HomeMy WebLinkAboutMEADOW BROOK BLK 1 LT 6Meadow Brook Block 1 Lot 6 #050-191-33 Future COSA's will not be approved w/o the berm in place. Inspection Report _1-1-12.doc Municipality of Anchorage Community Development Department Page 1 of 3 On -Site Water & Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907)343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP161010 PID Number: 050-191-33 ❑ New ■Upgrade Name: SHERRY CARLSON ABSORPTION FIELD ❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address: 10946 IDITAROD CIRCLE *EAGLE RIVER, 99577 ❑ Other Phone: No. of Bedrooms: Sail Rating: Total Depth from original grade: (228) 539-4655 5 GPD/Sq. Ft. Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath e: Ft. R. Subdivision: Block: Lot: Fill added above original grade: Croy ngth: MEADOW BROOK 1 6 G Ft. owns Ip: anger Section: Gravel width: Rede Number of linea. Distance between linea: R. Ft. SEPARATIONDISTANCES To al abso pli area: Number of trenches: Dist. between trenches: To Septic Absorption Lift Holding Public/Private From Tank Field Station Tank Sewer Unes So. Ft. Ft. Well AWWU EXISTING EXISTING EXISTING 25'+ TANK ■ Septic ❑ S.T.E.P. OHolding ❑Other Manufooturer: Capacity: Surface Water *45'+ ANCHORAGE TANK 2000 Gal. Lot Line 5'f N/A Material: Number of compartments: STEEL 2 LIFT STATION Foundation 5'+ Curtain Drain NONE KNOWN Manufacturer. r S�\NG cal. 'Pump on' level at: Pump off I High water alarm air Remarks: PER CONTRACTOR, OLD SEPTIC TANKS DECOMMISSIONED PER UPC. Pump Make & Electrical Inspections performed by: *PROFESSIONAL SURVEY CONTROL ONSITE DURING PIPE MATERIAL INSPECTION. House to tank D3034 Tank to D3034 Lift Station Installer NORTHERN EXCAVATION Drainfield EXISTING CO/MT EXISTING Inspector GEG, Ltd. BENCH MARK (Assumed elevation) 100.00 Ft Inspection Location and Description: Dates: 1 st 2/26/2016 2nd 3rd 4th BOTTOM OF SIDING 10' NORTH OF POINT A ENGINEER'SS L Community Development Department Approval _00600 �4 o Conditional approval: Date: :-7 If ........ ..... ........... �a .J ff y Gar ess. �O CE— 00 �p�4pfP^• Approved: � I Date: �/2 . 31�s �6.'c�oo u04d prof IA esslono, 004�vo�a Inspection Report _1-1-12.doc PfkMIT NUMBER: PARCEL ID NUMBER: OSP161010 RECORD DRAWING - 050-191-33 A I B DB2 18.4 19.6 ST1 20.0 21.2 AWWU WATER ST227.9 30.8 MEADOW BROOK; BLOCK 1, LOT 8 AWWU WATER MEADOW BROOK; BLOCK 1, LOT 9 OLD TANKS PUMPED AND FILLED WITH CONCRETE. EAGLE RIVER HEIGHTS NORTH; BLOCK 5, LOT 7 AWWU WATER EXISTING 5 BEDROOM HOME MEADOW BROOK; BLOCK 1, LOT 7 AWWU WATER WATER LINE IS 10'+ FROM SEPTIC TANK, 'EXISTING 250 STEVE PANONY GALLON PUMP VAULT NEW 2000 GALLON SEPTIC TANK, �\ SPA WAS REMOVED, / r \ NO DECK OR \\ PLATFORM TANK / �� A f° \ i ti0 AWWU WATER EAGLE RIVER HEIGHTS NORTH; BLOCK 5, LOT 8 EXISTING TRENCH AS SHOWN ON 10/19/2015 INSPECTION REPORT G AX -20 PODS MEADOW BROOK; BLOCK 1, LOT 5 AWWU WATER AWWU WATER EAGLE RIVER HEIGHTS NORTH; BLOCK 5, LOT 9 GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS 3101 E. 1000N H , SONE 101 ONCHgVCE. M 99501 • PHONE (907) 331-9179 • FM (907) 339-329 M£B91E wwn9amapm9lne<Nn9cam PREPARED FOR: PHONE NUMBER: PAGE NUMBER: SHERRY CARLSON (228 539-4655 2 OF 3 LEGAL DESCRIPTION: DRAWN BY: MEADOW BROOK; BLOCK 1, LOT 6 L.K.B. TYPE OF WORK: DATE. . RECORD DRAWING -A/-A/7n1r, 31 On -Site Water and/or Wastewater System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP161010 Tax Code Number: 05019133000 Work Type: SepticTank Upgrade Permit Effective Dates: February 04, 2016 to February 03, 2017 Design Engineer: GARNESS ENGINEERING GROUP LTD Subdivision: MEADOW BROOK Site Legal Address: MEADOW BROOK BLK 1 LT 6 G:0153 Owner/Address: CARLSON MATTHEW A & SHERRY P 18031 CEDARDALE RD SAUCIER MS 395740000 Site Mailing Address: 10946 IDITAROD CIR, Eagle River Lot Size in Sq Ft: Total Bedrooms: This permit is for the construction of: N Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must be in accordance with: 24396 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, Secial Provisions: LEnginee�rto A, OSC151579, issued 10/21/15 is not valid due to the failing septic tanks. New COSA may be submitted with the new tank information as a change order. Change Order fees confirm that any surfacing effluent will travel 100' before entering surface water. Received By: Issued By: P1 2 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 Sewer/Well Permit Application For A Single Family Dwelling Parcel I.D. 050-191-33 Property owner(s) SHERRY CARLSON Day phone (228) 539-4655 Mailing address 10946 IDITAROD CIRCLE *EAGLE RIVER, AK 99577 Site address 10946 IDITAROD CIRCLE *EAGLE RIVER, AK 99577 Legal description (Sub'd, Block & Lot) MEADOW BROOK; BLOCK 1, LOT 6 Legal description (Township, Section & Range) Lot Size Sq.Ft. Number of Bedrooms 5 APPLICATION IS FOR: APPLICATION IS AN: (Pan that apply) Initial ❑ Absorption Field ❑ Upgrade Septic Tank Renewal ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR: TYPE OF DEWELLING: Single Family (SF) (w/wo ADU) Duplex (D) ❑ Multiple Dwellings ❑ (SF and/or D) SEPTIC TANK TO SURFACE WATER Distance: 45 FEET I certify that the above information is correct. I further certify the' this is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/RushFees: a15� Waiver Fees: Date of Payment: l lao1I �// Date of Payment: �d11 So Receipt Number: b' ��"i Receipt Number: o l tnq�\ Permit No. dS'l?I k'o `01 O Waiver No. 015V 1% 100 \ (Rev. 01/11) GARNESS ENGINEERING GROUP, Ltd CIVIL &ENVIRONMENTAL ENGINEERS January 8, 2016 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Proposed Septic Tank Upgrade for Meadow Brook; Block 1, Lot 6 To whom it may concern: The existing 5 bedroom home is served by AWWU water and a private septic system. The existing 1973 concrete septic tanks (2 at 1000 gallons each) are leaking and need to be replaced. We are proposing to decommission the existing concrete septic tanks per UPC and install a new 1500 gallon deep burial steel septic tank. Waivers: The existing 500 -gallon lift station and the existing drainfield have a variance from 100' to surface water to 56.9 and 69.4 feet respectively. We are requesting your department issue a variance from 100' to 45' for the proposed 1500 gallon septic tank. As can be seen on the attached drawing, the proposed septic tank is approximately 45 feet from the edge of the creek. Additionally, the attached drawing shows "edge of ice" which was professionally located by Fred Walatka and Associates. Per conversation with James J. Crewdson, P.E. on inI2016, the edge of ice is not considered the edge of the stream; therefore, we are requesting a waiver to the edge of creek and not the edge of ice. We are requesting your department issue a 45' waiver from the proposed septic tank to the existing creek. Justifications for this waiver are as follows. • During the installation of the existing drainfield a berm was constructed (see attached drawing) to divert potential overflow away from the stream. If septic tank effluent were to overflow, it could not flow directly towards the stream. • The area between the septic tank and the surface water is vegetated. • The area of the proposed septic tank is in a visible area, if effluent were to overflow, it would be noted and corrected by the homeowner. • The lift station downstream of the proposed septic tank is part of an Advantex system with remote monitoring. 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. 