Loading...
HomeMy WebLinkAboutLOYE BLK 3B LT 1Loye Block 3B Lot 1 #050-521-70 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP191424 PID Number: 050-521-70 Dwelling: © Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ✓❑ New ❑ Upgrade Name Deborah Lunny ABSORPTION FIELD ❑ Deep Trench © Wide Trench ❑ Bed ❑ Mound Site Address 25534 Berryhill RD. Eagle River AK 99577 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade (843)-509-2075 3 1.2 GPD/SF 5.83 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 2.90 Ft. Gravel depth beneath pipe 2.5 Ft. Subdivision Block Lot Loye 3B 1 Fill added above original grade 135-1.72 Ft. Gravel length 48 Ft. Township Range Section Gravel width 7 Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 375 Ft z 1 Ft. Well TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer GREER Capacity 1000 Gal. 100+ 100+ NA NA NA Surface Water 100+ 100+ NA NA Material Plastic Number of compartments 2 Lot Line 10+ 10+ NA NA NA Foundation LIFT STATION Manufacturer Capacity Gal. 10+ 10+ NA NA Remarks Alarm location Electrical installed by PIPE MATERIAL House to tank Tank D3034 drainfield D3034 Installer Dean Construction Drainfield F810 CO/MT D3034 Inspector Arcterra Consulting BENCH MARK (Assumed elevation) 100ft Inspection 1s[Location and description dates: 10/17/19 2nd 10/17/19 31"10/18/19 411 10/18/19 1 Top of door frame. ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date``+�aP"'""`'4•,,�4 ♦+*��+♦♦ ♦+ 4 I• + 2 49111 , * ♦s f Septic System �G / "&K,"ff Tn? �c_A/bate �VENNE'rH DU FU +�,i ♦ �C �° IF ♦+♦�F,p'tiAV Approved t 1 ► o , . ♦ � O 4♦♦�All Note: this approval does not include well permit requirements. ���i +! (Rev 05/02/18) isarl� rr�uu A—C=75.4' B—C=60,3' A—D=80.2' B—D=65.5' A—E=101,1' B—E=82.9' A—F=102,1' B—F=85.0' A—G=123.4' B—G=87.6' A—H=124.6' B—H=89.1' AS—BUILT SYSTEM DETAILS/SITE PLAN Permit ❑SP191424 L❑YE BLOCK 3B LOT 1 PID# 050-521-70 3 BEDROOM BUILDING o z w NEW 1000Lu GAL. TANK C a w C 0 DI VERTER--- IJ-- MT � CO MTe o F NFA, CO M F/F40 T ^G s = Z � W Z W �QC U O A 7.9 7�P FINAL 000 GAL SEPTIC Imp �OFAL4� * 4 TH ./ KENNETH FUS / CE 71 wa� ® �FESSIO�� SEWER ROCK 48' PREPARED FOR: Lunny Deborah 25534 Berryhill RD. Eagle River, AK 99577 (843)-509-2075 FIELD BOOKS COMPUTED: BOUNDARY: N A DRAWN: KSD STAKING: N A CHECKED: KMD ASBUILr M SEWERD DATE: 10 28 DWG. FILE GRID: SW262 AOAD FILE` FILE JOB No-: 19-059 -Filed By ega oye o oye SCALE, 1' = 30' i 290' es• 62,6 B014 10/17/95 -DRY SCALEi NTS T1 �L z= �-�-< ��za Z RvrO m ® m Qr �z� zam��= o rrn �0 z Z !ammm o omZ m � z�O<x_ w Opp vmzZNo�� �< �m mzm=8 ao -irr lz OCoii p0'��m= p v D mdZr M �-I m�m„zy°- cmi�o nm�x�C��- arr 3m;u-1iNm �m < °—o�mcmnzWx-�-IrTl cn MCD z �mrlc o: �c NBo�oo m CD Z ' m . m � W D CO) 1 ril rTi Cn �� t7 m cn 0 c� H a� S'� r ®Q en co • 1 � � I � a f ijtl �0 a POST IN A CONSPICUOUS PLACE ALL WORK MUST BE INSPECTED Field Inspection Request required 2 working days in advance of starting work and 2 working +ir , days in advance for final inspeciton. Call (907) 343-8206 (voice recorder) for scheduling. Permit is not valid without the call-in and also must include the one-call ticket (utility locate)Al number. MUNICIPALITY OF ANCHORAGE - RIGHT OF WAY DIVISION Department 4700 ELMORE ROAD TELEPHONE (907) 343-8240 FAX (907) 343-8250 RIGHT OF WAY PERMIT 8192686 Type: Encrchmnt Status: °' 3Issued Grid: SW0262 Date Applied: 10/31/2019 Dateassued. ` 10%31%2019 Issued By.,, y ciaudia.pinard Construction Start Date: ; Last Updated 10/31/2019 Last Updated By claudia.pinard Permittee LUNNY DEBORAH L Work Order } Utility: Contact PeISOn Primary insnoefnr• Inn+.Canai row 1 ` $120.00 Total Fees: $120.00 See reverse for requirements/remarks. I have read and understand both sides of this permit. I agree to the terms and conditions; and i certify that all work will comply with federal, state, and municipal codes and regulations and the provisions of t is permit. : c Signature: Date: Construction Requirements and Notes: 1. This permit has been issued based on the assumption that the information contained in the pals and supporting documentation is correct. Any and all omissions are the responsibility of the permitee. Any change in the scope of work requires a revised or new permit and Traffic Control Plan (TCP). 2. Contractors' acceptance of this permit constitutes acceptance of the Municipality's bonding requirements, and is contractor representation that contractor has and will comply with those requirements. Unless a specific bond is applied to this permit by written reference, the contractor's performance bond on file with Development Services, Right of Way Enforcement, shall suffice as the required bond. 3. The Permittee shall post a copy of the permit in a conspicuous location at the place to which the permit pertains before any work there is started and shall remove the permit only after the Right of Way Inspector has accepted the work as being in compliance with the permit. 4. The Municipality has the right to inspect and/or reject materials and workmanship not to Municipal standards, to stop work until corrections are made, or to require removal of the facility and to charge time, material and equipment to the Permitee to correct the facility if they fail to comply with the conditions of the permit. 5. Permitee is responsible for locating and protecting all utilities and survey markers in the work vicinity. For utility locates, call Alaska Digline at "811" or (907) 278-3121. 6. The contractor shall erect signs, barricades and detours in accordance with the U.S. Department of Transportation "Manual on Uniform Traffic Control Devices", Part VI — Traffic Controls for Street and Highway Construction, Maintenance, Utility and Emergency Operations. Failure to do so may result in fines being assessed under Title 14 for work not in conformance with a permit. 7. Changes in the approved road closures or scope of work resulting from emergency circumstances may be allowed during construction. It shall be the responsibility of the contractor to notify the Permit Office, 343-8206, and/or obtain an approved Traffic Control Plan (TCP). It shall be the contractor's responsibility to notify the following agencies: Fire Dispatch 267-4950, Police Dispatch 786-8900, Alaska State Troopers Dispatch 269-5511, People Mover 343-8253 and School Bus 742-1207 or 742-1209. 8. All construction shall be in accordance with the current edition Municipality of Anchorage Standard Specifications (MASS), applicable municipal codes and regulations and the approved drawings and special provisions of this permit. 9. As a condition of this permit all excavations will conform to the standards outlined in OSHA 29CFR, 1926 Subpart P. 10. The Right of Way shall be restored to the same, or better condition, than it was prior to the contractors' work being performed. The work shall be performed diligently and continuously, until completed to the satisfaction of the Municipal Right of Way Inspector. 11. All underground installations within a public place shall be buried at a minimum depth of forty-two inches (42") below the final surface elevation, i.e. bottom of drainage ditches, road shoulder or finished grade. 12. Permanent paving, recycled asphalt pavement (RAP), chip seal, sidewalks and curb and gutter must be replaced within 7 working days after underground work is completed. 13. Winter Condition Requirements (applicable to all Right of Way Permits). a. No trenching and or excavation is allowed within the road prism except for emergency repair of existing utility facilities or by approval of the Director of Development Services. b. Crossing of the road prism shall be by boring technology. c. No frozen material shall be placed in the excavation as fill and/or backfill. A source of non -frozen fill and/or back fill material shall be available. d. All frozen ground within the Right of Way shall be thawed prior to excavation. Ment MUNICIPALITY OF ANCHORAGE sP�G Development Services Department q ,,.. Right of Way Section Department THIS AGREEMENT, made this 31st day of October, 2019, by and between DEBORAH L LUNNY and their heirs, administrators, and assigns, hereinafter called "PERMITTEE", and the Municipality of Anchorage, a municipal corporation organized and existing under its Charter and the laws of the State of Alaska, hereinafter called the "PERMITTER". WITNESSETH: WHEREAS, PERMITTEE is the owner of the following described real property: LOYE SUBDIVISION, BLK 313, LOT 1, according to the official records thereof, on file in the office of the District Recorder, Anchorage Recording District, Alaska, and; WHEREAS, PERMITTER owns and/or maintains the real property more particularly described as follows: The FIFTEEN FOOT UTILITY EASEMENT, immediately on the north side of PERMITTEES property as shown on Plat No. 75-116, on file in the office of the District Recorder, Anchorage Recording District, Alaska, and; WHEREAS, PERMITTEE has placed a well upon the referenced real property which encroaches 0.9 -foot upon the PERMITTER'S 15.0 -foot Utility Easement. NOW, THEREFORE, it is mutually agreed between the parties hereto that: 1. The PERMITTER, acting through the Director of Development Services Department, hereby grants to the PERMITTEE the privilege of allowing well to encroach 0.9 -foot upon the PERMITTER'S 15.0-foor Utility Easement, as shown on "Attachment A," included herewith. 