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HomeMy WebLinkAboutBROADWATER HEIGHTS BLK 3 LT 10Broadwater Lot 10 #050-131-69 Municipality of Anchorage + Community Development Department PIpB 1 of 3 On -Site Water & Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 •http://www.muni.arg/onsite •(907)343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number. OSP161251 PID Number. 050-131-69 ❑ New ■Upgrade Name: MIKE FISCHETTI ABSORPTION FIELD ❑ Deep Trench ❑ Shallow Trench ❑ Bedound Address: 11806 W. SKYLINE DRIVE 'EAGLE RIVER ❑ Other Phone: No. of Bedrooms: Per S 1Rid Op. TOW D.PM 441-9711 3 GEb GPWSQ. Ft H LEGAL DESCRIPTION Dp Wpl„„,„„ -dg,lW, G '""u°4' G F. summs,on. Book: Lot: BROADWATER HEIGHTS 3 10 ` F11 MJ . .aem.I paM'. Ak G.v wpm'. Ft •Numbwallies. °�eNrca belv.�a,n owns ip Range. on: GmwlMm V SEPARATION DISTANCESF1 Tox• .i.r. Mro.ay.,w,a. GstOa...,vrrnr- T0 sepuc Absorption LM Holding PuWi Pn,nne From Tank Field stebw Tank Saxer Liras sG. Ft F1. Well 100'+ - - 25•+ TANK 0 Septic ❑ S.T.E.P. ❑Holding ❑Other ManaacW Gapw.kx surface Water 100'+ - - ANCHORAGE TANK 1250 GW r?o Lot Lina 5'+ % ^ MateM1l' Nurb ammpaRnwme. �} - _ N/ IY /-1 STEEL 2 LIFT STATION Foundation 51+ - Curtain Drain NONE KNOWN MnaacW,ar. cr. Remarks: PER CONTRACTOR, OLD SEPTIC TANK WAS •Pump on•kwM a[ Pu,ry aT ■M a[ Npk lwrslnn ac DECOMMISSIONED PER UPC. Pump klab s [weal isapaceona parlmrnaE W PIPE MATERIAL House to tank D3034 Tank to D3034 drainfield Installer ARM SERVICES, LLC Drainfield EXISTING CO/MT D3034 Inspector GEG, Ltd. BENCH MARK (Assumed elevation) 100.00 F` Inspection Lw and Gaavwbo. Dates: 1st 11/11/2016 2nd - 3rd - 4th BACK MAN DOOR THRESHOLD ENGINEER SEAL Community Development Department Approvaltit \\\\ • �P I Conditional approval: Date: ## . : ...... ........ ....'...... �.....3 1 fi e q Ga .. : �,, I r 13 A,%•' • ��i Approved: OLIDater *4FESSIC7� Impaction Rapoh 1-1-12e GARNESS ENGINEERING GROUP, Ltd ENGINEERING SALES , CONSULTING - December 26, 2018 Municipality of Anchorage Development Services On -Site Water & Wastewater Program 4700 Elmore Roade Anchorage, Alaska 99507 Phone: (907) 343-7904 Attention: Tim Eklund Reference: Response to MOA Onsite Comment Sheet for Record Drawings for Broadwater Heights S/D; Block 3, Lot 10 Mr. Eklund: We have received a comment sheet regarding the 2016 record drawings for the referenced property (MOA sewer permit # OSP161251). The following is you comments and our response to the comment and how we resolved it: • Cama's tax records indicate 4 bedrooms, your permit is for two. Please resolve. — Attached is a recent print out of the public inquiry parcel detail which shows the property as a 3 bedroom house (see attached). In short, the MOA records have been updated showing the house is only 3 bedrooms. Your drawing indicates a 3 bedroom, vet your permit is for two bedrooms. Please resolve. - At the time of the order and design, the owner stated that the house was only 2 bedrooms. After the installation, it was discovered that the house was more than 2 bedrooms. Page 2 of 3 of the record drawing does reflect a 3 bedroom house, but page 1 of 2 (the Inspection Report) states 2 bedrooms. Based upon our review of the MOA records, the two (2) previous HAA's issued in 1986, stated