HomeMy WebLinkAboutVALLI VUE ESTATES #2 BLK 3 LT 42 Municipality of Anchorage Page t of 3
Development Services Department
On-Site Water and Wastewater Program
4700 South Bragaw Street
P.O. Box 196650 Anchorage. AK 99519-6650
www.ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: SW030415 PID Number: 015.322-21
ha..: Wastewater System: New
Bob and Bobby Cannon
Address:
10411 Lone Tree Drive Anch., AK 99516 ABSORPTION FIELD
Phone: Nun'~er O~ Bedroom: Deep Trench
351-9014 Four (4)
LEGAL DESCRIPTION 1.2 o,o~,' 7 F~.
3 42 Valli Vue Estates No. 2 2 n. 5
1.5-2 ~,.50 F,.
Well: Class A Water System 3 r,. 1[
Class~ficahon (Pnvale, A, B, C): Total Depth; Cased to: Tota~ abs~4-pb(~t area, P~pe I~lenal: I ~ i
F,. ~,. 500 F,' ASTM 3034 P~JC"" /
F,. Pisano's Dirtworks 12/10-1112003
Yield: Pump S,,,,: I C~,,,Q ~,Qh, A~O, C~O~,d. TANK
SEPARATION DISTANCES STEP
~,~'~o Septic Absorption Lift Holding :~ublicJPdvate Manulaclurer. Gapaoly in L~allo~$.
Tank Field Station Tank Sewer Line Anchorage Tank 1,500
w~, >200' >200' >200' N/A >25' Steel Two (2)
s~,a~w~,~, >100' >100' >100' NIA ~ LIFT STATION
Lo, U.. >5' >10' >10' NIA 250 c~. Anchorage TanldOrenco
~o~.da,,o~ >5' >10' >5' NIA 42 ,,. 42 ,,. 44 ,..
Cur~,n~,. None Noted Orenco Municipality of Anchora~le
"~': BENCH MARK
Existing Septic Tank Crushed, Backfiiied and
............................. ;] ...... r ............. ~sumed Elevabon:
Abandoned in Place. 100.0 F,.
Engineer's Stamp
Inspections performed by: A. Harala Dates: 1't 12/11/2003 ~' ~ 49th ~ ¥"'~
Department of Health and Human Services approval ~':~,X No. C£-4381
Reviewed and approved by: ~ Date: 17..J~z ~or ",%~:,P~4 .......... ,~.: ......... ~g,-" ~7_,;;~.
, ~. 'WOFESS W~'~L'.,
Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904
On-Site Wastewater Disposal System or Well Inspection Report
Permit Number: SW030415
Page 2 of 3
PID No. 015-322-21
Swing Ties
A B
SPt 21.3 23.7'
SP2 21.4 23.1
MH 21.6 25.3
MT1 63.5 73.0
MT2 79.0 68.4
Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK, 99519-6655 - 343-7904
On-Site Wastewater Disposal System or Well Inspection Report
Permit Number: SW030415
Page 3 of 3
PID No. 015-322-21
])ralnFleld Rock
I
PROFILE AS-BUILT
Scale: 1' = 10'
.Dec.12. 2'003
~'25PM
9075226779
12/1~-/2003.. 5: 57 pA~r 1/i
o o
· 4,.,5,., P.
3nspectJon Report'
Munleipelity ~f Anchorage, Building Safety Division
4700 SDUth Brmgaw
/NSPECT/ONI vo'rcE 343-8300
]NSPI"CT~IONI FAX ¢9 073 24g-7777
OWNER ~'~'~'( ' /
10411 LONE TREE DR
DK3 LT47.
VALLT VU E ESTATES
Name
Leg~i
Subdivision
commenb or Dir~:tione
ZnBpecUan final Electrical
"'""~] NO NONCOMPLTANCE OBSERVED
[] CORRECTIONS E$SENT~LAS EXPLAINED BELOW
[] WZLL RE-EXAMINE AT NIDO'
XNSPECT'XON
COMMENTS: (far inspector use only)
Permit 03-3539
Pllone 351-9014
~.pectiDn Date 12/32/2003
Reinepection
[~ DO HOT CONCEAL UNTZL RE~NSPECTZON
N
~flspecbar
MUNICIPALITY OF ANCHORA GE
Development Services Department
On-Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Oct 06, 2003
Expiration Date: Oct 05, 2004
Permit Number: SW030415
Legal Description: ~A[~'i~LJEESTATES f~2BLK
Design Engineer: 0019 Flattop Technical Services
Owner Name: Bob & Bobby Cannon
Owner Address: 10411 Lone Tree Drive
ANCHORAGE, AK 99516-2460
Parcel ID: 015-322-21
Site Address: 010411 LONE TREE DR
Lot Size: 20530 SQ. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of:
[] Disposal Field [] Septic Tank [] Holding Tank [] Privy
[] Private Well [] Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
Issued By:
Date: I~/' ~q ! o~
Date: /o/%' ~3'
Parcel I.D.