2. The PERMITTEE agrees forever to indemnify, defend, save and hold harmless, the Municipality, its officers and employees, from any and all lawsuits, claims or actions brought to any person for or on account of damage to property or injury, disease, illness or death of persons, including all costs and expenses incident thereto, arising wholly or in part from or in connection with the existence of, alterations, maintenance, repair, renewal, reconstruction, operation, use or removal of the encroaching well, as placed upon the PERMITTER'S 15.0 -foot Utility Easement. 3. The PERMITTEE shall not assign or transfer any of the rights granted herein to another individual or company without first notifying and securing the approval of the Director of Development Services Department. 4. This Agreement and Permit grants PERMITTEE no interest in PERMITTER'S real property whatsoever, except only the encroachment rights described herein. 5. The PERMITTER reserves the right to revoke this permit upon twenty (20) days written notice to the PERMITTEE. The PERMITTEE agrees upon such notice of revocation, to move said encroachment(s) from the 15.0 -foot Utility Easement in which it is placed. Should the PERMITTEE refuse or fail to comply with said written notice, the PERMITTER may, without further notice to the PERMITTEE, remove or cause to be removed the encroachment(s), and the PERMITTEE hereby agrees to reimburse the PERMITTER for all costs incidental to the removal thereof. In addition to the mutual promises heretofore made, the PERMITTEE has paid the PERMITTER a one-time permit application fee of $120.00. The PERMITTER hereby waives the annual fee of $315.00. IN WITNESS WHEREOF, the parties hereto have hereunto set their hands and seal the day and year first hereinabove written. GRANTEE: Deborah L Lunny Owner GRANTOR: MUNICIPALITY OF ANCHORAGE A L,4,� IS*nn M. McGee, on behalf of Jack L. Frost, Jr. Right of Way Supervisor STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT ) THIS IS TO CERTIFY that on this 1 Ith day of November, 2019, before me, the undersigned, a Notary Public in and for the State of Alaska, duly commissioned and sworn as such, personally appeared Lynn M. McGee on behalf of Jack L. Frost, Jr., known tome to be the Right of Way Supervisor for the Municipality of Anchorage, Alaska, who executed the foregoing instrument, and he acknowledged to me that he executed said instrument as the free and voluntary act and deed of said corporation for the uses and purposes therein mentioned, and that he was authorized to execute said instrument. WITNESS my hand and official seal on the day and year first above written. 11TIIl/to����//LA Qg..•••••••••. • L�,p N ARY PUBLIC i for Alaska My Commission Expires: NOTARYIM PUBLIC 14 STATE OF ALASKA } ) ss. THIRD JUDICIAL DISTRICT ) THIS IS TO CERTIFY that on this _� day of (�/P_►M�{.1/ , 2019, before me, the undersigned, a Notary Public in and for the State of Alaska, duly commissioned and sworn as such, personally appeared be-DLra.h L. Lu n n known to me to be the individual(s) named herein who executed the foregoing instrument, and (s)he acknowledged that (s)he did so freely and voluntarily for the used and purposes therein mentioned, and on oath stated that (s) he was authorized to execute said instrument. WITNESS my hand and official seal on the day and year first above written. State ofAluska NOTARY PUBLIC in and for Alaska NOTARY PUBLIC My Commission Expires: _� at C. Benedict-Monnens My commWon Eons kQ 3i, 2023 ao� <*m Za -n 1a m_n �'� r�i 00 o rm z>rri _ z=r�n�do x w 1 • rr�>ztnv z 1610 z\ -4 �- o m mmp zoo<�—4 rn in Z ecmi� 0 Z ,,Ux n� ow mz — td� zZm \. C: z -im= o m = ;a �g�m�� v -a cn icn0 Cnom 0r=;uL<v3-N\o m -mt � a v �;a NjZm �m m -� -o com�mm - X M N m mccn zOM_mr—u'-t`1't < u' �3J r"no6o�p m A' �C �8� 0 —� c— E3 0-i `�Wcnz z z -< :r> x m m m CD x D n M ?� ! \ln Cl) d 0 n H ecn SP 7$ c� Q ih` `n p • s 4eh ,1 co 4 � —� a i �� r October 31, 2019 RE: 25534 Berryhill Road Eagle River To whom it may concern, 6C1 Subject to your agreement to indemnify the company as set forth below, GCI Communication Corp has no objection to the well encroaching into the utility easement of Block 3A, Lot 1 of Loye subdivision, also known as 25534 Berryhill Road, city grid SW0262, GCI WO# 19-0001-58. This letter of non -objection in no way precludes GCI Communication Corp from full use and enjoyment of any rights it may have within any portion of the utility easement and or the right-of-way, including unlimited access for servicing its facilities. Also, any additional and extraordinary costs incurred during any future required construction, repair or reconstruction of GCI's facilities to accommodate any or all the encroachments shall be paid by the property owner. By signing below, you agree to indemnify and hold GCI Communication Corp harmless, now and forever, for any damage, costs, expense (including reasonable attorney's fees), liabilities and iniury to anv r)erson or oronertv occurring as a result of the encroachmei Please indicate your acceptance by sign address below. Sincerely, Aj< Date Markus Kofoid Manager Outside Plant Design & Data Management GCI Communication Corp 5151 Fairbanks St. Anchorage, AK 99503 907-868-6168 Office 907-868-8580 Fax EMSTAR Natural Gas Company October 31, 2019 Deborah L. Lunny 25534 Berryhill Lane Eagle River, AK99577 Subject: Letter of Non -Objection Lot 1, Block 3B, Loye Subdivision To whom it may concern: ENSTAR Natural Gas Company A DIVISION OF SEMCO ENERGY Engineering Department, Right of Way Section 401 E. International Airport Road P. O. Box 190288 Anchorage, Alaska 99519-0288 (907)277-5551 FAX (907) 334-7798 ENSTAR Natural Gas Company has no objection to the existing well encroachment within the fifteen foot (15 FT) wide utility easement, coincident and parallel to the north lot line of Lot 1, Block 3B, Loye Subdivision, according to Plat No. 2016-91, located within the Anchorage Recording District, Third Judicial District, State of Alaska. Acceptance and use of this letter of non -objection by yourself, your heirs, your assigns, or your successors, will constitute agreement to the following stipulations: • Landowner/Contractor working near ENSTAR gas facilities shall contact the Alaska Digline, Inc., (907) 278-3121 or 811 for line locating two (2) business days prior to any related excavation. This service is free of charge. • ENSTAR will be held harmless, now and forever for any damages or injury to any person or property as a result of this encroachment. • Any ENSTAR facility damaged or destroyed, as a result of this encroachment will be repaired at no cost to ENSTAR. • Any costs incurred by ENSTAR for special construction necessitated by this encroachment will be borne by the land owner. • All applicable safety code regulations will be observed and maintained. • This letter of non -objection will in no way preclude ENSTAR from full use and enjoyment of its rights within any portion of its right-of-way. Sincerely, Cassie Acres Right of Way & Compliance Technician ENSTAR Natural Gas Company NON -OBJECTION TO EASEMENT ENCROACHMENT DOCUMENT By this document Matanuska Telephone Association, Inc. (MTA) declares that it has no objection to the encroachment of the well in the platted 15' utility easement of Lot 1, Block 3B of Loye Subdivision, Plat Number 2016-91, filed in the Anchorage Recording District, State of Alaska. Please be advised that MTA through the issuance of this document does not forfeit any of its rights to the use of the area cited. In the exercise of these rights MTA will, if needed, upgrade, maintain, repair, and/or replace buried or aerial telecommunications facilities within the easement. Any repairs that may be required to the encroachment as a result of utility construction will be borne by the property owner of record. This document does not authorize the placement of any additional encroachments within the easement area. Property owners are required to obtain utility locates before doing any kind of work in the utility easements and will be liable for any damages caused by their construction work in the easements. This document is in no way an agreement to vacate any portion of the utility easement and should not be interpreted as such. Issued for Matanuska Telephone Association, Inc. this 1" day of November 2019, by, Jessica Burnett, Right of Way Agent THIS IS TO CERTIFY, that on this I" day of November, 2019, before me the undersigned, a Notary Public in and for the State of Alaska, duly commissioned and sworn as such, personally appeared Jessica Burnett known to me and to me known to be the