19 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com LETTER THAT PERTAINS TO THIS DESIGN. NOTE: THE CONTRACTOR TO OBTAIN A COPY OF THE LETTER BLOCK CONTACT GEG. BY PROCEEDING FORWARD SHALL HAVE THE 45' MEADOW BROOK; WITH THIS INSTALLATION, THE ENGINEER, I IOFFSET FROM THE EDGE OF 1, LOT 7 WELL DRILLER, CONTRACTOR AND CREEK FLAGGED BY A PROPERTY OWNER AGREE THAT THEY I REGISTERED. LAND SURVEYOR I HAVE READ THESE SPECIFICATIONS AND AGREE TO ACCEPT THE TERMS AND PRIOR TO CONSTRUCTION AWWU WATER MEADOW BROOK; BLOCK 1, LOT 9 45' OFFSET FROM ASSUMED EDGE OF CREEK l AWWU WATER AWWU WATER APPROXIMATE LOCATION OF EXISTING WATER LINE PER MEADOW BROOK; 10/19/2015 INSPECTION REPO BLOCK 1, LOT 8 BY STEVEN R. PANNONE, P.E/ EXISTING 500 GALLON STEP TANK V EAGLE RIVER HEIGHTS NORTH; BLOCK 5, LOT 7 AWWU WATER EDGE OF ICE PROFESSIONALLY— LOCATED BY FRED WALATKA AND ASSOCIATES ASSUMED 5' OFFSET CREEK CENTERLINE CENTERLINE OF CREEK, ASSUMED - A WIDTH OF 5' FOR A 45' WAIVER TO THE PROPOSED SEPTIC TANK EXISTING 5 BEDROOM *4 INSTALL DOUBLE— CLEANOUTS BEFORE THE TANK / i i L¢ li P i � O / 250 PUMP VAULT TRENCH AS SHOWN 9/2015 INSPECTION EXISTING AX -20 PODS APPROXIMATE LOCATION OF i EXISTING BERMS PER 10/19/2015 INSPECTION REPORT BY STEVEN R. PANNONE, P.E.. BERM TO BE EXTENDED, IF NEEDED, TO EXISTING DOUBLE PROVIDE 100' SEPARATION TO CLEANOUTS STREAM. I MEADOW BROOK; BLOCK 1, LOT 5 PROPOSED 2000 GALLON AWWU WATER DEEP BURIAL SEPTIC TANK APPROXIMATE LOCATION OF EXISTING 1973 CONCRETE SEPTIC TANKS TO BE DECOMMISSIONED PER UPC IAWWU WATER 2 AWWU WATER i EAGLE RIVER HEIGHTS NORTH; BLOCK 5, LOT 8 EAGLE RIVER HEIGHTS NORTH; BLOCK 5, LOT 9 GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS snnl F. relax RO . M0 101 • MCH WE. M 9950) • MNE (90)) 331-0179 • FM (907) 338-3248 • WE M; wwRgomeevanglma0n9.R9m PREPARED FOR: I PHorvt 15MULK: rA�L NVMeeK: SHERRY CARLSON (228)539-4655 1 OF 1 LEGAL DESCRIPTION: DRAWN BY: MEADOW BROOK; BLOCK 1, LOT 6 D.J.G. TYPE OF WORK: DATE: . 40 SCALE SEPTIC TANK DESIGN UPGRADE 1/8/2016 .................... ... .. °. f A. G mess Fes= Inspection ReporY1-1-12.doc Municipality of Anchorage Community Development Department Page 1 of 3 On -Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP151278 PID Number: 050-191-33 ❑ New ❑✓ Upgrade Name: Matthew & Sherry Carlson ABSORPTION FIELD ❑ Deep Trench ❑✓ Shallow Trench ❑ Bed ❑ Mound Address 10946 Iditarod Cir. Eagle River, AK 99577 ❑ Other Phone - Number of Bedrooms Soil Rating Total depth from original grade - 5 6.0 GPD/SF 4.5 Ft. LEGAL DESCRIPTION Depth to pipe invert om original grade /%� 3. S /Ft. Gravel depth beneath pipe 1 Ft. Subdivision Block Lot Meadow Brook 1 6 Fill added above original grade 0 Ft. Gravel length 22 Ft. Township Range Section Gravel width 5Ft. Beds: Number of Lines N/A Distance between lines N/A FL SEPARATION DISTANCES To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line 110 Fez 1 N/A Ft. Well NIA N/A N/A N/A N/A TANK ❑ Septic [] S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage Tank Capacity I 500Gal. Surface water N/A 69.4 56.9 N/A Material Steel Number of compartments 1 Lot Line N/A 17.7 41.8 NIA NA Foundation N/A 38.9 16.5 N/A LIFT STATI N Manufacturer Capacity Curtain Drain N/A N/A N/A N/A Anchorage Tank 250 Gal. Pump on level at Pump off level at High water alarm at Remarks Used existing concrete tanks. Added 500 gallon 43 in. 42 in. 1 45 in. advantex recirculating tank. Pump make and model P2005 Electrical Inspections performed by Capstone Electric PIPE MATERIAL House to tank 3034 drainfeld Tank to 3034 Installer Wilco Contractors Drainfield 3034 CO/MT 3034: Inspector Pannone Engineering Services, LLC. BENCH MARK (Assumed elevation) 10011 Inspection ts` 10/8/2015 m 2 10/8/2015 Location and description dates: 3" 10/8/2015 a`" Garage finished floor COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp �''Qr�h Conditional Approval: Date ,r /. ........ •'�a�even •h�l�anrior�e ��OFE551 Approve 4 Date1 44 i� ,��•• `,\\its►+' Inspection ReporY1-1-12.doc A B / \ DC 16.1 34.9 MH1 17.0 32.6 i MH2 20.2 37.0 i , - POD1 25.0 39.5 ,-"�-- PGD2 27.0 42.8 M 1 41.2 45.0 M2 61.0 64.6 SURROUNDING LOTS SERVED BY PUBLIC WATER INSTALLED ABSORPTION FIELD NEW'* 22LFx5.0'Wx1.O'E.D.,TD ' 4.5' 1.25" 2) PERF PIPE W/ 1/81, HOLES DRILLED 18" 0. C. " INSTALLED 250AUX / `. PUMP TANK NEW � DRIVEWAY w�c an \ S� O INSTALLED 500 TANK �� & 2EA AX -20 PODS AND w�Z+ ( ) �i DCO BEFORE TANK NEW i o M2 w B SIC) TH-1 s=pp2� M2', as— MH1 A Mit _ DC HE 5 BIR HOUSE Pooz \ so (S,EPTIC AREA \ N 9 ^'ABANDONED ABSORPTION FIELD \ 'IN w / PLACE PER MOA CODE \ REMOVED ALL PARTS OF FIELD 2(EA) 1000 CONCRETE WITHIN 10' OF NEW TRENCH SEPTIC TANKS (E) _, TH-1986 NO GROUNDWATER TO 13.0' x(APPROX. EARTHEN BERM 1.0'H W 1 :3 LOCATION) \ ' SIDE SLOPES TO PROVIDE 100'+ OVERLAND SHEET FLOW TO STREAM TS &V o L / 96 kp NOTES: ��T7�� 7�7� P.o �7 ENG i��� \\ Date RECORD DRAWING eox�i 01oi ACK yL r �(('•�F A�gsl)I� �y++ 0/19/2015 PHONE (907) 272-8218 FAX (907) 272-8211/�rrj�p Scale j*.49TM..........*ll =30 �'••" •• P.LD. NO MEADOW BROOK B1 L6 -191-3 DRAWN NJC MATTHEW & SHERRY CARLSON / Steven R. Pannone % P CE 8149 .fir// PERMIT NO. 10946 IDITAROD CIRCLE �+ r 00 OSP151278 PLAN PLAN EAGLE RIVER, AK 99577. 4ssk Sheet e0E \ N� 3 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION WAS INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS. 2. SCOPE OF WORK: INSTALLED NEW SOOg RECIRCULATING TANK W/ 2 EA. AX -20 PODS & 250g AUX PUMP VAUL-T. INSTALLED NEW SOIL ABSORPTION SYSTEM. INSTALLED NEW EARTHEN BERM SYSTEM. 3. GROUNDWATER WAS NOT ENCOUNTERED TO A. DEPTH OF 13.0 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. NO APPARENT WATER TABLE WAS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 13.0 FEET BELOW EXISTING GRADE. -LD SO 1,25" 0 PERE PIPE W/ 1/8" HOLES DRILLED IS" CC, -DRAIN RDCK 6" ABOVE PIPE INV 98.8 DESIGN PARAMETERS METERS PRIMARY SEPTIC SYSTEM NO. BEDROOM: 5 (750 gpd) TANK SIZE: 2(EA)1000g CONCRETE P'ERC RATE: <1 MPI (SEE ATTACHED SOIL ANALYSIS) SOIL RATING: 6.0 GPD/SF SYS. TYPE: WIDE TRENCH 1.0'ED REDUCTION FACTOR: 0.87 .AREA ROD: 108.75 SF MIN LENGTH: 21.75 LF USED 22LFx5.0'Wx1.O' E.D„ TD 4.5' TOTAL AREA: 1 10 SF NOTES: PANNONE ENG SVC, LLC AWING P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 MEADOW BROOK B1 L6 MATTHEW & SHERRY CARLSON DRAWN N,1C 10946 IDITAROD CIRCLE PLAN EAGLE RIVER, AK 99577 ABBREVIATIONS -13 J LJ TH TEST HOLE (P)_ PROPOSED FILTER FABRIC (E) EXISTING , CO CLEAN OUT NO. 90.5 MT MONITOR TUBE N0. TYP TYPICAL `SOA l F ... CgSI�+ r'�P7Ae'�ot Oate 10/19/2015 Scale rc DRAIN ROCK 6" ABOVE z PIPE INV S sEL.10}.8 p ELIJ12 II I 5=J 02J TH-l EL.LO35 OR -1 -10 W EL 100 0 2. 20 E CM 988 8. 98-8 S A� I S i ppy pppppppp PITC SEPIX: Tb --------------1-- DESIGN PARAMETERS METERS PRIMARY SEPTIC SYSTEM NO. BEDROOM: 5 (750 gpd) TANK SIZE: 2(EA)1000g CONCRETE P'ERC RATE: <1 MPI (SEE ATTACHED SOIL ANALYSIS) SOIL RATING: 6.0 GPD/SF SYS. TYPE: WIDE TRENCH 1.0'ED REDUCTION FACTOR: 0.87 .AREA ROD: 108.75 SF MIN LENGTH: 21.75 LF USED 22LFx5.0'Wx1.O' E.D„ TD 4.5' TOTAL AREA: 1 10 SF NOTES: PANNONE ENG SVC, LLC AWING P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 MEADOW BROOK B1 L6 MATTHEW & SHERRY CARLSON DRAWN N,1C 10946 IDITAROD CIRCLE PLAN EAGLE RIVER, AK 99577 ABBREVIATIONS TH TEST HOLE (P)_ PROPOSED (E) EXISTING , CO CLEAN OUT NO. MT MONITOR TUBE N0. TYP TYPICAL `SOA l F ... CgSI�+ r'�P7Ae'�ot Oate 10/19/2015 Scale Steven R. Pannone j rET N0. CE 8149 .'c�� 1278•....FPR..... N0F 3 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: OSP151278 Tax Code Number: 05019133000 Work Type: Septic Upgrade Permit Effective Dates: September 04, 2015 to September 03, 2016 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: MEADOW BROOK Site Legal Address: MEADOW BROOK BILK 1 LT 6 G:0153 Owner/Address: CARLSON MATTHEW A & SHERRY P 18031 CEDARDALE RD SAUCIER MS 395740000 Site Mailing Address: 10946 IDITAROD CIR, Eagle River Lot Size in Sq Ft: 24396 Total Bedrooms: 5 This permit is for the construction of: Y Disposal Field N Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Special Provisions: The location of the existing septic field is unknown. If, during construction, the field is located, construction of the system will stop and a design change submitted to On -Site for review and approval. Received By: A ),La Date: I I '^ I ul S Issued By: rdN-L1/' Date: `1 iciDality of A 0,ent 41 A,C G 'L n a y Temp armenti **** VARIANCE/WAIVER REVIEW **** Waiver#: OSV161101 COSA#: Permit#:OSPI61278 PID#: 050-19143 Legal Description: Meadow Brook Block 1 Lot 6 Engineer: Pannone Enalneerinsr Services Applicant: Matther and Sherry Carlson " Your request for a waiver of the required 100 feet horizontal separation from the absorption field and septic tank to the surface water has been approved. The approved separation distance is 75 feet for the field and 55 feet for the tank. In addition, the trenchmay be perpendicular to the slope contours. This waiver approval applies to the proposed absorption field and 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 The .affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of nonobjection have been received from the owner(s) of the affected adjacent property. 