that the seepage pit type drainfield has 252 sq.ft. of effective area and had a soil rating of 85 sq.ft./bedroom (252 sq.ft. / 85 sq.ft./bdrm = 2.965 bedrooms). The new septic tank that was installed in 2016 is a 1250 gallon steel septic tank. Based upon this information, the septic tank and drainfield are adequately sized for a 3 bedroom house. We request that you hand change the number of bedrooms on the inspection report (page 1 of 3) and have it rescanned with a copy of this letter for your records. Please do not hesitate to call us at 337-6179 if you require further information. Thank you for your assistance. SindWret 7 t S u %A i��s �s L�Jeffss, P. .M.S.PreSo m o'J D ,JAS o&iat m 8 LA'S• 3701 East Tudor Road, Suite 101 ' Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com PERMIT ID OSP1 1251: RECORD DRAWING PARCEL1NUMBER: OSP161251 050-131-69 U7:I f � Ici W� Id3� IcS � 1 BROADWATER HEIGHTS; BLOCK 3, LOT 13 \ 'o ,1 BROADWATER HEIGHTS; BLOCK 3, LOT 12 DBL3 & 1 1 \ 1 \ 1 1 R► '1 \ 1 11 /' NI 1111 // WELL PRE -TANK DOUBLE CLEANOUTS WERE V INSTALLED IN PLACE OF FCO DUE TO THE STRUCTURAL CONFIGURATION OF 1 THE OVERHANGING DECK. PER CONTRAC TORNO 90' FITTINGS WERE USED PRIOR TO NEW SEPTIC TANK EXISTING CRIB)� i / \A DBL1 & EXISTING 3BEDROOM HOUSE II / I 1 I 1 / 1 / 1 - � 1 1 1 / 1 1 • / 1 / 1 J � \ \ -NEW 1250 GALLON \ STEEL SEPTIC TANK \ PER CONTRAOLD \ \ ` CONCRETE SEPTICIC TA TANK WAS \ DECOMMISSIONED PER UPC. \ \I \ ASSUMED LOCATION \ / \ OF CRIB INLET \ / \ \ / BROADWATER HEIGHTS; BLOCK 3, LOT 11 GARNESS ENGINEERING GROUP, Ltd -- - -- -- - - CIVIL & ENVIRONMENTAL ENGINEERS - 3701 E. TLDOR ROAD, SUITE 101 ' ANCHORAGE, M 99507' PHONE (907)3374179' FAX (901) 330-3240 - WEBSITE: w nems gine M9.mm PREPARED FOR: MIKE FISCHETTI IONE NUMBER: 441-9711 PROJECT/LEGAL DESCRIPTION: BROADWATER HEIGHTS S/D; BLOCK 3, LOT 10 TYPE OF WORK: RECORD DRAWING OF SEPTIC TANK UPGRADE PAGE NUMBER: • (" %/ 69C iiuy-Ai_- drIICJI 2 OF 3 �j�� CE -79 3 DRAWN BY:♦j� ,p,•�,.•i iL3 ( /I (,•.,... L.K.B./J.L.M. ♦ '�p.. r DATE:Sk LICENSE ,1�1�"S„ 11/23/2016 #AECCW u m SEPTIC AR!�D �' � \ y PER ROB CAMPBELL WITH ARM SERVICES, OWNER \, WILL BE INSTALLING ADDITIONAL FILL ON DOWNHILL SIDE OF TANK IN THE SPRING. THIS IS TO INSURE COVER DOES NOT SLOUGH AWAY FROM TANK.� i (7SEPTIC �\ AREEA BROADWATER HEIGHTS; BLOCK 3, LOT 12 DBL3 & 1 1 \ 1 \ 1 1 R► '1 \ 1 11 /' NI 1111 // WELL PRE -TANK DOUBLE CLEANOUTS WERE V INSTALLED IN PLACE OF FCO DUE TO THE STRUCTURAL CONFIGURATION OF 1 THE OVERHANGING DECK. PER CONTRAC TORNO 90' FITTINGS WERE USED PRIOR TO NEW SEPTIC TANK EXISTING CRIB)� i / \A DBL1 & EXISTING 3BEDROOM HOUSE II / I 1 I 1 / 1 / 1 - � 1 1 1 / 1 1 • / 1 / 1 J � \ \ -NEW 1250 GALLON \ STEEL SEPTIC TANK \ PER CONTRAOLD \ \ ` CONCRETE SEPTICIC TA TANK WAS \ DECOMMISSIONED PER UPC. \ \I \ ASSUMED LOCATION \ / \ OF CRIB INLET \ / \ \ / BROADWATER HEIGHTS; BLOCK 3, LOT 11 GARNESS ENGINEERING GROUP, Ltd -- - -- -- - - CIVIL & ENVIRONMENTAL ENGINEERS - 3701 E. TLDOR ROAD, SUITE 101 ' ANCHORAGE, M 99507' PHONE (907)3374179' FAX (901) 330-3240 - WEBSITE: w nems gine M9.mm PREPARED FOR: MIKE FISCHETTI IONE NUMBER: 441-9711 PROJECT/LEGAL DESCRIPTION: BROADWATER HEIGHTS S/D; BLOCK 3, LOT 10 TYPE OF WORK: RECORD DRAWING OF SEPTIC TANK UPGRADE PAGE NUMBER: • (" %/ 69C iiuy-Ai_- drIICJI 2 OF 3 �j�� CE -79 3 DRAWN BY:♦j� ,p,•�,.