individual named in and who executed the foregoing instrument and acknowledged to me that he signed and sealed the same as a voluntary act and deed for the uses and purposes therein mentioned. IN WITNESS WHEREOF, I have hereunto set my hand and official seal the day and year first above written. �,v= °FFicw�s No lic in and for Alaska NoNy sp�ow Icy Pubr le ofAl�lce My commission expires: 9 `t t I a �L P.O. Box 3550 Palmer, Alaska 99645 1 mtasolutions.com 1907.761.2510 zi co r- ;F 'lI,-'-",l;---j 0-) Cl) co co 0 o D > Z3 :3 CD > 0 C: CD 0 0-0 ;Z Cr 0 > 103 ;07; m cn,< 0 0 (v =r 0 (D (D =r zy 'T C, , o 0 (D (n (D Z; 0 CD -a CD CD M m :3 (D (D 0) -1 > O C m 0 - 0 'o a- 0 CD CD C) > CD -n (D 0 a—) 0 (D < 3 50 E3 3 m (D Q a w = 0 F- 1 0 0 cn (D (D > CD (D D (D D cn '0 C/) (" (D m cn r- 0 r�' _ 3 q w Cr 0 cr 0 > 0 W M > :3 — D CD 0 (n (0 D 0 CD (D * c 0 cn (D CD < (D (D CL CD -3 CD 3 :3 3 Erl CD (D :3 m a — (D CL - ::r CD :3 (:Dj (D CD _-:r o 0 =r CD 0 a 0 CD (D =r 0 0 -n (D (D (D cD (D 0 0 (D < (D 0 (D cr cr W (n -T (D w0 cu (D 0 3 (D > EF cn (D x > n LD, (D a) 0) 1 "1 CD a) (D Cr o- 0 " =r '< ET ZN: i :D w a) CD CD 5 :3 3 3 3 < 0- (D (n (D Z. 3 w 0 77 0 C: p :3 (D (D (D CD (D W CD CD U) CD - cn 3 U) — , 0 C: 0 :3 3 -u) U) CD 0 a (D CD — :3 CL 0 CD 0 CD C l< cr :3 of CO T n- (n Z cn 0 0 n:33 :3 D � < CD :3 :7 cr C.) :3 (n (n �E 3 a (D 0- (D (D (D amu' D- :D 'a (D ZF U) 0) 3 (D — a) o C)- CD (D — (D (D 6 0 m c Z:r = 3 a) OL Q) (D a) (D zr -- '< -3, 0 —3 > 0 l< -1 l< o < 0 Z3 0 :3 o- =r n r- (n 0 (D a) (D (D CL a C) CD 3 3 o f 0 go \)� :3 3 10 0 0 U) 5* C: 0 Cn o cp :3 a CD :3 < l< 03 0 5 a a zr 0 (D N (D (D 0) � CD CD 3 CD (a (D 0- a) m (D (D 3 3 z a 0 cn (T (D 0 C) (n w Z3 cn 0 _0 CD cn Z) (D 0 cn C: 0- - < (A 3 - . En D 0 _0 CD cn (D ZY 0 cn :3 (D CO (D (a (D 0 :E 0 (D —E l< 0.) 0 0 (D 3 0 C) > (D 0 (D W w (1) a flOi :3 X. (D (D 3 U) C) 0- 0- Z3 Q0 (n CD Cl CD 0 0) 0 = 0- - -1 03 0- 0� ::)- (n (D :3- :3 cn cnw (D 0 cn. 0 (D 0 +1 F - w (D 13 U co 0 0 C: 0 (n D c - (D 65 w a) (D CD w (D Qo = CD n) CD (D 0 9 C :3 0 &, '< - c: w (D :r •3 :E 0 0 CD W -0 CD (D 0 0 - (D CD CD 0 0 (n o :D CD Erl (n 0 CD w CL (D CD X (n co (T C7 (D o w < 0 3 C 3 (D C < 5 CD — 3 (n 0 a) (D CD 0- (D Pf, E (D CD :D 0 3 CJ w 3 0 :3 CL CD (D D Q� w 0 (D w cn (a CT a U)- 0 m CD (D D > cmn UD CD 0 n Q) W (D zr m 0 0 cl (D < (D 0 rz CD w > CD CD (D CD :3 3 3 w 0 l< — C: 0 — D E (D (0 D :D m 'j CD 0 0 0 0 (D (D ch 0 (D (D cn (D (D 3 5 =r w (D w 6 - -0 C: ZY, 0 rCD n (D (D (D :3 Z) (D M, " (D CD —3 cr (D 0 (D 0 (D X CD m N) 0 CD 01 CD z 0 r— u 0 < (D O 3 < CD cr CD r- 0 (D D 0 77 > co w (0 (0 `01 (D C/) CL cn A 0 Z3 m cn --j m ;u rri 0 rn n 0 z o z 0 1 0 (D m 0 (D 0 00 3. 0- 0 D z N'"""`"Y MUNICIPALITY OF ANCHORAGE On-Site Water &Wastewater Program .5.; PO Box 196650 4700 Elmore Road Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 r, httpalwww.muni.orglonsite -% ,.• 1 enart„e(tr 4NCNORPG' On-Site Wastewater Disposal System Permit Permit Number: OSP191424 Effective Date: 9/26/2019 Work Type: Septic Upgrade Expiration Date: 9/25/2020 Tax Code Number: 05052170000 Site Legal Address: LOYE BLK 3B LT 1 G:0262 Site Mailing Address: 25534 BERRYHILL RD, Eagle River Owner: LUNNY DEBORAH L Lot Size in Sq Ft: 74488 Design Engineer: ARC TERRA CONSULTING INC Total Bedrooms: 3 This permit is for the construction of: 0 Disposal Field Q Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72)and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: Contractor shall verify there is an existing foundation cleanout 1-4 ft from the building foundation. If none is present, a foundation cleanout shall be installed or a set of opposing cleanouts shall be installed on the upstream side of the new tank (within 10 ft of the inlet). Received By: ,Z& / i Date: l� Issued By: Aeil/��fi� 'Z`�t' Date: 2 , MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section % Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 050-521-70 Property owner(s) Deborah Lunny 843-509-2075 Day phone Mailing address 25534 Berryhill, Eagle River AK 99577 Site address 25534 Berryhill, Eagle River AK 99577 Legal description (Sub'd., Block & Lot) Loye, Block 3B Lot 1 Legal description (Township, Range & Section) Lot Size 74'488 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field [J Initial Single Family (SF) A (w/wo ADU) Septic Tank A Upgrade " Duplex (D) Holding Tank — Renewal I IMultiple Dwellings [A Privy (SF and/or D) Private Well LJ Water Storage I THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. lgnature .1 . •perty owner or authorized agent) Permit/Rush Fees: 56K Waiver Fees: Date of Payment: 9I OI/9 Date of Payment: Receipt Number: LiMa -t Receipt Number: Permit No. 05 i°/q/ti L( Waiver No. G:\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc ARcT ERRA CONSULTING, INC ' 20441 Ptarmigan Rid,Eagle River,AK 99577 Office(907)696-6111,Fax(907)868-3793 • ,w��lf' ,ULT I NG.;je" 99f ' September 20,2019 Municipality of Anchorage Development Services Department On-Site Water& Wastewater Program P.O. Box 196650 Anchorage,AK 99519-6650 RE: SEPTIC UPGRADE PERMIT- LOVE , BLOCK 3B LOT 1 The owner has requested we proceed forward to obtain a septic permit to upgrade the septic system for this 3-bedroom system. The general slope of this lot is from north to south at a grade of approximately 10-15% over the septic area. A test hole was dug on Oct. 17, 1995 to a depth of 14'. Groundwater was observed at 9'. The proposed upgrade will serve the existing 3-bedroom single-family residence. We propose to install a 48' L x 5' W x 2.5' ED Wide trench. The total depth of the system is 5' from original grade. The property and adjacent lots are served by private wells. There is no surface water within 100' of the proposed system and there are no known curtain drains within 50'. We do not expect there to be any adverse effect on adjacent lots by the development of this system. If you have any questions, please contact me at 696- 6111 / FAX 868-3793. Respectfully submitted, ArcTerra Consulting, Inc. ft,410. Duffus, P.E. Attachments: On-Site Sewer Application Wastewater Absorption System Details/Site Plan 20441 PTARMIGAN BLVD • EAGLE RIVER,AK 99577-8736 • PH(907)868-3791 • FAX(907)868-3793 WELL & WASTEWATER DISPOSAL SYSTEM DETAILS/SITE PLAN LDYE BLOCK 3B LOT 1 _ , , ,\ rH8. iocfrw 59313 ;199 ' M OFATRA T 5A is,utsEs„t ` se'43 . 40 111111111*'11110 47 SI 9l W p 'e9I a�x s �� 39 . 1 ij 0 6 rbr 30 �o "-1e• , N hb Inti M d- o — ‘-•43 r 30 �! r - O _ NI \ .g) d s�9 'o 0. Dn AOY v i0 A, OA _ O . p F T F 4, B S n s-.0f> '�b� w I 00 s FLAG PROPERTY LINES scale: 1'= 100' • WELL RADII g< EASEMENTS PAGE 1 OF 2 PRIOR TO CONSTRUCTION DESIGN DETAILS13 BDRM X 150 GPD = 450 GPD 450 GPD/1.2 GPD PER SQ. FT. (5 MIN/IN.)= 375 SQ. FT (375 / 5')X 0.64 (REDUCTION FACTOR) = 48 FT. TRENCH USE 1 TRENCH - 48' (L) X 5' (W) X 2.5' (D) aa TOTAL DEPTH OF SYSTEM IS 5.' MAX FROM ORIGINAL GRADE. NOTES: TOTAL DEPTH OF GRAVEL BELOW DISTRIBUTION PIPE IS 2.5' . 1, INSTALL 1000 GAL. TANK & INSULATE TANK IF <4' COVER. NO PUBLIC WELLS WITHIN 200 OF 2. INSTALL DIVERTER, CONNECTING NEW FIELD WITH EXISTING FIELD , PROPOSED SYSTEM. 3. INSULATE TRENCHES WITH 2' HD BURIAL FOAM IF < 3' OF FILL. 11 NO PRIVATESEWELLS WITHIN AS NOTED.OF MIN. 2' FILL WITH INSULATI❑N, >3' COVER NO INSUL REQ. � PROPOSED SYSTEM EXCEPT ,, NO SEPTIC SYSTEMS WITHIN 100. OF 4. TEST HOLE PERFORMED BY S&S ENGINEERING ON 10/17/95. 9 PROPOSED WELL EXCEPT AS NOTED. 0 5. CONTRACTOR WILL ENSURE MINIMUM 2% SLOPE INT❑ SEPTIC TANK. F! 6. CONTRACTOR WILL ENSURE ALL SEPARATIONS TO ADJACENT I WELLS, SEPTICS EASEMENTS, PROPERTY LINES, ETC... 0 7. WELL LOCATIONS DEPICTED ARE APPROXIMATE ONLY. CONTRACTOR S _` IS REQUIRED TO VERIFY SEPERATION DISTANCES PRIOR TO A OF \ COMMENCING WORK. AllirA ���� • `•<Q� PREPARED FOR: CTE D� Air Ai. ' , Deborah Lunny oti �RR 1 '7 A 25534 BerryhIll RD. a r /* 4 9TH /\ * Eagle RIver, AK 99577 '° n / / 843-509-2075 /irkitEk\l, c. I .��i111111P ./. ' / IKE '• gUFFUSFIELD BOOKS COMPUT(D: 3 4$ ` 4va / BOUNDARY:N/A DRAWN: KSD Z � 11:.,., 1 cn / '4v/ STAKING: N/A CHECXED: K M D . 1'•' ISI” `S� ' ASBUILT: DATE: v'"rte-- / p� 1y�, SLS 9/18/19 F9 � 06� E \ FESSIO = DWG. FILE: GRID' SW262 c(F C'ON,S �NC,9o'�, o `_' ACAD FILE: JOB No.: '4,4, "CI 14.1'1 h(i �36 FILE19-054 AK.99577- WELL & WASTEWATER DISP❑SAL SYSTEM DETAILS/SITE PLAN L❑YE BLOCK 3B LOT 1 uUKLUING ' O O 'I k &Al/m1\ ADalimm 74fr XISTING INSTALL NEW TANK TO BE 1000 GAL. TANK �W /� REPLACED �, C.s C `o INSTALL Os/ DIVERTER :• o CO EXISTING FIELD T MT MT 1111M11THo ' CO a 10.0' MINIMUM a CO 1° Y, 10 CONSTRUCT NEW SEPI'1 ® 11 FIELD PER DESIGN iiiiwCitli 0 J b u O�\\ 'ilO o O. J 410 O J 9 9 u r 0 J O O T FLAG PROPERTY LINES I WELL RADII & EASEMENTS �_`� il PAGE 2OF PRIOR TEl CONSTRUCTION ' 1~ 30'2 J AP.-.� O•F �•�,, 1 PREPARED FOR: ROTER /AI if- 1 Deborah Lunny ti kq 4, th —,� • `7 i 25534 BerryhIll RD. ° �� °� o /* 49TH �� * Eagle RIver, AK 99577 I % \ / \ - • 843-509-2075 ( I11II 00 KEFIELD BOOKS COMPUTED: ;CE-71 ��� / BOUNDARY:N�A °RAWR: KSDZ �-\,` \ 1 .