0 Adjacent properties are not affected by this waiver. Waiver is Granted: X Waiver is not Granted: Date: 9 Approved by: Name of Revi r **** VARIANE/WAIVER REVIEW,**** 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. 050-191-33 Property owner(s) Matthew & Sherry Carlson Day phone None Available Mailing address 10946 Iditarod Circle, Eagle River, AK 99577 Site address 10946 Iditarod Circle, Eagle River, AK 99577 Legal description (Sub'd., Block & Lot) MEADOW BROOK B1 L6 Legal description (Township, Range & Section) Lot Size 24,396 Sq. Ft. Number of Bedrooms 5 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) - Absorption Field ❑X Initial ❑ Single Family (SF) E9 AbU) Septic Tank El Upgrade Upgrade ❑X Duplex (D) F-1Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Separation distance from absorption field to surface water,k�a Distance: 55'Xi' I 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: '50 , Date of Payment: d""_ Receipt Number: �5 Permit No. 05915121$ PermitApp_-'-: :L.,�c, Waiver Fees: ` 45q Date of Payment: CAM5 Receipt Number: og(ojgG Waiver No. nsvi 5 1101 Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve6DPanengak.com September 02, 2015 Subject: MEADOW BROOK 61 L6 Septic System Permit Request Design Narrative This is a design narrative for a permit to install an upgrade septic system to be issued for this property. The proposed systems will serve an existing five (5) bedroom house. Currently the lot is developed. The proposed system will add a 500g Recirculation Tank, 2 ea AX -20 Pods and 250g auxiliary pump vault to a 5' wide absorption field. This lot and surrounding lots are served by a public water. There are no wells within 200' of the proposed septic system Soils. One test hole was performed in the vicinity of this system by Pannone Engineering Services in July of 2015, and groundwater was monitored for at least seven days. Ground water was not observed to a depth of 13' below the surface in the test hole monitor tube in September of 2015. A test hole conducted in 1986 determined there was no groundwater to a depth of 13.0' at that location. Based on the results of the percolation tests and soils analysis conducted by Crowther Associates (w/ 60% passing the #4 Sieve) classifying the soil as "SM"; an application rate of 6.0 gallons/day/square feet was used for an advanced waste water system in the area of these test hole. 2. Soil Absorption System Design. a. See Sheet 1 of the design package. 3. Surface Water: There is a small stream within 100 feet of the proposed lift station and drain field. Using an earthen berm system (see Sheet 1 of the design package) the proposed drain field will maintain an overland sheet flow of at least 100 feet from all surface water and drainage ditches (see Waivers). 4. Topography: The existing overall topography slopes up from the southwest to the northeast at approximately 2% in the area of the septic system with the area near the tanks and the proposed system being approximately 2% due to landscaping and grading of the property. There are no steep slopes within 50' of the proposed drain field. 5. Waivers: a. We are requesting a waiver for the separation distance from the absorption field to surface water of 75' and for the tank to surface water of 55'. The surface water is approximately 79.1'± from the field and 59.2'± from the tank. Construction of an earthen berm system (see Sheet 1 of the design package) will extend the overland sheet flow distance to 100'± from the proposed system to the surface water. Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 Page 2 of 2 b. We are requesting a waiver for the drain field orientation. The contour lines available on the Muni maps is not representative of existing grades on the lot. The area of the proposed drain field has an existing slope of approximately 2% in the direction of drain field. 6. Drawing Markings: The Drawings are marked "For MoA Review Only'. When written notification that the review is complete and that there are no further comments is received from MoA On -Site Department, the note will be removed and "Issued for Construction" drawings will be issued. The proposed installation will not affect the future development of this or the surrounding lots. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor Ave, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 MIL 7 � 1 , INSTALL ABSORPTION FIELD P i�`t - } "<22LFx5.0'wx1 .0'ED.,TD 4.5' SURROUNDING LOTS SERVED BY PUBLIC WATER (SEE DESIGN SHEET y2) 1.25" 4 PERF PIPE W/ 1.25" ` 9 jpq HOLES DRILLED 18•' O.C.�tl` ; a 100 INSTALL 250 AUX fJ(� fit- Ro \ 55 PUMP TANK P UC w✓A 6 \1 INSTALL 500 TANK rw / _ & (2EA) AX -20 PODS AND \ -- OCO BEFORE TANK(P)'�- 92 (;S�EPTIC AREA �\ I�Y 2 EA 1000 CONCRETE /%; /ysso°�i �I ,J SEPTIC TANKS ABANDON ABSORPTION FIELD 7 SBR \ HOUSE s \ J ,LUFLS IU I'HUVIUL IOU + OVERLAND SHEET FLOW TO STREAM TS&V --------- \1 / / / / / r I 9 TH TEST HOLE s������\\� of a r (� • • •...g,9, I' ig�P 1 —101* TH - ..... .. ...... tven.' onnone / ��'P CE 8149 'ter •� �lll�p'y?s' Q� (P) PROPOSED- o - (E) EXISTING - MEADOW BROOK B1 LIS....so-191-3 MATTHEW & SHERRY CARLSON 10946 IDITAROD CIRCLE EAGLE RIVER, AK 99577 CO CLEAN OUT NO. - - DRAWN JRL MT MONITOR TUBE NO. 1 o Util Esmt TYP TYPICAL ------------ ------------- 10 I 9 TH TEST HOLE s������\\� of a r (� • • •...g,9, I' ig�P 1 —101* TH - ..... .. ...... tven.' onnone / ��'P CE 8149 'ter •� �lll�p'y?s' Q� (P) PROPOSED- o - (E) EXISTING - MEADOW BROOK B1 LIS....so-191-3 MATTHEW & SHERRY CARLSON 10946 IDITAROD CIRCLE EAGLE RIVER, AK 99577 CO CLEAN OUT NO. - - DRAWN JRL MT MONITOR TUBE NO. 1 o Util Esmt TYP TYPICAL ------------ ------------- NOTES: PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 s������\\� of a r (� • • •...g,9, I' ig�P 1 —101* TH - ..... .. ...... tven.' onnone / ��'P CE 8149 'ter •� �lll�p'y?s' Q� Date 09/c/5 FOR coNsrRucTIDN Scale P.I.D. NO PERMIT NO. OSP151278 MEADOW BROOK B1 LIS....so-191-3 MATTHEW & SHERRY CARLSON 10946 IDITAROD CIRCLE EAGLE RIVER, AK 99577 DRAWN JRL PLAN meet 1 OF 3 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION-IDF ON—SITE WASTEWATER DISPOSAL SYSTEMS. 2. SCOPE OF WORK: INSTALL 500g RECIRCULATING TANK W/ 2 EA. AX -20 PODS & 250g AUX PUMP VAULT (P). INSTALL SOIL ABSORPTION SYSTEM (P). INSTALL EARTHEN BERM SYSTEM (P) J. GROUNDWATER WAS NOT ENCOUNTERED TO A DEPTH OF 13.0 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 13.0 FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY. - DESIGN PARAMETERS PRIMARY SEPTIC SYSTEM N0, BEDROOM: 5 (750 gpd) TANK SIZE: 2(EA)1000g CONCRETE PERC RATE: <1 MPI (SEE ATTACHED SOIL ANALYSIS) SOIL RATING: 6.0 GPD/SF SYS. TYPE: WIDE TRENCH 1.0'ED REDUCTION FACTOR: 0.87 AREA ROD: 108.75 SF MIN LENGTH: 21.75 LF USE: 22LFx5.0'Wx1.O' E.D.,TD 4.5' TOTAL AREA: 110 SF FILTER FABRIC 1.25' 0 PERF PIPE W/ 1.25' HOLES DRILLED 18" O.C. -DRAIN ROCK 6' PROVE PIPE INV FILTER FABRIC / I -DRAIN ROCK 6 ABOVE NOTES: PANNONE ENG SVC, LLC CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 MEADOW BROOK B1 L6 MATTHEW & SHERRY CARLSON DRAWN JRL 10946 IDITAROD CIRCLE PLAN EAGLE RIVER, AK 99577 TH-I ELI03.5k :44- I a 90.51 ABBREVIATIONS TH -LO (P)-. 