•i iL3 ( /I (,•.,... L.K.B./J.L.M. ♦ '�p.. r DATE:Sk LICENSE ,1�1�"S„ 11/23/2016 #AECCW u 'PERMIT NUMBER: PARCELIDNUMBER: OSP161251 RECORD DRAWING 050-131-69 PER ROB CAMPBELL WITH ARM SERVICES, OWNER WILL BE INSTALLING ADDITIONAL FILL ON DOWNHILL S1DE OF TANK IN THE SPRING. THIS IS TO INSURE COVER DOES NOT SLOUGH AWAY FROM TANK. FINAL GRADE = 100.10 - 100.30 2' OF INSULATION TOP OF TANK AT INLET =97.57- I / (PER CONTRACTOR) I I STOP OF TANK AT OUTLET =97.50 INVERT OF BUNG AT INLET = 96.96NEW 1250 GALLON SEPTIC TANK INVERT OF BUNG AT OUTLET = 96.76 GARNESS ENGINEERING GROUP, Ltd 4 , CIVIL & ENVIRONMENTAL ENGINEERS 3701 E.NOOR ROAO, SUITE 101 -ANCHORAGE, AH 99507'PHME(9W)337L179'FM(9W)33 3246'WEMIM: www.9ameve,gineen,q.mm ' ••• • • ••••••••••••• •050 • •••••• • 00-11 By,A. GBm SS . 4 PREPARED FOR: PHONE NUMBER: PAGE NUMBER: • # 'S- MIKE FISCHETTI 441-9711 2 OF 3 -' �� J, CE�7 X14044 PROJECTILEGAL DESCRIPTION: DRAWN BY: BROADWATER HEIGHTS; BLOCK 3, LOT 10 L.K.B./J.L.M. p'�)'�.i23U\`P� :.� /1LICENSE� '� TYPE OF WORK: RECORD DRAWINGS DATE: 11/23/2016 `S". �4• #AECC884 V4 III On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP161251 Tax Code Number: 05013169000 Work Type: Septic Upgrade Permit Effective Dates: September 23, 2016 to September 23, 2017 Design Engineer: GARNESS ENGINEERING GROUP LTD Subdivision: BROADWATER HEIGHTS Site Legal Address: BROADWATER HEIGHTS BLK 3 LT 10 G:0253 Owner/Address: VREELAND BARBARA F 136 CHANGEBRIDGE RD UNIT 0-1 MONTVILLE NJ 070459525 Site Mailing Address: 11806 W SKYLINE DR, Eagle River This permit is for the construction of: N Disposal Field Y Septic Tank N Holding Tank N Privy Lot Size in Sq Ft: Total Bedrooms: N Private Well N Water Storage 20595 2 All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received Issued By: _'�, % t -t -A W23//& Date: 7 - 23 zC= MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Fax: 907- 343-7997 On -Site Water & Wastewater Program Mayor Dan Sullivan On -Site SewedWell Permit Application For Single Family Dwelling Parcel I. D. 050-131-69 Property owner(s) BARBARA VREELAND Day phone N/A Mailing address 11806 W. SKYLINE DR. *EAGLE RIVER, AK 99577 Site address 11806 W. SKYLINE DR. *EAGLE RIVER, AK 99577 Legal description (Sub'd, Block & Lot) BRAODWATER HEIGHTS; BLOCK 3, LOT 10 Legal description (Township, Section & Range) Lot Size Sq.Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DEWELLING: (Nallthatapply) Initial ❑ Single Family (SF) Absorption Field ❑ ® (w/wo ADU) Septic Tank ® Upgrade Duplex (D) El❑ Holding Tank ❑ Renewal Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: Z t 5VAG Waiver Fees: Date of Payment: 1-7-1 h Date of Payment: Receipt Number: ('57 )J C G Receipt Number: Permit No. 0 ' &I ZS/ Waiver No. (Rev. 01111) GARNESS ENGINEERING GROUP, Ltd `d---d7 1 CIVIL & ENVIRONMENTAL ENGINEERS ffillaffigmAr September 21, 2016 — RJ7=VISED q& Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Proposed Septic System for Broadwater Heights; Block 3, Lot 10 To whom it may concern The existing 3 bedroom house is served by a private well and septic system. We have been contacted by the Owner's representative, Mike Fischetti (Son-in-law to the owner) who stated