$ STAKING NSA CNECKCFD. KMD % \ / ''14 .to ! • 1 DFESSIOit ASBUILT: SLS DATE 9/18/19 c9c' �e I \ DWG. FILE GRID: ! �' L 11 E SW262 F b \� 0 `_� ACAD FILE: FILE JOB NO.: 19-054 /SFR S K.99577' Municipality of Anchorage Page 1 of .1 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: Sw95o3go PID Number: oSUsal7o Name: -DRvI� Wastewater System: ❑ New Upgrade R. ST��s Address: EA&I-EP-lV0Z/ Af-A6KA -Box I7o3 cfcls`77 ABSORPTION FIELD (p,8� Phone: a5? ay6q No. of Bedrooms: 3 0 Deep Trench Shallow Trench ❑ Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: Total Depth from 5.5nalgrade: I 1 GPD/Sq. Ft Lot: Block: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe -:5B LvyLw- I I Ft. :11Z Ft. Township: Range: Section: Fill added above original grade: Gravel length: �— �- G. S a 1 Ft. H 8 Ft. WELL❑New ❑Upgrade £'X IS'f �N(s Gravel width: Z3 Ft. Number of lines: I Distance between lines: I Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: {}S"i'tM 1:-_9Io%D3O34 �21 Vs:7+r� Ft. Ft. %S SQ. Ft. Driller: Date Static Water Level: Installer: Date installed: Ft. Yield: Pump Set at: I Casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES KSeptic ❑ Holding ❑ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: ,/ AN<N17eYAeE Capacity in gallons: 10007 From Tank Field Station Tank Sewer Lines IAN( Well t I ly' — aS I+- Material: S-r��r- Number of Compartments: a (o t urf fe 10014-— _ — LIFT.STATION Wat wo'4 Lot f t Size in gallons: Manufacturer: Line So a 3 — t .�- "Pump on" level at: 'Pump off' level High water alarm at: Foundation 5'D �� Curtain IJP C�WI� Pump Ma Electrical Inspections performed by: Drain Remarks: E XI S TING Y STf,rI BENCH MARK P� fmp �i) CAv S/r`�i/J A8;4-tj a v LD Location and Description: -roY or- 6ArrA(ve SLAB C:0M LL7-1LL y F t' isoItjT Q Assumed Elevation: (UC7. ENG�L f k: 0 �3 ENGINEERING , I I- 95 Inspections performe ce a -aa No --?04 Dates: 1st 1 I •VE, k 9t 6••«: «.•«. ....:......� `�!�„� Q age p Eagle River, Alaska 99577 2nd _(1_11 _ 4 S f+...«.......<..... ,.,r % F ROBERT C. COWAN i Department of Health and Human rvices app_ro`vJal !A l� ay CE - 8801 Reviewed and approved by: z- 72-013 (Rev. 9/91) MOA 25 Permit No. SW9503.80 Page 2 of Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 0 Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal Description LOT 1, BLOCK 36, LOYE SUBD. PID No.: 05052170 72-013 A (Rev. 9/91) MOA 25 STI ST2 / FINAL GRADE MT CO 92.5' 93.2' INSULATIO N INSULATION NEW 90.1' 1000 GAL 89 9. SR SEPTIC 89.9' TANK 87.2' ♦82.7' WATER FOUND 10--26-95 W1 LL A B ST 1 74' q� 52' LOT 1 op, ST2 78' 58' �F C01 811, 61 CO2 82: 60' A �Fp�sTi Aptic CO3 90 oG C04 121' 82' 4 `sF 0 3 11T1 91' 71' MT2 120' 81' N O I O N ti NEW 1000 GAL A^'. SEPTIC TANK 7ST2. ••""�"441 �{9,t 4f MT p � tt2 V-2 :.......... ...... ROBERT C. COWAN ti '124 SCALE >- = ao• NEW TRENC 00 +j�Gi�r;`^ CE -8801 %� 72-013 A (Rev. 9/91) MOA 25 PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW950380 DESIGN ENGINEERS & S ENGINEERING OWNER NAME:STEVENS DAVID R & MIKE G OWNER ADDRESS:HCR 83 BOX 1703 EAGLE RIVER, ALASKA 99577 PARCEL ID:05052170 LEGAL DESCRIPTION: LOYE BLK 3B LT 1 LOT SIZE: 74488 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: DATE ISSUED:11/07/95 EXPIRATION DATE:11/07/96 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ISSUED BY: DATE: // / 3 lgs' DATE : //` �' / HEALTHAUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSALSYSTEM DESIGN S&S� �1n��ninG October 26, 1995 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 1, Block 3B, Loye Subdivision ROBERT C. COWAN, P.E. ROBERTA. SHAFER, P.E. CIVIL ENGINEERS (907) 694-2979 FAX(907)694-1211 Request you issue a permit to upgrade the septic system serving the three bedroom house on the referenced property. A test hole was excavated and a percolation test performed in the area of the proposed upgrade. The approximate location of the test hole is located on the attached site plan. At the time of excavationq'-cfwater was encountered in the test hole and after seven day ground water monitoring, water was found at nine feet in the monitoring tube. Attached is the proposed upgrade design. We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic system. If you require additional information, please contact us. z Sincerely, „ g 9 = w z � Robert C. Cowan, P.E. w RCC/gk c " r Q r � Z Enclosure a U Z O Z w 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 C) r rq z omn�� AAmm NNA �mZ Om= ,Nzm Z i O i o ��C) mm ADO �D AZO mC% {�O r'i r F- 0 0 140 zi A (ENGINEER'S SEAL) Municipality of Anchorage�'c f+ DEPARTMENT OF HEALTH & HUMAN SERVICES 9 825 "L" Street, Anchorage, Alaska 99502-0650 qt SOILS LOG — PERCOLATION TESTS PERFORMED FOR: "\ll` t"E-\(� �S DATE PERFORMED:0,° LSA 0 ^95 LEGAL DESCRIPTION:L�� 1 �_14 Township, Range, Section: SLOPE SITE PLAN 2 3 4- 5 6- 8- 9-' 89 a / U 10 0 12- 13 2 13 %. 14-- 15- 16- 17- 18- 191 4 1516171819 20 COMMENTS Lq�/S P 1�(�r�T s1V'r S WAS GROUND WATER , ENCOUNTERED? IF YES, AT WHAT I L O DEPTH? p E Depth to Water After ) Monitoring? Date: 0 PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND 1,6 --FT PERFORMED BY: 17034 Eagle River Lana Rogd NA -2 6�nl. ✓-Aa Po CERTIFY THAT THIS TEST WAS PERFORMED IN Eagle River Alaska 9957 ACCORDANCE WITH ALLSTATE AND MUNICIPA GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) s&S� ,tneening HEALTHAUTHORITY APPROVALS ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS REFERENCE: Lot 1, Block 3B, Loye Subd. October 26, 1995 SEWER & WATER MAIN EXTENSIONS ROBERT C. COWAN, P.E. ROBERTA. SHAFER, P.E. CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 1. The scope of this project includes the installation of a 1000 gallon septic tank and a five foot wide SEWER&WATER drainfield to serve the existing three bedroom INSPECTION residence on the referenced property. The existing septic tank is to be excavated, pumped, crushed and abandoned. The existing leachfield is to be abandoned in place. ENGINEERING STUDIES _ AND REPORTS 2. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal WELLINSPECTION &FLOWTEST Regulations. 3. The contractor shall be responsible for obtaining any necessary underground utility locates. SITE PLANS 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. On all ROADDESIGN leachfield mound systems, the property owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded area. SOILTEST 5. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the PERCOLATION Municipal Health Department. TEST SEPTIC TANK INSTALLATION: STRUCTURAL& 1. A septic tank is to be constructed by a certified MECHANICAL septic tank manufacturer. Construction shall include INSPECTIONS two 4" cleanouts for pumping access. 2. The septic tank shall be sufficiently bedded to ONSITE prevent settling or shifting of the tank. WASTEWATER DISPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 Page Two Lot 1, Block 3B, Loye Subd. October 26, 1995 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. 5. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: 1. Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (roughed -up) before gravel (sewer rock) placement. 2. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 3. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. 4. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. U Page Three Lot 1, Block 3B, Loye Subd. October 26, 1995 5. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements. Page Four Lot 1, Block 3B, Loye Subd. October 26, 1995 INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: 1. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre -construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. Page Five Lot 1, Block 3B, Loye Subd. October 26, 1995 S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER ' MUNICIPALITY OF ANCHORAGE�� fry DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION I( ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE ❑UPGRADE MAI LI NGA DRESS f C) 70 S_ /Z LEGAL DESCRIPTION LOCATION NO. OF BEDROOMS < Llr 1 L L-7 U Y DISTANCE TO: �II �/ �`ZJ Absorption Veal Dwelling �� PEFfJI N ` Z £/ p H z CL F Manufacturer t"�jr �� M I -- No, of co part5pents G rn Liqec a y�q iyygallon s / lGC� IF HOMEMADE: Inside length Width Liquid depth he DISTANCE TO: Well Dwelling PERMIT NO. JOZ O.Z Q 2—F Manufacturer Material Liquid capacity in gallons DISTANCE TO: W la r Neare t lot�linel/_, Pg IT 'A N 6 = -, 1 /�v o-7Foundati -w.i Z F � No. of lines / Length iqe T T Total nn�/,�� of�lirujf, - I� �' Tren�width L< c._ n inches Distance et7epn li es IILL'' 14 f Top of ti o ZnijYgrade - tel'ial bp ep4h tile t Total effective sorption area Q —2. Z inches Length Width Depth PERMIT NO. Lu Q F Type of cribC ' tame r Crib depth Total effective absorption area as LU ti DISTANCE TO: Well Building foundation Nearest lot line J Class C2 s, Depjhh OxWer Distance to lot line PERMIT NO. +� LU DISTANCE TO: Building founca ' n Sewer line Septic tank Absorption area(s) v OTHER PIPE MATERIALS ,�Ip Co C / P Z4 Z11 SOIL TEST RATI NG `(/ / C zc INSTAC REMARKS e -el t /C nYr�L'/� svL� A y,d Jn �d v19F <nC G f. W 3 4'J[ beri P_ Wil.'fcr 'imay G.