3.0 (E) EXISTING CO 0.5 MT MONITOR TUBE NO TYP 1.01 SM a.0-a.s 90.St O O EL10S5 V wa o 3 EL.100.Dx 98A 3 I � B ppppqq PIIC �ppppp SFYIIC *F(4 TNK(q - - DESIGN PARAMETERS PRIMARY SEPTIC SYSTEM N0, BEDROOM: 5 (750 gpd) TANK SIZE: 2(EA)1000g CONCRETE PERC RATE: <1 MPI (SEE ATTACHED SOIL ANALYSIS) SOIL RATING: 6.0 GPD/SF SYS. TYPE: WIDE TRENCH 1.0'ED REDUCTION FACTOR: 0.87 AREA ROD: 108.75 SF MIN LENGTH: 21.75 LF USE: 22LFx5.0'Wx1.O' E.D.,TD 4.5' TOTAL AREA: 110 SF FILTER FABRIC 1.25' 0 PERF PIPE W/ 1.25' HOLES DRILLED 18" O.C. -DRAIN ROCK 6' PROVE PIPE INV FILTER FABRIC / I -DRAIN ROCK 6 ABOVE NOTES: PANNONE ENG SVC, LLC CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 MEADOW BROOK B1 L6 MATTHEW & SHERRY CARLSON DRAWN JRL 10946 IDITAROD CIRCLE PLAN EAGLE RIVER, AK 99577 TH-I ELI03.5k :44- I a 90.51 ABBREVIATIONS TH TEST HOLE (P)-. PROPOSED (E) EXISTING CO CLEAN OUT NO. MT MONITOR TUBE NO TYP TYPICAL ���?tel Steven .�. •f�annone• }._•. CE 8149 ,•,��; 09/01/15 "-s0' P.I.D. NO 50-191-3� PERMIT NO. 2 OF SOILS LOG - PERCOLATION TEST SLOPE aop 96 TEST HOLE HOU E WAS GROUNDWATER ENCOUNTERED? -N IF YES, AT WHAT DEPTH? -0-' \O , 9 v ------ --- - TH-1986 \ NO GROUNpWATER T( \ / �,� (APPROX. LOCATION) 9 DEPTH TO WATER AFTER MONITORING? - DRY - DATE: 29JUL15 NSR q/Zlii� SLOPE TH 1 READING DATE TEST HOLE 1 NET TIME WATER LEVEL READING NET DROP OR 1 22JUL15 1148 4706" TOPSOIL 1 2 11:58 325 MIN 2 7439' 0.44 3 1201 3 4 706" 4 4 4.08 MIN 12.145" 7.439" 0.55 5 1220 4706" 6 6 1230 5.63 MIN 12.145" 7439" 0]6 Brown Silty 7 SM SAND & 8 1241 GRAVEL S 7439" 0,433 9 9 4.706" 10 1252 6.30 MIN 12.145" 7.439" 11 12 13 BOH DATE PERFORMED: 22JUL15 SOILS LOG - PERCOLATION TEST SLOPE aop 96 TEST HOLE HOU E WAS GROUNDWATER ENCOUNTERED? -N IF YES, AT WHAT DEPTH? -0-' \O , 9 v ------ --- - TH-1986 \ NO GROUNpWATER T( \ / �,� (APPROX. LOCATION) 9 DEPTH TO WATER AFTER MONITORING? - DRY - DATE: 29JUL15 NSR q/Zlii� SLOPE TH 1 READING DATE GK TIMEK NET TIME WATER LEVEL READING NET DROP RATE (MPI) 1 22JUL15 1148 4706" 2 11:58 325 MIN 12.145" 7439' 0.44 3 1201 4 706" 4 1211 4.08 MIN 12.145" 7.439" 0.55 5 1220 4706" 6 1230 5.63 MIN 12.145" 7439" 0]6 7 12.31 4.706" 8 1241 6.20 MIN 12.145" 7439" 0,433 9 1242 4.706" 10 1252 6.30 MIN 12.145" 7.439" 0.85 SOILS SIEVE ANALYSIS: PERFORMED BY CROWTHER ASSOCIATES 27JUL15 60% PASS #4 SIEVE PERCOLATION RATE <1MPI / PERC HOLE DIAMETER 6" / TEST RUN BETWEEN 2 FT AND 3 FT COMMENTS: Test hole excavated byJR's SEPTIC PUMPING. Test Hole was presoaked before Perc test. PERFORMED BY: Joseph Lawendowski. I CERTIFYTHATTHIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. NOTES: 7�,�7��T �7� T �-1 ���� FOR CONSTRUCTION PANNONE ENG SVC, LI,C - 3 QF Q \�t Date P.O. BOX 102954 ANCHORAGE, AK 99510 O (�• ��+��� os/o1/1s PHONE (907) 272-8218 FAX (907) 272-8211 /•Vg�P �y+) Scale MEADOW BROOK 31 L6 DRAWN JRL MATTHEW & SHERRY CARLSON 10946 IDITAROD CIRCLE SOILS LOG EAGLE RIVER, AK 99577 NTS .... .... ..... P.I.D. NO 50-191-3 •Steven •R�•Pannorae %PERMIT N0. 8149 r r OSP 151278 3 OF 040.002 Client: Pannone Engineering Services Projects: 21928 Arms Drive, Dale Briggs, and Meadow Brook Date: July 27, 2015 Crowther Associates Particle Size Distribution Table Sample Source 21928 Armas Drive 4' 21928 Armas Drive 10' Dale Briggs Block 1 Lot 4 Meadow Brook Block 1 Lot 4 Sieve Size Percent Finer Percent Finer Percent Finer Percent Finer 3 inch 100 1-1/2 inch 90 100 94 93 inch 56 84 83 77 #4 35 47 50 60 #10 53 29 37 53 940 8 6 17 40 #100 4 2 8 24 #200 4 2 5 19 0.02 mm Classification Sandy Gravel (GP) Sandy Gravel (GP) Sandy Gravel (GP) Silty Sand (SM) 1632 Bellevue Circle /Anchorage, Alaska 99515 Telephone (907) 349-21981E mail: crowther@alaska.net ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT BETWEEN MUNICIPALITY OF ANCHORAGE AND THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this Day of4- of 20�, by and between herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Maintenance and Repair Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as located at (legal description). _�N�&AZ tJ cos�-L 1131 , L to 2. Definitions. Alteration. Any change to the design or function of an AWWTS that includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Certificate of On -Site Systems Approval (COSA). An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with Anchorage Municipal Code (hereinafter, "AMC") 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an AW WTS that were included in the original design which would allow the AW WTS to continue to perform as designed. Permit. An On -Site Wastewater Disposal Permit as required by AMC 15.65 to construct and operate an AW WTS. 3. Term. The term of this Maintenance and Repair Agreement shall begin on the date of approval by the Municipality to operate the installed system or issuance of a COSA, and shall continue while the AW WTS is in use or is operational or until the property is sold or title is transferred by the owner and a new COSA is issued to the new owner or transferee of the property. 4. Alterations. Installation and Removal of Additional Enuipment. Prior to performing any alterations to an AW WTS, the owner agrees to obtain an On-site Wastewater Disposal Permit from the Municipality in accordance with AMC 15.55. 5. Maintenance and Repairs. A. Throughout the term of this Maintenance and Repair Agreement, the Owner shall maintain their AW WTS in a satisfactory condition capable of producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. The owner shall enter Into a service agreement with an AW WTS service and maintenance provider approved by the municipality and the manufacturer of the AW WTS for the entire term of the AW WTS In addition, it shall be the responsibility of the Owner during the term of this Maintenance and Repair Agreement, and any renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs. B. Owner agrees to comply with all applicable ordinance, laws, regulations, rules and orders for the AW WTS. C. Upon request by the Municipality, the owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed an the system. When a record of maintenance is documented and maintained by the system vendor, the owner agrees to allow the Municipality access to this information. D. Owner acknowledges that the fine for failing to maintain and repair all A W WTS may be assessed in accordance with AMC 14.60 for improper discharge. E. Owner agrees that only maintenance and repair personnel approved by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. F. Owner agrees to grant the Municipality reasonable access to test and inspect the AW WTS upon 24 hours written notice. G. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. H. Owner agrees that the AW WTS installation and maintenance requirements as provided by the AW WTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWW'TS. 1. Owner agrees to provide and maintain a telephone connection to the A W WT'S as required by the A W WTS approval. b. Nonwaiver. The failure of either party at any time to enforce a provision of this Maintenance and Repair Agreement shall in no way constitute a waiver of the Provisions, nor in any way affect the validity of the Maintenance and Repair Agreement or any part hereof or the right of such party thereafter to enforce each and every provision hereof. 7. Amendment. A. This Maintenance and Repair Agreement shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties, with the same formality that this Maintenance and Repair Agreement was executed With, and such writing shall be attached to this Maintenance and Repair Agreement as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this agreement, the only authorized representatives of the parties are: a. Owner: b. Municipality: director, Qg1ro nuni devcio went or designated authority C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 8. Jurisdiction: Choice of Law. Any civil action arising from this Maintenance and Repair Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Maintenance and Repair Agreement. 