that they would like to have the septic tank replaced. We are proposing to decommission the old 750 gallon septic tank and install a new 1,250 gallon septic tank (oversized per the owner representative's request). Per the MOA records, the 1986 HAA was previously approved for 2 bedrooms. However, per the 1986 HAA by Robert R. Shafer, P.E. the soil rating was 85 FTz/Bedroom with a total drainfield area of 252 FTz. Based upon this fact, the drainfield is adequately sized for approximately 2.9 bedrooms (252/85). Given that the home is three bedrooms and the existing system has functioned for approximately 30+ years. It seems reasonable to approve the septic system for a 3 bedrooms. 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. P.E., M.S. 3701 East Tudor Road, Suite 101 *Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.gamessengineering.com BROADWATER GEG, Ltd. HAS A 8 PAGE SPECIFICATION PHONE NUMBER: LETTER THAT PERTAINS TO THIS DESIGN. TO BARBARA VREELAND I N/A OBTAIN A COPY OF THE LETTER CONTACT 201=2 G,PO GEG. BY PROCEEDING FORWARD WITH THIS DRAWN BY: BROADWATER HEIGHTS; BLOCK 3, LOT 10 INSTALLATION, THE ENGINEER, WELL DRILLER, PNB TYPE OF WORK: CONTRACTOR AND PROPERTY OWNER AGREE DATE: SEPTIC TANK UPGRADE DESIGN THAT THEY HAVE READ THESE 6/6/16 SPECIFICATIONS AND AGREE TO ACCEPT THE TERMS AND CONDITIONS OUTLINED. NOTE: THE CONTRACTOR SHALL HAVE THE SOUTH & WEST LOT LINES, AND ALL WELL RADII FLAGGED BY A REGISTERED LAND SURVEYOR PRIOR TO CONSTRUCTION. NOTE: CONFIRM WELL LOCATIONS ON BLOCK 3, LOTS BROADWATER HEIGHTS; Q SEPTIC ARE SEPTIC ARE BROADWATER HEIGHTS; BLOCK 3, LOT 12 3, LOT 9 ;1 ---------------- INSTALL ------------- INSTALL FCO IF ONE IS NOTEXISTING 3 PRESENT BEDROOM HOUSE TO BE PROPOSED 1250 GALLON SEPTIC TANK FOLLOWED BY DOUBLE C!O'S DRAINFIELD HEIGHTS; BLOCK 3, LO%11 GARNESS ENGINEERING GROUP, Ltd PREPARED FOR: PHONE NUMBER: PAGE NUMBER: BARBARA VREELAND I N/A 201=2 PROJECTILEGAL DESCRIPTION: DRAWN BY: BROADWATER HEIGHTS; BLOCK 3, LOT 10 PNB TYPE OF WORK: DATE: SEPTIC TANK UPGRADE DESIGN 6/6/16 4L LICENSE #AECC884 I 1 1* gus MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section ''W Fax: 907-343-7997 Certificate of On -Site Systems Approval C' Parcel I.D. 050-131-69 Expiration Date: ) 1. GENERAL INFORMATION Complete legal description Broadwater Heights, Block 3, Lot 10 Location (site address) 11806 W Skyline Drive Eagle River, AK Current property owner(s) Barbara Vreeland Day phone 441-9711 Mailing address 3 Afterglow Way, Motville, NJ 07045 Real estate agent Chris Swires Day phone 830-0073 2. TYPE OF DWELLING: E] Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 2 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well El Private Septic El Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 306 Date of Payment 9fia f`9 Receipt Number o''3jc-q"db COSA # 0-5091C131 Waiver Fee $ Date of Payment Receipt Number Waiver # 6. 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. 