type of Residence "CONDITIONS OF APPROVAL ( ) DISAPPROVED Single Family 3 ❑ Multiple Family No. of Bedrooms DATE (� r ❑ Other BY: Water Supply Soils Rating Date Sewer Installed k Individual Well Log Received r % ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. / ❑ Community r Septic Tank Size For wells drilled prior to that date, give well depth (attach log if available). ❑ Public Utility V Sewer Disposal R Individual Year Individual Installed: ❑ Public Utility When Connected to Public Utility: _ ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. o- T Time Time Time Time Date Date Date Date 11A,7103 03 Inspector Inspector Inspector Inspector n Field Notes; + MUNICIPALITY O ANCHO G rEPT. OF H`r'' Tr• I ^: �— ENV IRO\?v1-NTAL PROTECTION. ���.� �e•�'9,� RECEIVED (�) APPROVED BEDROOMS "CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' DATE (� r BY: Soils Rating Date Sewer Installed Well To Absorption Area / b -t) r Well Log Received r % 2t f � _ g 'a Well to Tank / o-6 r -I- Septic Tank Size 72023 (3182) CHEMICAL & GLcJLOGICAL LABORATORIES Or ALASAA9 INC, .TELEPHONE (907) 562-2343 ANCHORAGE INDUSTRIAL CENTER 5633 B Street Le.,oe:ae Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER TO BE COMPLETED BY LABORATORY WATER SYSTET-L Analysis shows this Water SAMPLE to be: ra` .D. O. ,Satisfactory L 17 v ❑Unsatisfactory Water System Name Phone No. ❑ Sample too long in transit; sample should not be over 48 hours old at examination Mailing Address to indicate reliable results. Please send new sdmple. City SAMPLE DATE: /C( Mo. Day Year SAMPLE TYPE:, ❑ Routine ❑ Check Sample (for routine sample with lab ref. no.► ❑ Tr ❑ Speclai Purpose ❑ Ur SAMPLE NO. LOCATION L 1 �• 2 I 3 4 5 Zip Code Ild Water ited Water rime ied 0011 tad I ' 1 o ! READ INSTRUCTIONS BEFORE b8-1220 (I y. Rev. 1978 Date Collected_ Date Recelved_ Hours a,vmn nwcvr, 24 Hours Date Received Time Received Analytical Method: © Fermentation Tube [;)-Membrane Filter Lab "Aef. No. Result* Analyst V _.�J C17 l I m �I No. of colonies/ 100 Source a.m. Time Received p.m. Lab. No EMB Poeth 24 hours: Broth 48 hours: COLLECTING SAMPLE Multiple Tube Report: 20ml Tubes Posltive/Total 10ml Portions ;Membrane Filter: Direct Count Collform/100ml Verification: LTB -BGB Final Membrane Filter Results > Collform/100ml Reported BY 1. Si' Date a.m. P.M.