9. Severability. Any provisions of this Maintenance and Repair Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Maintenance and Repair Agreement. OWNER: C By L e_ r , . 1 ci t:, (signature) Date: -)I 7 ) Ci ct , t�kexrsJ P, (printname) STATE OF,ALAS 'Vn 554`x, ss. THIRDJUDICIALDISTBI_CTr'1 i±i` ) 20 My Commission expires: MUNICIPALITY: before me fl is��day of By: (signature) name) Date: Title: fim f- t F} ( Q? -A=JMr s E GQi4 Municipality of Anchorage On -Site Water & Wastewater Program; �_ (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 050-191-33 Expiration Date: 10-2 — /7 1. GENERAL INFORMATION Complete legal description MEADOW BROOK; BLOCK 1, LOT 6 Location (site address) 10946 IDITAROD CIRCLE *EAGLE RIVER, AK 99577 Current Property owner(s) SHERRY CARLSON Day phone (228)539-4655 Mailing address 10946 IDITAROD CIRCLE *EAGLE RIVER, AK 99577 Real Estate Agent SHAWN BABBOT Day phone 441-2500 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 5 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site ■ Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System 0 Public Sewer ❑ WaiverNariance request for: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 1 G9— 1-j I Date of Payment f Receipt Number d_3Y (�g G Date: q / 1116 Waiver Fee $ Date of Payment Receipt Number COSA# 0SC 1E_15- 72 Waiver# Distance: — 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 "ANCHORAGE, AK, 99507 Engineer's Printed Name Engineers Comments: JEFFREY A. GARNESS, P.E. In conducting this evaluation, GEG provided an engineering evalualion of the well and/or septic system in accordance e47h the guidelines and regulations established by the Municipality or Anchorage and industry practices. The reported results describe the condition of the systeMs on the dates of the evaluation. Separation dulances were measured to readilydendfiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend on a vadelyof variables including, but nor' limited to, soil conditions, groundwater levels (that may fluctuate during the year), qualify of construction (materials and rrorkmanship), and the water usage oflhe family utilizing The systenvis. These conditions can vary, and are outside the control of GEG. Satisfactory fest results do not guarantee future performance of the systeass, therefore, GEG makes no warranty (express orimp'ied) regarding the future performance of the well orsepflc system. GEG makes no represenfaflon whefheran alternative well or septic system can be installed on the properly in the even either of the current systems fail. The conlenl of this report is for the sole benefit of the persor✓party, who retained GEG. Rehan6e upon the information provided in this report by any other person or party, including but not limited to subsequent property purchasers, is not authorized. In short, GEG disavows any legal duty to anyone atherthan the persoalp arty who paid for this report. 6. DSD SIGNATURE V System 91 Approved for bedrooms. System #2 Approved for Disapproved. Conditional approval for bedrooms. Phone 337-6179 Date } 1 Z a If L, bedrooms, with the following stipulations: 1 By: lnnn �� 3� 30%l(� Original Certificate Date: .;1 OF,4/%, WATER AND NASTEWAT�E Z p � er nnn co 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. 10112/12) Nitrate Advisory Arsenic Advisory Other o, If 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: MEADOW BROOK; BLOCK 1, LOT 6 A. WELL DATA Well type _ Date completed Total depth ft. Date of test Static water level Well production WATER SAMPLE PUBLIC If A, B, or C provide PWSID# _ _ Sanitary seal (Y/N)— Cased to ft. FROM WELL LOG Coliform colonies/100 ml. Nitrate mg./L. Parcel ID: 050-191-33 Well Log Wires properly protected Casing height (abo n AT I CTION Collected by: ft. in. nic: ug./L. Date of sample: B. SEPTICIHOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 2/26/2016 Tank size 2D00 gal. Number of Compartments E Cleanouts (YIN) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping NEW Pumper C. ABSORPTION FIELD DATA *BELOW EXISTING GRAD Date installed 10/8/2015 Soil rating qiEJft r ftlbdrm) 6_0 System type SHALLOW TRENCH Length 22 ft. Width 5 ft, Gravel below pipe 1 ft. Total depth *4.5 ft. Eff. absorption area 110 112 Monitoring tube YES Depression over field NO Date of adequacy test NEW Results (Pass/Fail) PASS For 5 bedrooms Fluid depth in absorption field before test NEW in. Water added NEW gal. New depth NEW in. Elapsed Time: NEW min. Final fluid depth NEW 'in. Absorption rate >= 750+ g,p,d, Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date — D. LIFT STATION/PUMP VAULT Date installed 10/8/2015 10* "Pump on" level at 32 in. *PER 10/20/2015 INSPECTION REPORT Size in gallons —70 Manhole/Access (Y/N) YES "Pump ofF' level at 22 in. High water alarm level at 36 in. Datum BOTTOM OF TANK Cycles tested NEW Meets alarm & circuit requirements? *YES E. SEPARATION DISTANCES PUBLIC SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer mainewei Sewer /septic service line Holding tank manhole/cleanout n amment areas Manure/animal excrete storage areas 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 *45'+ Wells on adjacent lots 100'+ PVT & 200'+ PUBLIC SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water **69.4' Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ PVT & 200'+ PUBLIC F. COMMENTS *WR#OSV161001 **APPROVED PER JAY CREWDSON AT MOA 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 JEFFREY A. GARNESS Date 312111 L (Rev. 11/05) AQAt IJ07eJ0 ?S A ZSV �waS ow i2�torw D�IawwtrS oo�Op° :. 49 *�p� ... . . '"•J ff A. G,10 a 0 CE 9 00N66 1 story ame Nouse oh 8aeament <� 5 Lot 6O' Utility Easement _M1t� Colics �IN �t O _ r tJ� `Wood fence0. to N \ dge of is N O Z �N�� ,3� AV91 g \ A/ Lot 7 �/ Approximate Centedine!J5� o 0 Lot 8 Meadow Creek'' Eagle River Heights North Subd: IN SCALE: V'= 40! EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. FB 15-7, pg 41-42 a e Lot 5 Al • 49th •' +iO4i / I #4 Fred Walatka. ff 0 P 3255 — S Lot 9 �L/ o . • • C6 tEV SEDT 1-05-15 1 " �' tECERTIFIED 10.22-15 .5 -BUILT NO CORNERS SET THIS BATE erebv cartiN that I have performed a Mortdaaee's Insnaction Anchorage, Recording District, Alaska, and that the improvements situated thereon are vWthinthe property lines and do not -overlap or encroach on the property lying adjacent thereto, that no improvements oha property lying adjacent thereto encroach on the premises, in question and that there are no roadways, transritsaton Ivies or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this 15th - day of JULY .2015. FRED WALATKA & ASSOCIATES BE tg07-24&1666) Engineers and Surveyors � • Municipality of Anchorage On -Site Water and Wastewater Program'n (907) 343-7904 'RUSH Certificate of On -Site Systems Approval Parcel I.D. 050-191-33 Expiration Date: — m )ell F 1. GENERAL INFORMATION Complete legal description Meadow Brook, Block 1, Lot 6 Location (site address) 10946 Iditarod Cir. Current Property owner(s) Matthew & Sherry Carlson Day phone Mailing address 10946 Iditarod Cir. Eagle River, AK 99577 Real Estate Agent Day phone 2. TYPE OF DWELLING: Fx] Single Family (w/wo ADU) [] Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 5 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual El Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System 0 Public Sewer ❑ COSA to be released to the engineer, unless otherwise requested by the engineer. - COSA Fee $�(o�l �fi 1W�o q,11 Waiver Fee $ Date of Payment �6/ 2p ! Date of Payment Receipt Number 03q toSS Receipt Number COSA# 65cj615-7q 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. - In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe 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 soil condition, ground water 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 this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. - - Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone Date 10119/2015 6. DSD SIGNATURE L_ _Z_�System #1 Approved for S bedrooms System #2 Approved for bedrooms Disapproved Steven nnone t t CE -8149 Conditional approval for bedrooms, with the following stipulations: ZVNdVNf/UUtA! Original Certificate Date: D� icipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only 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 blue sheet ° .