1 acknowledge that On -Site staff may visit the site.to verify the information submitted. Name of Firm Forge Engineering Phone 907-522-7773 Address 1399 W. 34th Ave Suite 101, Anchorage AK 99503 Engineer's Printed Name Michael E. Anderson, P.E. Date 9/12/19 6. DSD SIGNATURE System #1 Approved for 2 bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following stipulations: _.. All l.,. By: '�-- `—�� Original Certificate Date: 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 i Legal Description: Broadwater Heights Block 3 Lot 10 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA Parcel ID: 050-131-69 Structure served by this system ❑ Well log is filed with Onsite (or attached) Well production at time of test 0.5** gpm Date drilled *1973 Water storage tank volume 600 gallons Total depth 189 ft Well disinfected for coliform test? ❑ Yes FOR No Cased to 13 ft ❑ Coliform bacteria is Negative ❑ Sanitary seal is functioning correctly Nitrate 9.74 mg/L ❑ Nitrate less than MRL (ND) ❑ Wires are properly protected Arsenic ug/L ❑ Arsenic less than MRL (ND) Casing height (above ground) '12 in. Collected by FORGE ENGINEERING Date of flow test for COSA 9/10/19 Date of Sample 8/28/19 Static water level at beginning of test 13 ft. Comments *No well log. Well drilled prior to 1975. **Well fracked & flow tested by Anchorage Well & Pump. Well info from AWPS Pump Report. Bedrock assumed at 11'. B. TANK DATA Age of tank(s) 3 years Tank type/material Septic/Steel Measured operating fluid level in septic tank 5 ❑ Standpipes/foundation cleanout per record drawing Date of pumping 10/22/18 ARM Septic Services C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Seepage Pit Which system tested (date installed) 7/2/73 Adequacy test date 8/26/19 - ❑ ALL standpipes present per record drawing Results ❑✓ Pass For 2 bedrooms Total measured depth from grade 9 ft (max) Fluid depth prior to test 14 in Measured depth to pipe invert from grade N/A* ft (min) Water added 500 gal ❑ N/A — pressurized field New depth 52 in ❑ Monitor tubes go to bottom of effective. If not, state Elapsed time 1440 min depth into effective ❑ Code -required soil cover over field Final fluid depth 20.5 in ❑ System presoaked Absorption rate '300 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) No date of test) If yes, enter date Gallons introduced gallons Comments/Deficiencies: 'Effective depth information taken from MOA records. COSA Checklist yellow sheet 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' Q✓ Yes Community Sewer Manhole/Cleanout > 100' ❑✓ Yes if No ft F Yes if No ft Neighboring Tank > 100' [71 Yes if No ft Private Sewer/Septic Line > 25' Q✓ Yes if No ft Absorption Field on Lot > 100' 0✓ Yes if No ft Holding Tank > 100' F/ Yes if No ft Neighboring Absorption Fields > 100' ❑✓ Yes if No ft Water Main > 10' Animal Containment > 50' Q✓ Yes if No' ft Fv Yes if No ft Yes if No ft Water Service Line > 10' ✓❑ Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway Community Sewer Main > 75' F Yes if No ft F,71 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' Q✓ Yes if No ft Surface Water > 100' ®✓ Yes if No ft Property Line > 5' ✓0 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' E✓ Yes if No ft Private Wells > 100' ❑✓ Yes if No ft Water Main > 10' ✓0 Yes if No ft Community Wells > 200'✓1 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' Yes if No ft If absorption field is under driveway comment below Property Line > 10' Yes if No ft Wells on Adjacent Lots: Water Main > 10'✓C] Yes if No ft Private Wells > 100' [✓ Yes if No ft Water Service Line > 10' Q Yes if No ft Community Wells > 200' Q Yes if No ft Surface Water > 100'✓� Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION l certify that l 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. COSA Checklist yellow sheet \ \\ Lot 9 f '� \ y \ _7• a" w ' a X 'I \ \tn f \ \ o f \ \ W 3 / t� Lot 13 \ \ \ , r6 ]Lot no P,0 ' A LO S Iry -j v. Porch % • !f, Lot 12 \ , o 2 $tory \ 1 o w House 12.3', fy N� \ r 8230.00' 00 1115'21'19,. • • (� �1 \ Cov Deck N '.