` � V APP ED DATE LEGAL ' �"^'�iz brit Ii14�53. �q ALASKA WATER WELL RECORD STATE OF ALASKA DEPARTMIENT OF NATURAL RESOURES Division of Geological & Geophysical Surveys LOCATION OF WELLDrilling Permit No. (Please complete either la, Ib or Ic.) la. B orough A.D.L. No. Subdivision Lot Block Ib. % �i/4 qt rs. Section No. Town ehiD N n Range E� Meridian �i� / g�—of_of_of Ic. DISTANCE ANO DIRECTION FROM ROAD .INTTIIERSECTIONS --SO� WnIT 3. OWNER OF WFI I Street Address and Area of Well Location 2. WELL LOG Moteria) Type -�anc� �artd-z�/tave:c �aR Ve �, _ _ Sand gmveL diEC 61cown and vtav/LOC Avi., Oennti Fauc6an4d Address: Feel Below Surface 4. WEII,.,➢EPTH: (final) 5.TE OF CO _�ETION f I. - _�_ – �f B. �� Cable tool M' otary [] Driven Dug ❑ Auger ❑ Jetted 0 Bored 0 Other: 7 60 7.USE: [Womesdic U Public Supply LJ Industry D Irrigatlon [j Recharge �� Commerical E] Test Well E] Other: . �y� S. CASING: Threaded --v diem._ (J in. to �2 ft. Depth Weight _-/7—lbs./ ft. __in to_ ft. Depth Stickup_— ft. ndiam. 9. FINISH OF 11 E!!O�(. �) H e " Type: �___-__________ Diameter: G Slot/Mesh Sl:e: _ Length: Set between _ ft. and ft Bockfilling _ Gravel pack 10. STATIC WATER LEVEL: _ _ft. ❑ Above or 0 Below land surface Equipment used: I I . PUMPING LEVEL below land surface and YIELD ft. after hrs. pumpin9 g.p.m. ft. atter hrs. pumping g. p. m, 12. GROUT ING Well Grouted: l� Yes [7] No Material: F] Neat Cement Lj Other: 13. Pump: (if available) HP Length of Drop Pipe It. eapacily Ej Subm. Jet ❑ Conlrifical LJ Olhe 14 REMARKS: Date -40&tc. i.on o/ 30 9M 16. -WATER WELL CONTRACTOR'S CERTIFICATION: 15. Water Temperature _-- F... 7h well was dr�IV2der my jurisdicliun and this report is Irua to Ihs yell n my knnule Age I I br liu (; 1 agRudon YtZ ung / 1 53 5 --- -- Regis ered Business - - - -- ------ - � Nam Nnmhar / O lOK ,n/� (- 7 Coral rnct Lich rase -� Address. • l//`Yl `%Qg e Aivelt, A. 99S/7 -.Signed:Duto 27j, _.- -- - Authorized Rcpreaentalivuv, --- ---------------- ---- Form 02-WWR (11/81) r....., n:,I--.:__ 0C g. P.m. ' DEPARTMENT Of |E8LTH AND ENVIRONMENTAL P TECTION 825 'L' STREET, ANCHORAGE., HK. 99501 264-4720 ��C-- IZI r-4 -F E=- ��L-A F= r---:! ���1�1 -1 -F . PERMIT . NO. ( 8]0162 ' APPLICANT DENNIS P FAIRBANKS PO BOX 1705 99577 594-4587 � LOCATION LEGAL L1B3B LOYE LOT SIZE 999999 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: DRHINFIELD MAXIMUM NUMBER OF BEDROOMS = SOIL RATING (50 FT/BR)= 140 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: 0 aNO'T"=— �_'-tx 1:3FeF:-7lVal �F::F:-" -T- =< THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD` THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). -T-"E-7- -1-F;;.E"P-4fl:::" t -J 7 0--r" I _E. 0_5, C-1 C) C-6 F-- E= E- -1F. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). F-_� WE Cm U I C -A ���F=" -F I C- -1F F-1 " F< E. I = F=� ���C-1 �F-19 I Cor-4!EF PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. ___ 'T_wcv ��� I " I—=. F=l E_= fl::_ _r I co " _�_. ��F_= F:;?. F=' C -A- U T P�_' F= E-8 — —— BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR H PRIVATE WELL OR 150 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM H PRIVATE WELL TO H PRIVATE SEWER LINE IS 25 FEET AND TO H COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ]0 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY, SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. C_sF=C-E:ME?-E=F2 � I CERTIFY THAT � 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR 0N -SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ]: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ] BEDROOMS. � ` SIGNED: ~~----~-_ APPLICANT CENNIS P FAIRBANKS ISSUED B � ---- DATE--- V4. 0 ❑ SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ❑ PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST //J�/Af> PERFORMED FOR: �LL'�G ✓✓ ) c�6 / C,i, C//I DATE PERFORMED:36 JA"J< r7' LEGAL DESCRIPTION: / �� U UC-�/✓ OPE A I SITE PLAN 1 2 3 4 5 6 7 9 10 11 12 13 14 15 16 17 18 19 20 CSIGz /✓I r, lC' /7 WAS GROUND WATER ENCOUNTERED? ,1614, / IF YES, AT WHAT / /U (J DEPTH? Rjvl�va A. •� i• fti0. 1d`.7YE. '• ~yap COMMENTS I,/'/4jj17/%rI ■N■■■■■■■. ■MEMEN■■■■ Date Gross Time Net Time Depth to Water Net Drop MWEENSMEMEN NOW" SMEN NEEMENNEW ENNEXREMON NEENNEMENE NNEENNEEME N■EM■MENNIN ENNNENNOMM L L O P E Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE (minutes/inch) EST RUNETWEFT AND T J' r i,--7 PERFORMED BY: /�'�iG�CERTIFIED DATEJII yVl ��5678g70�* e !, • Municipality of Anchorage Qr On-Site Water and Wastewater Program a R (907) 343-7904 OCT 2 Y L5 A CERTIFICATE OF ON-SITE SYSTEMS APP E�` AL oz g8Lg5 Parcel I.D. 050-521-70 Expiration Date: �� 1/ 1� 0 1. GENERAL INFORMATION Complete legal description Loye Block 3B Lot 1 Location (site address) 25534 Berryhill Rd. Current Property owner(s) Deborah Lun Mailing address Real Estate Agent 25534 Berryhill Rd. Christian Washburn 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ WaiverNariance request for: 3 Day phone Day phone (907)-202-6322 a� I��i4 iil q TYPE OF WASTEWATER DISPOSAL: Individual Holding Tank ❑ Community ❑ Public Sewer ❑ Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ qg$ Waiver Fee $ Date of Payment 10129 1I9 Date of Payment Receipt Number XqL4LIq /nnQ Receipt Number COSA # 05 P t 9151(o 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 ARCTERRA CONSULTING, INC. Phone 696-6111 Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date lev 1 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen �F aL\ \, encroachments, deficiencies or discrepancies exist. / cS� <Q ; 6. bSD!SIGNAT 0 LIFEIT System #1 Approved for System #2 Approved for Disapproy:ed'. Conditional approval for 3 bedrooms. bedrooms. 49 Til -� r KENNET \i. F 1 `,r 116 ,F ' Age bedrooms, with the following stipulations: OF ON-SI� AND p�S-vEW p,TE o P% ?FAIT SER`!' By: vc�&kz �' &/z cl 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 blue sheet 10-10-12.doc Legal Description: Loye Block 3B Lot 1 Parcel ID: 050-521-70 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system 1 A. WELL DATA Well log is filed with Onsite (or attached) Date drilled 6/25/83 Total depth 406 ft Cased to 162 ft FN Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 24 in. Date of flow test for COSA 10/22/19 Static water level at beginning of test 165 ft. Comments B. TANK DATA Age of tank(s) NEW years Tank type/material Septic/Plastic Measured operating fluid level in septic tank NA Standpipes/foundation cleanout per record drawing Date of pumping NEW TANK D. ABSORPTION FIELD DATA Which system tested (date installed) NEW 11 ALL standpipes present per record drawing Total measured depth from grade 7.7 ft (max) Measured depth to pipe invert from grade 4.2 ft (min) ❑ N/A — pressurized field FN Monitor tubes go to bottom of effective. If not, state depth into effective Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Well production at time of test 1.0 gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes N No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Arcterra Consulting Date of Sample 10/18/19 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date Results ❑ Pass For bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ® Yes if No Community Sewer Manhole/Cleanout > 100' ® Yes if No ft [7] Yes if No ft Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' m Yes if No ft Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' ® Yes if No ft ® Yes if No ft ft If septic tank is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No ft ® Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water > 100' ® Yes if No ft Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: ® Yes Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No ft Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No ft Water Service Line > 10' ® Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' 21 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' ® Yes if No ft Private Wells > 100' ® Yes if No ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No ft Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yellow sheet Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 050-521-70 1. GENERAL INFORMATION Complete legal description Loye Block 3B Lot 1 Location (site address) 25534 Berrvhill Rd Current Property owner(s) Mailing address Real Estate Agent Same Expiration Date: '�2 - 1'1 Day phone 865-6472 Unity Home Group, Keller Williams Day phone 865-6472 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class C Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Received by: Date: // ZQ f COSA to be released to the engineer, unless otherwj a requested by the engineer. COSA Fee $ Date Date of Payment 6 -23 (L Receipt Number V-yL COSA # c)SC I l [2_L(7 Date of Payment Receipt Number. Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm _NorthRim Engineering Phone 694-7028 Address PO Box 770724, Eagle River Engineer's Printed Name Steve Eng Date 11/28/2016 6. DSD SIGNATURE System #1 Approved for bedrooms. System #2 Approved for bedrooms. Disapproved. /11127ke Conditional approval for bedrooms, with the following stipulations: ,��UUtiiill u, Byl�� L (' ('et g- I Original Certificate Date: The Municipality of Anchorage Devlopment 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 blue sheet 9-1-12.doc 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 1-6 y�r— i3L0el4 HS L O7-.( Parcel ID: OSo S2/ 70 A. WELL DATA Well type P If A, B, or'C provide PWSID # _ Date completed Z S- &3 Sanitary seal (Y/N) �[ G / Total depth!#Ob'ft. Cased to /6 aft. FROM WELL LOG ` Date of test. Static water level Well production 30 9.13 M. WATER SAMPLE RESULTS: Coliform _colonies/100 mL Nitrate lVb mg/L Arsenic IV h ug/L , Date of sample: 26 Well Log (Y/N) Wires properly protected (Y/N) Casing height (above ground) ZZ in. AT INSPECTION /er % rs ft. g.p.m. Collected by: .. B. SEPT ICIHOLDING TANK DATA Tank Type/Material' SE>o-%/GAS % c"EL' Date installed Tank -size/ aO gal. Number of Compartments Z_ Cleanouts (Y/N) Foundation cleanout (Y/N) Depression over tank (Y/N) High water alarm (Y/N) Date of pumping - Pumper C. ABSORPTION FIELD DATA 1 • sN• ct mtJ Date installed / I s Soil rating (g.p.d./ft' or ft2/bdrm) Iq 2 System type. . Length ft. Width 5 ft. Gravel below pipe 7 ft. Total depth 6 ft. Eff. absorption area _7 5ft2 Monitoring tube Depression over field L Date of adequacy test O IC Results (Pass/Fail) _� _ For bedrooms Fluid depth in absorptibn'field before test 7 in. Water added�,SD gal.. New depth Z I in. Elapsed Time: GG min. Final fluid depth /7 in. Absorption rate >= 41'.57,9 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) 'da If yes, give date D. LIFT STATION Date installed "Pump on" level at Datum Size in gallons in. "Pump off' level at E. SEPARATION DISTANCES F G. nrmwellat•ll Cycles tested Septic tank/lift station on lot n 6't Absorption field on lot Public sewer main 1 its ` t Sewer /septic service line z 5 Animal containment areas 50 -f- SEPTIC/HOLDING TANK ON LOT TO: Manhole/Access (Y/N) in. High water alarm level at Meets alarm & circuit requirements? in. On adjacent lots l00 On adjacent lots Public sewer manhole/cleanout /f• Holding tank 160 it Manure/animal excrete storage areas / 110'•- t ' Building foundation S f' Property line .��� Absorption field 5 i" Water main l� /t Water service line �/ O Surface water ZOO r f Wells on adjacent lots /Q Q ABSORPTION FIELD ON LOT TO: Property line �O /%� Building foundation % 6 /� Water main 16r f— t Water Service line'. O r"f Surface water O 1? :- ; DriGeway,parking/vehicle storage z '� Curtain drain VAJI�� Wells on adjacent lots _� /7 � y¢LL SZ�AJAei85%Sr=A)j7- fz o Af &i�-pole T ENGINEER'S CERTIFICATION I 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. STF_r%r� �itlts za, ,4 Engineer's Printed Name Date _ ."7 ZO//e �0 me°� Steven w. Eng COSA yellow sheet_2-6-15.doe °RoF Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 050-521-70 1. GENERAL INFORMATION Complete legal description Loye Block 3B Lot 1 Location (site address) 25534 Berrvhill Rd Expiration Date: Current Property owners) Pinson Day phone 865-6472 Mailing address Same Real Estate Agent Unity Home Group Keller Williams Day phone 865-6472 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class C Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Received by: Date: / / COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 5-24-60 Date of Payment 66 0_6 Receipt Number 0 Y4Z J Date of Payment Receipt Number COSA # _ 0.Sr A /o? V 7 Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm NorthRim Engineering Phone 694-7028 Address PO Box 770724, Eagle River Engineer's Printed Name Steve Eng Date 6/23/2016 r A q 6. DSD SIGNATURE System #1 Approved for bedrooms. System #2 Approved for S S'nv bedrooms. Disapproved. - Conditional approval for bedrooms, with the following stipulations; �`-` By: (� h� r< , Original Certificate Date: 7—/ `/-f//6 The Municipality of Anchorage Devlopment 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 Septic System Advisory Well Flow Advisory COSA blue sheet 9-1-12.doc X Nitrate Advisory Arsenic Advisory Other 10 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: S[.00L 315 Z07-/ ParcellD:O5 1ZI 7B A. WELL DATA Well type If A, B, or C provide PWSID # Well Log (Y/N) Date completed !6 z_ Z a -T Sanitary seal (Y/N) Total depth 4106 ft. Cased to /6Z ft. FROM WELL LOG Date of test. 4915_ 25 -3 Static water level ll,,41 1. ft. Well production, 36 g p.#. WATER SAKPkE RESULTS: Coliform colonies/100 mL Nitrate /U6 mg/L Arsenic ug/L Date of sample: 4_ B. SEPTICIHOLDING TANK DATA Tank Type/Material 5r_r 7-1C Tank size Z6.aQ gal. Number of Compartments Z Wires properly protected (Y/N) T Casing height (above ground) /Z in. AT INSPECTION / 6 7.4; ft. g.p.m. i Collected by: Date installed Cleanouis (Y/N) _ Y Foundation cleanout (Y/N). Depression over tank (Y/N) 1j[ High water alarm (Y/N) Al l Date of pumping _7113.1V Pumper %Z S C. ABSORPTION FIELD DATA Date installed/1 S Soil rating p.d./ft2 r ftz/bdrm r r �_ System type 4440e..a Length - .!�/ 9.ft. Width S ft. Gravel below pipe 2 7 ft Total depth ft EfF'absorption area3 75ft2 Monitoring tube Depression over field Date of adequacy test Results (Pass/Fail) _ For bedrooms Fluid depth in absorption -field before test -L-T in. Water added S 0 gat. New depth in. Elapsed Time: ''e ^d mih; Final fluid depth/ in. Absorption rate >= © g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION 1.,14 Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off" level at in. High water alarm level at in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot /Q 0't On adjacent lots /OO'f Absorption field on lot /Qp' On adjacent lots 160 �4- Public sewer main fQd * Public sewer manhole/cleanout /11Y9 `f Sewer/septic service line z5 Holding tank /Oa If Animal containment areas S� Manure /animal excrete storage areas 10e t SEPTIC/HOLDING TANK ON LOT TO: Building foundation /6 'f Property line Absorption field S Water main /Q 't Water service line /Off Surface water /00 Wells on adjacent lots Z60 !' ABSORPTION FIELD ON LOT TO: Property line ILI �+� Building foundation /d �} Water main WateCService line /�j ' r Surface water /410 Driveway; parkingNehicle storage Curtain drain U/t/%- Wells on adjacent lots F. COMMENTS LL -PR6�?,CWT PL54 7-11V Id G. ENGINEER'S CERTIFICATION I certify that l have determined through field inspections and + $� .<.••>•.., Q� D� review of Municipal records that the above systems ere in °j•.� 8® conformancewith MOA COSA guidelines in effect on this date. • %gyp,® Engineer's Printed Name S / tiiJF_ A=-7 111 \N s aaeao Date ��Z3�/6 �. �sro.®ow Net 'W 6436. COSAyellow sheet_2-6-15.doc 0 u _ (T_P.) NckOR N77-03, S�S� 00 w 287 4g'(R) 287.18. WELL � _. 1` moi\ � • Yilf 15' UTILITY \ R\ EASEMENT �34`i ro� a G Os \ g 201'zk 4't W ' LOT DECK co (TYP,) 1.71 Ac. CANT. O 0 w �O (�') C? a O N GREENHOUSE 4" PLASTIC 763 3 t Ql NO FND. RISER (TYP.) i --I � v SHED oO NO FND. ® Z C3 N ' � Q O Q ' O 3 � ( o H S80'40'29 -E& . 79'(0) 320.53' o E, E-� r (C) Z a I W ' LOT 2 (C}=CALCULATED DATA � (M)=MEASURED DATA ,_., I (R)=RECORD DATA PER PLAT > BLOCK 3B ohu=OVERHEAD UTILITIES U.G.=UNDERGROUNQ ,'Y+ T&E=TELECOMMUNICATION & (� ELECTRIC NAT. -NATURAL I FND.-FOUNDATION ✓ 1� = 50' (TYP.)=TYPICAL NOTES: I. EXCEPTING FOR GROSS NEGLIGENCE, THE LIABILITY FOR THIS SURVEY SHALL NOT EXCEED THE; COST OF PREPARING THIS SURVEY. 2. THIS SURVEY REPRESENTS VISIBLE IMPROVEMENTS & CONDITIONS ON THE DATE OF SURVEY. 3. THIS DOCUMENT DOES NOT CONSTITUTE A BOUNDARY SURVEY & IS SUBJECT TO ANY INACCURACIES THAT A SUBSEQUENT BOUNDARY SURVEY MAY DISCLOSE. 4. THIS SURVEY SUBSTANTIALLY COMPLIES WITH ASPLS MORTGAGE STANDARDS. 5. TIES TO PARTIALLY MONUMENTED OR UNMONUMENTED PROPERTY LINES ARE f1 FT. 6. THIS SURVEY PERFORMED FOR PATRICIA PINSON, IT SHOULD ONLY BE USED FOR A SINGLE PROPERTY TRANSACTION. REUSE OF THIS DRAWING FOR ANY PURPOSE NOT STATED ABOVE WITHOUT THE EXPRESS WRITTEN CONSENT OF ALASKA RIM ENGINEERING, INC. IS A VIOLATION OF FEDERAL COPYRIGHT LAW. EXCLUSION NOTE: IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE LINES. Ic ALASKA RIM ENGINEERING, INC. AS -BUILT 9131 E. FRONTAGE RD. Q, •°°°°° A �S PALMER, ALASKA 99645 PH: (907)745-0222 : FAX: (907)746-0222 °°°°•••••••• • "° EMAIL: akrim®alaskarim.com : WEB: www.aloskarim.com �e°49TH •° �.� sem,. y WO: 1600548 FB: 16-1 1 fi °°q � PAGE: 1 of 1 GRID MAP: SW0262 • aV, •.%.�!°.�..°-rte° °e • • • En sneers : Planners : Sunre rs ° obert J. Farmer :,o g Y� SCALE: 1" = 50' 1 FILE: 1600548AS 's `• 10615—s °; I HEREBY CERTIFY THAT A MORTGAGE INSPECTION WAS PERFORMED 'Pfd°•°e° °° = `'J UNDER MY DIRECTION ON, THE FOLLOWING DESCRIBED PROPERTY: pROFEssl N� �'P�9 LOYE SUBDIVISION, BLOCK 3B, LOT 1, PLAT No. 75-116 ANCHORAGE RECORDING DISTRICT, ANCHORAGE, ALASKA. SURVEYED ON THE 7th OF JULY, 2016. 