- If more than 1 septic system is on the lot: COSA Checklist # 1 of 1 Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: Meadow Brook, Block 1, Lot 6 Parcel 15:_050-191.-33 A. WELL DATA Well type Public If A, B, or C provide PWSID # AWWU Well Log (YIN) Date completed Sanitary seal (Y/N) _ Wires properly protected (Y/N) Total depth ft. Cased to ft. FROM WELL LOG. Date of test Static water level ft. Well production 9.p -m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate mg/L Arsenic ug/L Date of sample: B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Concrete/Steel Casing height (above ground) in. AT INSPECTION Collected by: Date installed Before 1973/ & 10/8/2015 ,,000 Tank size gal. Number of Compartments Cleanouts (YIN) Y Foundation cleanout (YIN) Y Depression over tank (Y/N) N High water alarm (Y /N) N Date of pumping 14919 1,101 S Pumper ©nt Sfvp pw, w ,e C. ABSORPTION FIELD DATA Date installed 10/8/2015. Soil rating (g.p.d./ft2 or ft /bdrm) 6.0 GPD/SF System type Shallow Trench Length 22 ft. Width 5 ft. Gravel below pipe 1 fE Total depth 4.5 ft. Eff. absorption area,' 10 ft2 Monitoring tube Y Depression over field N Date of adequacy test Now Results (Pass/Fail) Pass For 5 bedrooms Fluid depth in absorption field before test New in. Water added New gal. New depth New in. Elapsed Time: New min. Final fluid depth New in. Absorption rate >= 750+ g p d Any rejuvenation treatment (past 12 mo.) (YIN &type) No If yes, give date , D. LIFT STATION Date installed 10/8/2015 Size in gallons 250 Manhole/Access (Y/N) Y Pump on" level at 48 in. "Pump off' level at 42 in. High water alarm level at 45 in. Datum Bottom Of Tank Cycles tested New Meets alarm & circultrequirements? Yes E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot On adjacent lots On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer /septic service line Holding tank Animal containment areas Manure/animal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Water main 10+ Water seryice line 10+ Wells on adjacent lots 200+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water Service line 10+ Surface water 100+ Curtain drain 50+ Wells on adjacent lots 200+ F. COMMENTS Absorption field 5+ Surface water 100+ Water main 10+ Driveway, parking/vehicle storage 10+ System has 50p gal recirculating step tank with auxiliary pump vault. G. ENGINEER'S CERTIFICATION I certify that / 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. Engineers Printed Name Steven R. Pannone Date " 10/19/2015 COSA canary sheet 2-6-15.doc ASBUILT I HEREBY CERTIFY THAT I HAVE SURVEYED THE LLL\L SCALE` FOLLOWING DESCRIBED PROPERTY: Z�� Cti Zaj' /f' Sr ' IaT�G3�/ AND THAT NO ENCROACHMENTSIEXIST 13CEPT DATE: -� AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY GRID; EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI_ VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB' ANY DATA UCTION BE USFOR OF FENCE LIINRESNOR FORESTABLISHING BOUND- ARY LINES. DRAWN: h - ®*%'ft % QF At4 % a ask -P -D Municipality of Anchorage • -� --- _ Development Services Department Building Safety Division x �* On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907).343-79D4 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. D 51D- 19 L 33 COSA# 01- WV4 Expiration Date: 7— a G, — O R 1. GENERAL INFORMATION Complete legal description Lot 6 Block 1 Meadow Brook Subdivision Location (site address) 10946 Iditarod Circle. Eagle River, AK 99577 Current Property owner(s) _Matthew b Shem Carlson Day phone Mailing address Lending agency Mailing address 10946 Iditarod Circle, Eagle River. AK 99577 Day phone Real Estate Agent Christine DoolevlDvnamic Properties Day phone 244-7653 Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 5 3. TYPE OF WATER SUPPLY: Individual Well ❑ Individual Water Storage ❑ Community Class Well ❑ Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding Tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure Indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system Is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Pannone Enoineerino Services LLC Phone 272-8218 Address P.O. Box 102954 Anchorage AK 99510 Engineer's Printed Name Steven R. Pannone, P.E. Date 7123107 Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & Regulations. The reported results describe 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 soil condition, ground water'��•�� OF aaaa.. levels that may fluctuate during the year, and the water usage of the family being served by the system. . �P Thesc conditions arc outside the control of the evaluator of this system. All systems eventually fail and /' �# satisfactory test results do not guarantee future performance of the system, nor do they guarantee that ory there arc no hidden defects or encroachments. PES can therefore not provide any warranty for future performance nor give any estimate of how long the system will continue to meet the operational 0 requirements of the MOA DSD. Thc content of this report is for the sole benefit of the owner listed Steven R. 'onnonef above. Any reliance upon or use of this report by any other person or party is not authorized nor will it 0 0- No E s �. confer any legal right whatsoever. 5. DSD SIGNATURE _J,,t�' Approved for —rL bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: „� j(/ �n �( Original Certificate Date: %' �o"U (RM. 71)05) Municipality of Anchorage Development Services Department Building Safety Division On-site Water & Wastewater Program 4700 Bragaw Street P.O. Box 198850 Anchorage, AK 9951943650 www.mund.org/onstte (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Lot 6 Block 1 Meadow Brook Parcel ID: O 5-h _ i k j - 3_3 L D TA A- WEL/,Wei tt Date compMW Date of test Static water Cottform If A. B, or C provide PWSID 8 RESULTS: mgA B. SEPTIWHOLDING TANK DATA Sanitary seal (YM) _ (�7- Tank Type/Material Conerete • 2 each g.p.m. mg/L Date of sample: Well Log (YM) Wires properly protected (YM) height (above ground) in. AT INSPECTION ft. Other bacteria coloniesl100 mL M. Date installed ire, — 19 7 3 Tank size IWO each gal. Number of Compartments 1_yaeh ift Cleanouts (YM) Yes Foundation cleanout (YIN) (� Dep�remikin over tank (YIN) 14 High water alar (YIN) WA Date of pumping 6158007 Pumper JR9 Pumping C. ABSORPTIOIiFIELD DATA Date installed jt+�1 I 7,3Soil rating (g•ad./e or felbdr)125 System type Leach Field Length kk* vxu1 ft. Width 3 toft. Gravel below pipe T+ ft. {Lr1pw% Total depth U fL Eft. absorption areaft` Monitoring tube Y Depression over field y Date of adequacy test 688007 Results (Pass/Fall) Pass For § bedrooms Fluid depth kr absorption field before test Q in. Water addedj¢Q gal. New depth] in. Elapsed Time: 1440 min. Final fluid depth Q in. Absorption rate >= 750+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date Date installed 'Pump on" level at _ in. Datum E. SEPARATION DISTANCES 'Pump sl at _ ink Cycles tes d DISTANCES FROM WELL ON LOT TO: Septic tank/lift staftn.Qn lot Absorption field on lot Public sewer main Sewer /septic service line Manhole/Access (Y/N) alarm level at Meats alarm b On adjacent lots On adjacent lots sewer manhole/cleanout Holding Animal containment areas IManure/animal excrete store SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 8+ Property fine JQ+ Absorption field 5+ Water main 10+ Water service fine 10+ Surface water Wells on adjacent lots +200 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 57 Building foundation 10 Water main 10+ Water Service line 10+ Surface water 82t Driveway, parking/vehicle storage 15+ Curtain drain None Observed Wells on adjacent lots 200+ F. COMMENTS G. ENGINEER'S CERTIFICATION I car* that I have determined through field inspections and review of Munlcxpal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Steven R. Pannone. P.E. 1� ��Sleven R. Ponnone ♦ �`, No. CC 81491 Daft —W?