\ , \ . \ .. • ..J e • A Hurst ; � � \ �\ \ 2 � \ F LS 17j96 0 15 30 Lot 11 USSURVEY \\ NOTES ,� PEr -All dimensions shown are grid bearings and ground distances, Record boundaries are per Plat No. 73-18. -49th Star has conducted a physical survey of the property and all details shown on this Asbuilt Survey are correct. Under no circumstances should any data hereon be used for construction or for establishment of property lines. It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. AS BUILT SURVEY Lot 10, Block 3, Broadwater Heights Subdivision, Eagle River,' AK LEGEND Qo Septic vent, C/o Power Pole O Well Tele -comer Pedestal —_. GHF -- Overhead Utility Line 49th Star Surveying ULC 321 Fireoved Drive Anchorage, AK 99508 (907)$91-6111 Jeremy949thSta rSurveyi ng.com W.O. 19031 1 DATE: 09/11/191 I SCALE: 1"=30' Well Water Advisory Certificate of On -Site Systems Approval # OSC191431 Subdivision: Broadwater Heights, Block: 3, Lot: 10 This well's productivity was determined to be .5 gallons per minute. The minimum well productivity required under (AMC 15.55) for a 3 -bedroom residence is .31 gallons per minute or 150 gallons per day per bedroom. Although the subject well currently exceeds this minimum requirement, the production capacity can fluctuate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. l MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL`S OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date IOF 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or direc ons) Rit..t/J v�`--�LOOBusiness v (b) Applicant Name ^ISQ�((,e�eG cam- Telephone: Home C/ ' Applicant Address &%� (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder ❑ ; Buyer'; Other ❑ (explain); (d) Lending Institution ,Z ng-te_ ' Telephone Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to tF q following address: C'�fS �✓�LL�./� .ii llOil i �..r Js 2. TYPE OF RESIDENCE Single -Family Multi -Family ❑ Other Number of Bedrooms CA—, 3. WATER SUPPLY Individual Well 0( Community ❑ 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 9 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 (11/84) ENGINEERING FIRM PROVIDINu INSPECTIONS, TESTS, FILE SEARCH, DA. A 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 Address Date S & S ENGINEERI SR B 196X EAGLE RIVER, AK 6. DHEP APPROVAL —0--2 r__ — — Approved for / CA t:C> bedrooms Approved Disappr Terms of Condition I Approval Telephone 46 5PfK_ZA?7IF Conditional ' CAUTION E o. AL4, h 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) 'Ja • 4,S I � � e. i • • • •61N0• • •fPIYO ¢•<• e t 7� �I� pen • (� V 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) „ INICIPALITY OF ANCHORAGE (MOA) �,N HEALTH AUTHORITY APPROVAL (HAA) MSN` Qp�(��� � �ZEG�tDN CHECKLIST VARY 1984 1RD�N 12 Legal Descripti �– 1 SEt �0 r�a�w A. WELL DATA Q �_� Well Classification S - � If A, B, C, D.E.C. Approved Well Log Present (Y�I �— Date Completed U•� ������ Total Depth � ©Y � Cased to `'fb� � Depth of Grouting Static Water Level � Pump Set At Casing Height Above Ground ��� -f' Sanitary Seal on Electrical Wiring in Conduit (�N) Depression Around Separation Distances from Well: To Septic/Holding Tank on Lot �Ob � � ; On Adjoining To Nearest Edge of Absorption Field on Lot � �� f # ; On Adjoining Lots To Nearest Public Sewer Line �`'`�A' To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Water Sample Collected by +�;Date Water Sample Test esults Comments � �fz[eT� B. ° SEPTIC/HOLDING TANK DATA Date Installed "� Size ! CM No. of Compartments SL 0 ir4 (Y/N) N /� Yield LA .r, Casing O)N) Wellhead (Y� Lots 1 C�tS� + Line on Lot 75 9/9/g& Standpipes 6DN) Air -tight Caps Y&) Foundation Cleanout (Y VQ Depression over Tank (YAM Date Last Pumped Pumping/Maintenance Contract on File (Y/N) WA- ; for Holding Tank High -Water Alarm (Y/N) ��A Temporary Holding Tank Permit (Y/N) 141A Separation Distances from Septic/Holding Tank: To Water -Supply Well ���� To Building Foundation To Property Line �� t To Disposal Field 5 To Water Main/Service Line ��� To Stream, Pond, Lake, or Major Drainage Course W Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata S6 4//3_' Type of System Design �Cr 1�AV'� PIT Date Installed Z --V ) Length of Field I Width of Field - Depth of Field Gravel Bed Thickness & Square Feet of Absorption Area zC, Standpipes Present (ON) Depression over Field (YoI Date of Last Adequacy Test Results of Last Adequacy Test / Tt S lcd U2.y Separation Distance from Absorption Field: To Water -Supply Well f.�0 ! To Property Line Z d" + To Building Foundation 2—Y To Existing or Abandoned System on Lot NIA ; On Adjoining Lots 5c) 14 To Water Main/Service Line �S df + To Cutbank (if present) N114 To Stream/Pond/Lake/or Major Drainage Course N/A To Driveway, Parking Area, or Vehicle Storage Area 3C>1 + Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off' Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all M A and HAA guidelines in effect on the date of this inspection. Signed S & S ENGINEERING Date Z Ar6 CompanySR B 196X MOA No. B'6''"040.3 EAGLE RIVER, AK77 -10 Receipt No. C2 Date of Payment �� � ,,� A,( •eeae�67 Amount: $ C�� �� » !•Nab Veer' a '% NOV .4. S Sol* b' sMa ax w' Page 2 of 2 � •eH aU�N 1e eA►®lr�e s ch % M. Iois�4 A�f &tee A � 72-026 (11/64) ��'J���►e.�N���(� � p�opt F, ... MUNICIPALITY OF ANCHORAGE u, 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 a1�� 1. GENERAL INFORMATION (a) Legal Qescription (include lot, block, subdivision, section, township, range) Location, (address or directions) 14 (b) Applicant Name( - Telephone: Home Applicant Address (c) Applicant is (check one): L nding Institution ❑ ; Owner/builder [ _ Business Buyer ❑ ; Other (explain); (d) Lending InstitutiorP«+1-n✓a` Telephone Address (e) Real Estate Company and Agent �iGh-yc ✓ G✓ Address Telephone (f) Mail the t %t� the follgwing address: ngineering Eagle 'River, Qlarkq 99+"77 2. TYPE OF RESIDENCE Single -Family K Multi -Family ❑ Other Number of Bedrooms �- 3. WATER SUPPLY Individual Well k Community ❑ 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 Public 1:1 Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department pf Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11/84) 5. ENGINEERING FIRM PROVIDINui INSPECTIONS, TESTS, FILE SEARCH, DA i A 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 Telephone Address 5RB 796x Date 6. DHEP APPROVAL Approved for Approvedy� 2 -7— V C ..