02016 r s 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 invest!qation 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& S ENGINEERING Phone 6 q "Y 1 "7 Address Eagle River, Alaska 99577 Engineer's signature Date ac /a L �OFgb til( A�°l ilA Additional Comments BY: �`�,_ /�_'r �—� 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 courtesyto 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. 72-025(RW.1/91) Sack MOAN21 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825"L" Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744 WATER SAMPLE RESULTS: Coliform d Nitrate Date of sample: /0 – 3o – y5' B EPTIC OLDING TANK DATA Other bacteria S & 5 ENGINEERING Collected by: !70,34 e i Riyar Loop Road No ene Eagle River, Alaska 99577 Date installed 11-11–q Tank size (000 &A'- Number of Compartments e2- Cleanouts(IYN)5 Foundation cleanout (&N) t/L-s Depression High water alarm (Y/&� Date of Pumping NIA -ra�j KPumper C. ABSORPTION FIELD DATA Date installed Soil rating g..d./ Z or ft'/bdrm) I . 2- System type SHA t-LOIJ' T0,&Nc H Length '-I �b Width 5 Gravel thickness below pipe a Total depth i� - 'S' Effective absorption area � i S Monitoring Tube present((DN) YES Depression over field (Y(9lV//O N.s w Date of adequacy test K A-raC+&N Results (Pass/Fail) For bedrooms Fluid depth in absorption field before test (in.); — Immediately after gal. water added (in.): Fluid depth (ins.) Minutes later: Absorption rate = �— g.p.d. Peroxide treatment (past 12 months) (YIN) If yes, give date -- Health Authority Approval Checklist c o� 75ipcK 3 5, Legal Description: t0r �, °Yg-5-80.Parcel I.D.: 0'50'9-11 -70 Y A. WELL DATA 0 N p cD ® rt D Well type iP2I�/ATE If A, B, or C, attach ADEC letter. ADEC water system number �I cap o G Log present (Y�,N) Yi�S Date completed (o Total depth q06 Cased to Casing height (above ground) / Z Sanitary seal ((DN) %s Wires properly protected (DN) YE5 FROM WELL LOG AT INSPECTION Date of test Static water level U/K / 73 Well production 250 � 9.p-m. WATER SAMPLE RESULTS: Coliform d Nitrate Date of sample: /0 – 3o – y5' B EPTIC OLDING TANK DATA Other bacteria S & 5 ENGINEERING Collected by: !70,34 e i Riyar Loop Road No ene Eagle River, Alaska 99577 Date installed 11-11–q Tank size (000 &A'- Number of Compartments e2- Cleanouts(IYN)5 Foundation cleanout (&N) t/L-s Depression High water alarm (Y/&� Date of Pumping NIA -ra�j KPumper C. ABSORPTION FIELD DATA Date installed Soil rating g..d./ Z or ft'/bdrm) I . 2- System type SHA t-LOIJ' T0,&Nc H Length '-I �b Width 5 Gravel thickness below pipe a Total depth i� - 'S' Effective absorption area � i S Monitoring Tube present((DN) YES Depression over field (Y(9lV//O N.s w Date of adequacy test K A-raC+&N Results (Pass/Fail) For bedrooms Fluid depth in absorption field before test (in.); — Immediately after gal. water added (in.): Fluid depth (ins.) Minutes later: Absorption rate = �— g.p.d. Peroxide treatment (past 12 months) (YIN) If yes, give date -- D. LIFT STATION Date installed Manhole/Access (Y/N) _ High water alarm level at* E. SEPARATION DISTANCES Size in gallons "Pump on" level at* *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: i Sep cit folding tank on lot tyi ; On adjacent lots i Absorption field on lot I t °-f ; On adjacent lots off' level at* 1UU fi � r Public sewer main '7G ' Public sewer manhole/cleanout (00 r Sewer /septic service line _ a S 4- Lift station "4-1A SEPARATION DISTANCES FRO EPTIC/ LDING TANK ON LOT TO: Building foundation 5d Property line S� Absorption field Water main/service line l o t Surface water/drainage too r�` Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: i r Building foundation (D (a Water main/service line 10 Surface water too I,, - r too .,I- CE-8801 Y Driveway, parking/vehicle storage area 00 V -- Curtain drain nN 14WO4 'N Wells on adjacent lots 1 n" '� Property line a3 F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review ofAlfunicipal records that tt nis are in conformance with All A 11AA guldelln 1 7 effect on this date. 01� A >t 1 ,� r•,••,•• •'••`j'I Signature �Z✓�-�-- A' W C •• FJ � a� th a G,s.c r C. C', v Engineer's Name w i9�✓ � t � Date 11 /�-e ( �i f it ;n I••ROBERT C. COWAN..{,Q CE-8801 •d HAA Fee $ �) b0 Waiver Fee $ Date of Payment i� r S Date of Payment Receipt Number O Cr �Z// �3 Receipt Number Rev. 8/95 OSS: haa.wk.doe ME Environmental Services Inc. AtL Laboratory Division Ref.# 30-1 Matrix WATERLaboratory Analysis Report client Sample TD Ll ELK 3B LOYE a/D Client Name 8 s 9 ENGINEERING WORK Order 19302 Ordered By R. COWAN Printed Date 11/03/95 0 10:59 bra, Project Name Collected Date 10/30/95 m 10:20 hrs. Project# Received Date 10/30/95 0 15:30 hra. pWSxD UA Technical Director STEPHEN C. EDS Released By Sample Remarks: SAMPLE COLLECTED BY: RAY. 0C Allowable Ext, Anal Parameter Results Qual --------------------------- --------------"------" Unice Method Limits Date Date Tnit Nitrate -14 0.10 V ------------------------------------------------------ mg/L EPA 353.2 10. — 11/01/95 C14R .... ....aavaavvvVevavaavaaaaayr... M aaaaaaayaaaaQaaaaYa� aaaammaam.uamnn6 aanaana Vaaammamaaaraaaaaav@aaMwYa aNha v..vamavam * See Special Instructions Above VA a Unavailable ** See Sample Remarks Above NA - Not Analyzed fiT,a Undetected, Reported value is the prsotical quantification limit, LT a Leas Than Secondary dilution. GT - Greater Than m O ((l 200 W. Potter brive, Anchorage, AK 99518-1605 — Tel: (907) 562-2343 Fax: (907) 561-5301 ENVIRONMENTAL FACILITIES IN ALASKA, CALIFORNIA, FLORIDA, II,LINOIS, MARYLAND, MICHIGAN, MISSOURI. NEW JERSEY, OHIO, WEST VIRGINIA 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 I.D. # �1�. % �� i - 1 .' HAA #`1 1. GENERAL INFORMATION Complete legal description Lot 1; Block 3B; Loye Subdivision Location (site address or directions) NHN Berryhill Lane Property owner venni s and r i nda Pai Thanks Day phone Mailing address Lending agency Mailing address Agent Sharon Minsra - Re/Max Address Eaale River Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water Day phone Day phone 694-4200 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 X 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 921 2# VOW A3QB (L6/L -natl) 960-ZL ->iaom s,jeeui6ua jeuoissa;ord ay; uI suoissiwo ao saoaaa ao; algisuodsaa IOU si a6eaoyouy ;o l;lledioiunN agl •panssi si a;eoi;ljfao e aao;aq elep azAleue ao suoi;oadsui jonpuoo }ou op SHHa;o saaAoldw3 •sluawaiinlow ale;s pue papal uieuao (;sides of aapao ui suoilnipsui 5uipual aiayi pue sawoy;o siasego.)nd of AsaIfnoo e se siva scop SHHa a41 •e�sely;o ajejS agl ui paaa;sibai aaauibue Ieuoissa;oid ;uapuadepui ue (q anoge 9 ydeil5wed ui uani6 suoijeluasaidaa ay; uodn Aluo paseq sa;eol;iva0 enoaddy /;laoyjny gIleaH sonssl (SHI-10) saoi/uaS uewnH pue g;leaH;o;uawuedaa 96eaoyouy;o Ailledloiunw agl � NVIlI1VJ "' a;ea suoi;elndi;s bulnnollo; ag; y;inn 'swooapaq 197V'�' 1S5?�pf' a I Y 9lZ' 'orl 9 C )S � �Sn�No2n nafres u®° js�..9' W y 1'JY s;uawwo0 leuoi;lppy ao; lenoadde Ieuoi;ipuo0 •panoiddesia •swooapaq ao; panoaddy 3linIVNJIS SHHa '9 ain;eul5is s,a9auil5u3 LLS66 Pr�1an�a)6aa {�0Z'Oj� aeob door aanla aI6e3 bEOL L ssaappy auoyd wail ;o aweN •uoi;oadsul sig; ;o a;ep ag; uo;oa;;a ui suoijelnl5aa pue 'seoueuipio 'sepoo a;e;s pue ledioiunw lie y;inn aoueildwoo ui si wa;sAs lesodsip Aa;ema;sern ao/pue Alddns aa;em a;ls-uo ay; 'uol;oadsui pue UOI;e6116GAUI (w woa; pue saki; a6eaoyouy10 A;iledloiunW ag; woa; pauie;go uoi;ewio;ui ag; uo paseq;eg;A;uanaagjAn; I 'uiaaag pa;eoipui aan;ona;s;o ad (; pue swooapaq;o aagwnu ag; ao; a;enbape pue leuoi;oun; 'a;es si wa;s (s lesodsip aa;erna;sem jo/pue llddns Aa;em a;is-uo ag;;ey; smogs uoi;eoildde Jenoaddy A;uoy;ny y;leaH S1q;10 uo1;e61;sanu1 Aw;ey;l;laan I 'Molaq uMogs a;ep uoi;epiIen ag;;o se pue o;aaag paxi;;e leaslw (q pai;i}Aao sy 8331NION3 A9 N01103dSNl d0 1N3W31V1S 'S Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: w -f l �6 F '�Afl Parcel I.D. A. WELL DATA Well type w'�, If A, B, or C, attach ADEC letter. ADEC water system number Al Log present((/N) Total depth :'r' 0 L Sanitary seal (9/N) Date of test Static water level Well flow Pump level — Date completed L.' -5 , 6 Driller w1 - Cased to (°y C h ht l2 FROM WELL LOG (9 . ZS - S; JtL asrng eig Wires properly protected (ON) J m AT INSPECTION oz N r � caP IIS m �7D. D g trrw. l,f� g.p.m. z J V_ ?7 11 r '� N ^n 0 N O y G) SEPARATION DISTANCES FROM WELL TO: 0 m r 1.I p� �} Septic/holding tank on lot 11GJ w' ti0� ; On adjacent lots tbo Absorption field on lot %d a �} ; On adjacent lots ,, `r Public sewer main Public sewer manhole/cleanout �Ip Sewer service line 2S Petroleum tank WATER SAMPLE RESULTS: Coliform d � Nitrate �•� Other bacteria 'ice -`ly Date of sample: Collected by: � � � � � �• B. SEPTIC/HOLDING TANK DATA Date installed -'29 "S') Cleanouts O/N) High water alarm (YA Date of pumping Tank size 100 Compartments Foundation cleanout O/N) V Depression (Y/�J f"t —Alarm tested (Y/N) �/ 0. iv -l2 Pumper S5�- SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO Well(s)onlot �6 nadjacentlots \*Z>k Foundation To property line 16 Absorption field S Water main/service line Surface water/drainage /00 Z rk 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 Manufacturer Manhole/Access (Y/N) SEPARATION-DfSTANCE FROM LIFT STATION TO: on lot On adjacent lots D. ABSORPTION FIELD DATA Date installed Length z� Total absorption area "Pump off" level at Cycles tested Surface water _ 4''Z'$ 5 Soil rating 14-c �� System type Te —Width 3o Gravel thickness S z Total depth q1,1�� k Cleanouts present �/N) Depression over field (Y/A Result pas_ ail) pF 10 M Peroxide treatment (past 12 months) (Y// )� bfo JA «J _ Date of adequacy testy ' �9 - 7z, for'rkee_�_ 3) bedrooms J/ If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot lUo ' On adjacent lots /00 ' To building foundation On adjacent lots Surface water Curtain drain — 0 rd- Property line to I -k 10 To existing or abandoned system on lot —Cutbank '114' Water main/service line_ o� Driveway, parking/vehicle storage area 09 14 E. ENGINEER'S CERTIFICATION it J4 I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. S & S ENGINEERING 77034 Eagle River Loop Road N9.2Qe� Signature995-77 [� Engineer's Name Date 0 Ne. R_15 ri w�X.J ?9:)0e oas1AG OFogt, F HAA Fee $ Z Ze - Cry Waiver Fee: $ 1//0 , OCD Date of Payment `? Z^ Date of Payment 9 Receipt Number ?