�eei rD`Q, ' ? 6�• COSA Fee $ '� Date of Payment � 4 kl Receipt Number 9 gJ (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number in. i Municipality of Ancho6age 0 '�G�PGEM1 g4C Development Services Department z Building Safety Division u , On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel 1.D. !V6-0 /9/- 3 3 HAA # L4050 Expiration Date: ! —,?,-1— O.51- 1. GENERAL INFORMATION Complete legal description _154rw o®w /_> Ca Location (site address or directions) io94,i Current Property owner(s) %Y,ey V I>Es + iUaea Day phone Mailing address Lending agency Mailing address Day phone Real Estate Agent �.i.uEY /1.,a pnAY AAZ Day phone yyO — Ago—,0 Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: Ir 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site X Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System R1 Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on- site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Ewes. TI✓sz.�'M�.vr�-- 5 s Phone r1y— 3%91' Address &&AV ro 5vire' "Z Engineer's Printed Name Date 71271cy 5. DSD SIGNATURE _1z*� Approved for Disapproved. E_ bedrooms. Conditional approval for bedrooms, with the following OPHER R MOOD CE,MLZ Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other By Original Certificate Date: _ a2 �' O (Rev. 01102) Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water & Wastewater Program s a 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: AE4,0A4J %5,0;yyX �3 / X.(2 Parcel ID: C)6'0- /9/- S3 A. WELL DATA P4,L', Well type �yi Date completed Total depth ft. If A, B, or C provide PWSID # Sanitary seal (YIN) _ Cased to ft. FROM WELL LOG Well Log (YIN) Wires properly pr ed (YIN) _ (above ground) in. AT INSPECTION Date of test Static water level ft. ft. Well production g.p.m. 9_10 M. WATER SAMPLE RE S: Coliform colonies/100 ml. Nitratemg./I. Other bacteria colonies/100 ml. Ar c: _ mg./l. Date of sample: _ Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material Date installed IKTank size 444y&p gal. '#Number of Compartments Chau Cleanouts®N) x/,63 Fo ndation cleanout (Y t/O Depression over tank (Y�j% .r�0 High water alarm (YAP .y� LA4 BE 5wi4cbp r(WM c wL4 ' ei Dateofpumping PumperC. ABSORPTION ABSORPTION FIELD DATA �'q �/�cs,' /s�o0 6Ne �iIC✓f s. ust� Csv P.Feriva*�T Date installed Soil rating (g.p.d./ftz or /bd ) �� System type �.Cwiu Fi¢ao Length /l. e_ . ft. Width 3 - 3 ft. Gravel below pipe / ft. Total depth 17 ft. Eff. absorption area cLk. ftZ Monitoring tube YX5 Depression over field Date of adequacy test V 3 / JO y Results ass/ ail) P -f s z For C5'- bedrooms Fluid depth in absorption field before test -50 in. Water added aVgal. New depths in. Elapsed Time: 50 min. Final fluid depth - in. Absorption rate >= 76-d g.p.d. Any rejuvenation treatment (past 12 mo.) (Y6& type) If yes, give date -C&114 D. LIFT STATION Date installed "Pump on" level at _ in. Datum Size in gallons %wFqaff evel at _ in. 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 Sewer /wpa ervice line ME (Y/N) High water alarm level at Meets alarm & circuit requirements? On adjacent lots Public sewer manhole/cleanout Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 8' Property line 71/v' Absorption field iB o Water main It .1 ' Water service line -,*/0, Surface water Wells on adjacent lots f Roo' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line .S,i' Building foundation i4' Water main Water Service linetla' Surface water !01 Aror ' Driveway, parking/vehicle storage X ap ' Curtain drain r So Wells on adjacent lots ?oe �/sf/.e .rc�J®wwJ F. COMMENTS VA G. ENGINEER'S RrwE'a 'BY DtP4.07M& lt. I certify that f 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�Av'6az �pi�Ee Tl GLerso Date WZIZQ!� HAA Fee $ g330 - '" Date of Payment /Z -f /0 -f Receipt Number C 8 795 - (Rev. 12/01) Waiver Fee $ Date of Payment Receipt Number in. iN t4�6. �6 S /'�NOf iL oG GS��2N ..9 / ASBUILT S.EWARD & I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY LoTG��� / THAT NO ENCROACHMENTS EXIST &dEPT AS SCALE: DATE - INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY GRID: e - EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB - ANY DATA HEREON BE USED FOR CONSTRUCTION OF FENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES. DRAWN; �li*__(_ �,•,'e.�e m A s 4 j•, Ls -5918 y Y L —33 MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel l.D.# t`l�n- 10�\- IS- iC)2L^ HAA#Q- 1. GENERAL INFORMATION Complete legal description Lot 6i Btock 1; Meadowbnook Subdivision Location (site address or directions) 10946 Idltanod Cikcte Riven, AK Property owner K and LatAeUe McRae Day phone Mailing address C/O iJon McKenzie Real E6.tate 13135 Old Glenn Hwy. Eagle RiveA. AK 99577 Lending agency Mailing address Day phone Agent Cindy pJit6on/ DON MCKENZIE REAL ESTATE Day phone _ 694-9035 Address 13135 Old G.2enn Hwy. Eagte Riven, AK 99577 _ Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water 5 XXX 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 XXX 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. r ),AL � 'Lt _ r"( 'e r-) - 16 `l 72-025 (Rev. 1/91) Font MOA N21 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 verifythat 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 5 & 5 E•NGINEERIN Address C -:)-;a r:na a River L ;4gie (:Iver, Alaska Engineer's signature 6. DHHS SIGNATURE AApproved for r1 Lj (0 bedrooms. Disapproved. Conditional approval for Additional Comments Phone Date bedrooms, with the following stipulations: By: &a_r� Date _ /6— / 9' 9� r �UITIC 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 orderto 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. Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: "T to &J -y- � �A 6t�ooys6arcel I.D. 01�70 — / 9 / —3 A. Well Data Well type If A, B, or C, attach ADEC letter. ADEC water system number. Log present (Y/N) Date completed Driller Total depth Cased to Casing height Sanitary seal (Y/N) FROM WELL LOG Date of test Static water level Well flow Puel1 SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot 20 a Public sewer main Sewer service line WATER SAMPLE RESULTS: Coliform Nitrate Wires properly INSPECTION ; On adjacent lots _; On adjacent lots Public sewer manhole/cleanout Petroleum tank Other MUNICIPALITY Of ANC HOR AUL ENVIRONMENTAI. SERVICES DIVISION g P,'C E CE IV l" B. SEPTIC/HOLDING TANK DATA��: Date installed j `A7'5 Tank size Zoo o Compartments 1 Doti _ Cleanouts (\ N) 4 -Foundation cleanout (Y/& l Depression Y& I ( High water alarm (Y/&� Alarm tested (Y/N, A Date of pumping ��— �� —`�� Pumper J LV_s's Poo t, ') (o o d e a r_- r'=-. VA — SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: l� Well(s) on lot 1�0 On adjacent lots '" Foundation To property line �O Absorption field t Water main/service line Surface water/drainage �4_ l %C.o 0_- �-r / L (c ,!�;,I -�4- iP� CONTINUED ON BACK PAGE 72-026 (3/93)` Front C. LIFT STATION Date installed Size in gallons Vent(Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y SEPARATION ULMNCE FROM LIFT STATION TO: on lot D. ABSORPTION FIELD DATA On adjacent lots Manufacturer Manhole/Access (Y/N) Cycles tested off' Level at Surface water Date installed \'A-(� Soil rating (GPD/Ftz) �ZS I PAZ System type F i L\D Length �_) Width - S Gravel thickness t Total depth �) 2\ Total absorption areayVL Cleanout present ON) T Depression over field (Y& Date of adequacy test <-- 1 - Results as ail) ?.mss 5. for Bedrooms Water level in absorption field before test Peroxide treatment (past 12 months) ( �% SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot _-2--t, o On adjacent lots After test k If yes, give date �� A Property line 1 0 To building foundation Zo \ To existing or abandoned system on lot _ r< On adjacent lots Cutbank Water main/service line Surface water S'J 1 Driveway, parking/vehicle storage area Curtain drain `m E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or Signature 5 & 5 ENGINEERII 17034 Eagle River Engineer' 91RiAlas! Date /6 //-r/ HAA Fee $ J'a U cf Date of Payment /0 -i 6" Receipt Number 72-026 (3/93)' Back No. 204 06-76 -. to all MOA and HAA guidelines in effect on the date of this ins�ect-i/yonn... L. yI ✓' (Y✓ Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services �} i On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel l.D.