` �w 443' 6( so* nin Rajbvd A. $haws `G14574 vara 1+1+x. «« da 4 �, °,•� .�� ops bedrooms by � .r,�-�-*� Date Disapproved Terms of Conditional Approval Conditional 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 79-n95 (11184) MUNICIPALITY OF ANCHORAGE (MOM) HEALTH AUTHORITY APPROVAL (HAA) UNICIPALITY OF ANE�%6h IST- FEBRUARY 1984 DEPT. OF HEALTH & 264-4720 a4VIRONNAENTAL PROTECTION Legal Description: F F � 7 ' 198 A. WELL DATA RECEIVED Well Classification �Q I V 41- 2L If A, B, C, D.E.C. Approved (Y/N) Well Log Present Date Completed Yield Total Depth Z(->4 Cased to ��� Depth of Grouting LA1<s Static Water Level 301 Pump Set At U K Casing Height Above Ground i Z- ti Sanitary Seal on Casing/Ddb Electrical Wiring in Conduit &K Depression Around Wellhead (YIQ Separation Distances from Well: To Septic/Holding Tank on Lot I UO t ; On Adjoining Lots I l + To Nearest Edge of Absorption Field on Lot 1 ; On Adjoining Lots To Nearest Public Sewer Line _ A" To Nearest Public Sewer I Cleanout/Manhole To Nearest Sewer Service Line on Lot�� Water Sample Collected by ��I�s 21h1 6 ; Date Z —7—C;)-8 G Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA Date Installed Size wy No. of Compartments l Standpipes (�/,w Air -tight Caps OK Foundation Cleanout { Depression over Tank) Date Last Pumped Z_ 11-86 Pumping/Maintenance Contract on File (Y/N) ;,for -a~t nl Holding Tank High -Water Alarm (Y/N) A Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: l To Water -Supply Well 1 b C� t To Building Foundation l To Property Line I To Disposal Field S~ To Water i/Service Line , T St P d L k M' D Course Comments Page 1 of 2 72-026(11/84) til W ream, on I a e, or alor ramage C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata9)5 f I P�- Type of System Design Date Installed 1-Z" r 3 Length of Field t �- Width of Field Depth of Field q Gravel Bed Thickness (01 Square Feet of Absorption Area Z 2 -Standpipes Present UY * Depression over Field "// ) Date of Last Adequacy Test Z- LO -8 L Results of Last Adequacy Test S A -1 -(6F_ -A,0 -'C -6K --V Separation Distance from Absorption Field: To Water -Supply Well 1 O b t � To Building Foundation Lot To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course ZO To Property Line ; On Adjoining Lots — To Existing or Abandoned System on 6z-) 1+ To Cutbank (if resent) ."� To Driveway, Parking Area, or Vehicle Storage Area ?jam Comments k q Z- I to D. LIFT STATION Date Installed Dimensions Size in Gallons Manhole/Access (Y/N) "Pump On" Level at t "Pump Off' Level at High Water Alarm Level at A Vent (Y/N) Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** 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 S & S Engineering Date Z - Z?� 8-6 MB 196x CompanyA!-Ska Y9577 MOA No. Receipt No. 3 1 Lo1�_ Date of Payment S Amount: $ 'CD) Page 2 of 2 72-026 (11/84) �'ti We �� gyp• fi �ey� R Zi` r. ' M Y :Walwo r - 140. �{ N&: awl