—�C) (`�G�J Receipt Number gy� 2d1� Municipality ®f Anchorage Department of Health and Human Services dhh5 Tom Fink, 825 "L" Street Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 November 24, 1992 Roger Shafer, P. E. S & S Engineering 17034 Eagle River Loop Road Suite 204 Eagle River, Alaska 99577 Subject: Waiver Request for Lot 1 Block 3B Loye Subdivision Waiver Request #WR920071, PID #050-521-70, HA920730 Dear Mr. Shafer: Your request for waiver(s) of the required 100 foot horizontal separation of a septic system to a private well has been approved. The approved separation distance(s) are private well to the septic tank of 95 feet. This waiver approval applies to the existing septic system to well separation only. Any future upgrade to either will require all separation distances be met or another approval from this department. Sincerely, Daniel J. Roth Civil Engineer On-site Services ljm:#6 Concur: )ohn Smi, P.E. gram Manager On-site Services -1 MUNICIPALITY OF ANCHORAGE. Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR# WR920071 PID# 050-521-70 HA# HA920730 Permit # Date Received: October 29, 1992 Legal Description: Lot 1 Block 3B Love Subdivision Engineer: Roger Shafer, P. E., S & S Engineering 17034 Eagle River Loop Road, Suite 204, Eagle River, Alaska 99577 Applicant: Dennis/Linda Fairbanks Waiver Requested: Well to septic tank 95 feet Criteria: 1. Geology: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Points: Waiver is Granted: ---,;.<— Waiver is NOT Granted: List Conditions or Reasons for above: 56-E 19 rF--0 YZ- 42. Date: f- 2 3 - y 2 By r Rec #: 24200/4615 Amount: $ 410.00 Date Paid: 10-29-92 L4./ vEn Ton C ol- / Bc /s 3,6 dry 54ov w1t'vF_ n N(4kDEI? wR 92 ao 7) w t,}iVCR FOR ow, -L vl !.VELE To s6P7'1c Tir,vX of A9#9 7-A - T14 sr--PT/c T/iNk /Av /N /}PRiL 1983, /I LL STEEL /OOO G/1LLOv SNOT/C %f%N/�Cf pub/tiG r�ris �>z� ���F rousrr��cT�� a-lT-i� /av�n7T o.� Tiff /N L ifr _ 0L- :TiG/t% cou Pj-/tiGS. seprIc r,A vA- 1. ,Ats co,�rr�eKcT�h i/RYOTi' To 7 FS WE LL lo.vrTr2li c% roti. Iv E L (_ Ort r-,4 l S L o C19- T E D 77-e4F 771-A,.k Oiv ce x o�- SteiPFiQI/aG SE to r/ C r,# N/< EFFLUENT G ri-fe L -6I -e J99E T"I.tE b -FG L / S 4( oC FEETY R NOC/f En�cvuNTXREP $T /6o ARig T. T( -CE 377-/9-7-1 R le� v EL / s / 74 6?6TwEEnv rxrE G/Pau4,1_ Sur4FI4L� IiFPR ac*- / r lle PpM/vBNTLY SIL T jf3AJO, 61efvEL, Po//yrs wIL1, loll j' FO/T hgiyAR �R Posy S. !l�EGC fy�Mp,L6S /tiAICR7E /va v17'eA7EJ or /dPP6 PP( = 4" .27 t7 SOi� 7-10 IV 7 T 9° 3 /90 l :NA TErz T/961t F p?1ti9leA-,T ssa,�E �/B�?►2 aivr,�L S �P��� rio� 70 TAL CdNCL�s,ow 6� f�tir w �vF., � noir rs Y'.5- 2,5 '.3 2,3 2.7 2.9 up � �. ROBERT SHAFER, P.E. ROGER SHAFER, P.E. CIVILENGINEERS October 29, 1992 (907) 694-2979 FAX 694-1211 LL-�(29 Q CIL-) I HEALTH AUTHORITY Municipality of Anchorage APPROVALS DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 SEWER & WATER MAIN EXTENSIONS REFERENCE: -Lot 1; block 3B; Loye Subdivision Request you issue the attached Health Authority Certificate and grant a waiver for the horizontal separation distance between the well and SEWER&WATER septic tank serving the referenced property. INSPECTION The septic system was installed in April 1983, while the well was drilled in June 1983. We suspect the driller measured a 100 ft. slope distance between the well and septic, whereas the horizontal separation ENGINEERING STUDIES distance is actually approximately 95 ft. AND REPORTS We feel the separation distance waiver may be granted for the following reasons: WELL INSPECTION 1. As can be seen from the attached site plan with topographical &FLOW TEST contours the well is located considerable up hill from the septic system. 2. Inspection of the drillers log for the referenced well shows SITE PLANS the well is deep, with water first encountered after 240 ft. We found a static water level at 174 ft. below the top of the casing. ROAD DESIGN 3. The driller's log shows bedrock at a depth of 160 ft. Given the topography, we feel it's reasonable to assume the contour of the bedrock would direct any septic effluent away from the well. SOILTEST 4. Bacteria and nitrate sample results show no nitrates detected, indicating the well is not being affected by the septic effluent. PERCOLATION TEST If you have any questions or require additional information for your review, please contact us. Sincerely, STRUCTURAL& MECHANICAL INSPECTIONS ROGER J. SHAFER, P.E. ON SITE WASTEWATER DISPOSALSYSTEM DESIGN 47n1A CAM C DI%ICD I nnD CI IITC o)nA FART F QIVFQ Al ASKA QQF77 1 17034 Eagle River Loop Road ROBERT A. SHAFER Eagle River, Alaska 99577 CIVIL ENGINEER ** WELL FLOW TEST DATA SHEET ## 6942979 PROJECT:--.. �t�C<�17I 1_ ltt�`�� F� - �F� Q 1pr� DATE OF TEST: LOCATION OFWELL (Legal Description):-�o� �L�-V-)—o VE 5`� WELL DEPTH: 4n & I FT. CASING:—A C,7. I FT. SCREEN: DATE DRILLING COMPLETED: b ZS' °03 DRILLER: 'tA Pr 6ttiJy5 O STATIC WATER LEVEL (Top of Casing): �7fq1 FT. DATE: '9 -29 - I 'z - CLOCK CLOCK TIME ELAPSED TIME SINCE PUMPING DI __ STOPPEDD,, MIN. IN. DEPTH TO -WATER, Fi. DRAWDOWN! RECOVERY PUMPING RATE, GPM REMARKS 0 (swq p 0 Start V:�-'Ou \v —7,lr 10 ;L -Z:7- 2G (� 7 �tZfi �. riL��J18tSln 15 20 25 n,a 30 2`19' IZS' SS 35 40 45 50 55 t' 60 (1 hour) 3 `)'j I ZZ�' (, 3 I-APMP 90 120 (2 hours) -x- 150 150 39-11 160 (3 hours) 210 391 yy3' 1. o 240 (4 hours) "59-1 ` 2 Z 3 ' , p RECOVERY t 0 0 5 10 . 15 20 25 30 35 uommenrs: \.0 6-1 p i -A Plow isnot Guarantee Subsequent Variations Can Occur. CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301 Client Sample ID Li B3B LOYE S/D PWSID UA Collected SEP 30 92 @ 11:10 hrs. Received OCT 1 92 @ 14:00 hrs. Preserved with AS REQUIRED Analysis Completed : OCT 2 92 Laboratory Supervisor PNEN C. EDE Released By : G ANALYSIS RESULTS for INVOICE # 59057 Chemlab Ref.# 92.5393 Sample # 1 Matrix: WATER Client Name :S & S ENGINEERING Client Acct :SNSENGP BPO# Req# Ordered By Send Reports to: 1)S & S ENGINEERING 2) PO# :NONE RECEIVED ............................................................................................................................. Parameter Results See Units Method Allowable Limits ----------------------------------------------------------------------------------------------------------------------------- NITRATE-N ND(0.10) NA- mg/l EPA 353.2/300.0 10 Sample ROUTINE SAMPLE COLLECTED BY: RAY. Remarks: .................................:.......P 1 Testa Performed See Special Instructions Above UA -Unavailable ND- None Detected See Sample Remarks Above NA- Not Analyzed LT=Less Than, GT -Greater Than 401SE ;S Memher of the SGS Grnun (Societe Generale de Surveillancel Time APPLIC� �T FILLS OUT UPPER HALF ALY Time Property Owner .�� y,n! -!. i >1 c%�._ fC r Phone Date Date (� Zip Code' Inspector Mailing Address 17r.. Inspector Ins P Inspector Buyer ( APPROVED BEDROOMS 'CONDITIONS OF APPROVAL Address - Zip Code Lending Institution / {� �/),%2 7/ _i { {�iiC. 1 �r� �-� Phone Address - !�, " - r = n Zip Code / / �, L� / �1)10-3 Realty Co. &Agent - Phone _ IV 0 n Zip Code Address Ci Legal Description I / Street Location ,! ., r I^�r ,l a A at - �� - /•' Type of Residence "'Single Family lz ❑ Multiple Family No. of Bedrooms ❑ Other Water Supply (?Individual -_ '�%t`� ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. �1.-. 'l - For wells drilled prior to that date, give well depth (attach log if available). ❑Community ❑ Public Utility ., Sewer Disposal % (XIndividual Year Individual Installed: - ❑ Public Utility When Connected to Public Utility: ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time nn Date Date Date Date (� Inspector Inspector Inspector Ins P Inspector Field Noes: ( APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' DATE BY: Soils Rating Date Se er Installed Well To Absorption Area Well Log Received _ Septic Tank Size t ,% (� �� Well to Tank