# CDL:�- 1al-11 1. GENERAL INFORMATION Complete legal description Lot 61 Block 11 Meadowbrook subdivision Location (site address or directions) 10c)46 Id t-arod Circle e Property Owner Kim and Latrelle McRea Day phone 694-9323 Mailing address Same 277-0725 or Lending agency (7itymorttgage/Mark mr sket t Day phone 696-0701 Mailing address 11401 Old Glenn Hwy, Ste. 11OA, Eagle River/ AK 99577 Agent Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water F � Day phone 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 regulations in effect on the date of this inspection. Name of Firm Phone Address 17034 Eagle River Loop Road No 204 Eaglo River, Alaska 99577 Engineer's signature Date 6. DHHS SIGNATURE c Approved for Disapproved. Conditional approval for Additional Comments bedrooms. %HT1(', OF 414,10t�, °� 9 q Napo u u •(o •{aSr(Tfr� may. PO^_ "FrR % O aSSO 44' 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 421 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L-Wc (-•0 0�1-V- \ QAEk®b\J.L3 14 -Parcel LD A. WELL DATA Well type If A, Fs, or C, attach ADEC letter. ADEC water system number Log present(Y/N) Total depth Sanitary seal (Y/N) Date of test Static water level Well flow Pump level Date completed Cased to FROM WELL LOG SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot — lff n Absorption field on lot Public sewer main 2odlk' Driller Casing height Wires properly protected (Y/N) g.p.m. AT INSPECTION MIJNIC:IVALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Sewer service line _Petroleum tank 0\)A\(,t,17nti \,� 4c<rl� WATER SAMPLE RESULTS: Coliform Date of sample: B. SEPTIC/MOLDING TANK DATA Nitrate Collected by: Other bacteria U } 1992 &CEI V - Date installed �� tu4, 1`��I Tank sizer X0°0 Compartments 1 Ertl Cleanouts (Y�N) —__Foundation cleanout (Y& DepressionlI(Y/t High water alarm (Y& Alarm tested (Y/N) �(A Date of pumping l- L Pumper -3-4 L656Paee <V 10 [�o�(��G�rG S Fi�T1 L -t'p-r 1G S l o OO lam �C­t� SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot '2-0_0 W- —On adjacent lots 4�I/.,S- Foundation SI To property line 101 Absorption field tL> Water main/service line Surface water/drainage �0 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent(Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y Manufacturer Manhole/Access (Y/N) SEPARATION D48TA-NCE FROM LIFT STATION TO: n lot D. ABSORPTION FIELD DATA On adjacent lots Pump off' level at Cycles tested Surface water _ Date installed Soil rating V2-6_ 8� System type Length J �• Width �) i( ' t I Gravel thickness Total depth S z - Total absorption area J1L Cleanouts present (9/N) �! Depression over field (Y/O Date of adequacy test S 1 -SZ Results 'fail) PASS for P�) QE(2� bedrooms Peroxide treatment (past 12 months) (Yo VJ k( If yes, give date 03 [/�, SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot Zoo On adjacent lots f'` Property line I c, To building foundation Zo I To existing or abandoned system on lot On adjacent lots 3 i Cutbank ' �`� Water main/service line Surface water Sd t Driveway, parking/vehicle storage area Curtain drain /h- I, -� P c -e- !fir' T I �f I,S 5 i 7N�t✓ r o ENGINEER'S CERTIFICATION I certify that ! have checked, verified, or conformed to all MOA and HAA guidelines in effect o0.,th' dal of this inspection. S & S ENGINEERING Signature 17034 Eagle River Loop No. 204 (Y3 u lr age Iva , as<a ie , nr �' { 'r u Engineer's Name f �.� I ._ Z , (,dr•r! .; Date ,,,)�,..; �,.. J. wil HAA Fee $ Date of Payment �{ Receipt Number 72-026 (Rev. 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) E Location (address or directions) (b) Applicant Name. Telephone: Hornelv__1 _�..- Business �P Applicant Address 31 (c) Applicant is (check one): Lending Institution ❑ ; O wner/builder; Buyer ❑ ; Other ❑ (explain); — (d) Lending Institution 1/�� s elephone - Address GG� (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA tttgoMn,a�d��N riG 5R -B-1 LE_R1VER, AK 99577- - TYPE OF RESIDENCE Single -Family Multi -Family ❑ Number of Bedrooms Other 3. WATER SUPPLY Individual Well ❑ 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 7i 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. 72-025 (11,84) Pagel of 2 5. ENGINEERING FIRM PROVIDIN.. 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 inspe§tjpr�a ENGINEERING Name of Firm _—S�tk_g E Telephone Address Date 0- G, °°r 1.10. 1 d57 -"i .: ,,•...., (C •u• .. r. •j7 9 a y�v,�,.� ;: "";:°.rte•`_ �� bey, L 6. DHEP APPROVAL I,� Approved for bedroomsk to Approved — Disapproved Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate Is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11/84) MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 1At1NICIpAt.IT}, OF ANCHORAGC 264-4720 DEPT. OF ENVI ONM NTALEFROIE&TION Legal Description: qry(� 1.70 A. WELL DATA )Ic �V Well Classification If A, B, C, D.E.C. Approved e�YN) Well Log Present (Y/N) Date Completed Yield Total Depth Cased to epth of Grouting Static Water Level Pump Set At — Casing Height Above Ground — Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lott Depression Around Wellhead (Y/N) ; On.Adjoining Lots To Nearest Edge of Absorption Field on Lot `1 "E"� Ih ; On Adjoining Lots To Nearest.Public Sewer Line Cleanout/Manhole Water Sample Collected by To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date Water Sample Test [Results 1 Comments ��)►a1G t4�/'=1— W,`— �-t'1 B. SEPTIC/#GL-DMG TANK DATA Date Installed ��� ti�1�-- Size- '©0c'^� �^No. of Compartments Standpipes CYN) — Air -tight Caps 6VN) Foundation Cleanout (Y4 — Depression over Tank (Y/ Date Last Pumped . 5149 Pumping/Maintenance Contract on File (Y/N) & ; for ItSN Holding Tank High -Water Alarm (Y/N) F, Q Temporary Holding Tank Permit (Y/N) Separation Distances from Septic4l4efditrlTank: To Water -Supply Well 2�c�1-1 "1)49 I To Building Foundation To Property Line (�� i "� To Disposal Field To Water Main/Service Line Course _ T t(ea� Pond, Lake, or Major Drainage Comments k-V°\,.t0 "Ot�. 10012 i D&L 15 � Page 1of2 te�rls 'n%y-(',' 3t -s itlb ptSrii,64t� p v�iL AI's {`Pz3�• �` U, �Gc�.lLl-r� bre i 72-026(11/84) C. ABSORPTION FIELD DATA Q Soils Rating in Absorption Strata L 13✓✓ Type of System Design T[ V <' t -)f" l&LD Date Installed1 �1-� aZ Tn I�t'7 3 Length of Field L IL Width of Field 3, �5 Depth of Field I��- f Gravel Bed Thickness Square Feet of Absorption Area - U. K-. Standpipes Present (DN) Depression over Field (Y/&) -.Date of Last Adequacy Test Results of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply Well ?--c' r-, I To Property Line To Building Foundation a Lot -- t3 b To Existing or Abandoned System on On Adjoining Lots %jam t+ To Water Main/Service Line t C7 To Cutbank (if present) a P To tr a Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments C Tlk� A Rom t�l ��J SCJ* �t t�►�a J� 'iU T-T'C� M1 t�E✓ ir—TS LIFT STATION L'✓D,G i� �Ir?�4� b 11� 4,f y G/�yA-r-f� V�6-<v Its= +J C� M WA -5 fPe-rA ,LEo VJA'f�-4- Date Installed Dimensions Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Manhole/Access (Y/N) "Pump Off" Level at ** Check Permitted Bedroom Rating Against HAA Request ** Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA 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 ENGIi ELIKIil+ C Date I 2T7DD' Company SR 196X MOA No. �S--vim 3 EAGLE RIVER, AK. Receipt No. P/a Date of Payment _ Amount: $ , crit / Page 2 of 2 72-026 (11/84)