Municipality of Anchorage
Development Services Department
Building Safety Division
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
ON-SITE SEWEPJVVELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Permit Number SW
Property owner(s) 13o/~ t~
Mailing address (1) I o w t
Mailing address (2) /~t~e..Ao
Legal description (Lot, Block & Sub'd.)
Legal description (Section, Township & Range)
Lot Size ~,~,('~ ~ ~,,~'~ Acres~
Day phone
Number of Bedrooms
THIS APPLICATION IS FOR:
Sewer Only [] Well Only []
Sewer and Well [] Water Storage []
Sewer Upgrade []
THIS PROPERTY CONTAINS:
Hot Tub [--~ Jacuzzi []
Swimming Pool [] Water Softening Unit []
Therapy Pool []
I cedify that the above information is correct. I fudher certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit Fees:
Date of Payment:
Receipt Number:
(Rev. 12/00)
Waiver Fees:
Date of Payment:
Receipt Number:
CIVIL & ENVIRONMENTAL ENG~2~EER~G * ENERGY CONSERVATION & ANALYSIS
TIIEODORE F. MOORE, P.E.
PH: (907) 345-1355
M.O~A. DSD
P.O. Box 19-6650
Anchorage, AK. 99519
October 3, 2003
14530 ECHO ST.
ANCHORAGE, ALASKA 99516
Dear Sirs:
The purpose of this letter is to provide the required design narrative in support of our application for
a permit to upgrade the wastewater disposal facilities on Lot 42, Block 3, Valli Vue Estates, Unit g2,
located at 10411 Lone Tree Drive. Soils logs, perc test results, a site plan, design drawings and
specifications are enclosed for your review.
The proposed system will be constructed in the vicinity of test hole # 2. As can be seen from the soil
log, the native material between 1.5 and 7 feet below ground level is coarse sandy grovel with a
measured perc rate of less than 1 minute per inch. Because this material is underlain by silty sand, there
should be no need to import additional filter material. Using the soil application rote of 1.2 gpd/sq, ft.
specified in the wastewater ordinance, this 4-bedroom residence requires a total absorption area of
(4x150)/1.2 -- 500 square feet. The proposed 50-foot long trench design with 5.0 feet of effective gravel
has a total absorption area orS00 square feet.
The topography of the lot in the area of proposed construction slopes down towards the west and
north at approximately 5%. Because the optimum stratum is shallow and uphill from thc house a STEP
system will bc needed.
The proposed project will have no significant impact on present or future water supply and
wastewater disposal systems serving adjacent properties, nor will it have any significant impact on
reserved space-surface and subsurface, or on drainage.
Please give me a call at 345-1355 if you have any questions on this submittal.
Sincerely,
Ted Moore, P.E.
AREA
LOT 41
ABANDON EXISTING
SEPTIC TANK & TRENCH
LOT 42, BLOCK 3
VALLI VUE EST. #2
T.H.
NEW 1500-GALLON
STEP TANK
CONSTRUCT SO-FOOT LONG
SOIL ABSORPTION TRENCH
w. $.0 FEET EFFECTIVE GRAVEL
SEPTIC
AREA
LOT 43
SEPTIC
AREA
LOT 7
1.25" DIA. SCHED 40 PVC
-- - w. 3116" DIA. HOLES
IN BOTTOM @ 18" O.C.
SEPTIC
AREA
LOT 6
LOT 42, BLOCK 3, VALLI VUE EST. #2
SEPTIC SYSTEM UPGRADE
SITE PLAN
FLATTOP TECl INICAL SERVICES
14530 EClIO STREET
ANCi IORAGE, ALASKA 99516
I INCH = 50 FEET
DRAWN BY TFM
SEPTEMBER, 2002
NOTE: THIS IS NOT A SURVEYED PLAT.
ALL LOCATIONS SHOWN ARE APPROXIMATE.
4" D-3034 1.25" SCHED. 40 PVC ,
yFROM FDN. C.O. ~
INSTALL NEW ~ 1.25" DIA. SCHED. 40 PVC
1500-GALLON ~ w. 3/16" DIA. HOLES
IN BOTTOM @ 18" O.C.
STEP TANK
50
PLAN VIEW
SCALE: 1" = 10'
CONSTRUCT 50-FOOT LONG
SOIL ABSORPTION TRENCH
w. 5.0' EFFECTIVE GRAVEL
Bc~ W. 2.0 & 7.0' B.G.L
~ GINAL GROUND -~--~_ ~ FILT.ER FABRIC
/
' ~ BOSOM OF ~CAVATION
CROSS-SECTION "A - A"
SCALE: 1" = 5'
LOT 42, BLOCK 3, VALLI VUE EST. #2
SEPTIC SYSTEM UPGRADE
PLAN AND CROSS-SECTION
FLATTOP TEC!INICAL SERVICES
14530 ECtIO STREET
ANCtlORAGE, AK, 995 ! 6
SCALE: AS SIIOWN
DRAWN BY: TFM
OCTOBER, 20O3
TEST HOLE
FLATTOP TECHNICAL SERVICES
14530 ECHO ST.
ANCHORAGE, ALASKA 99516
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION: _Lot 42~BIock3~Valli_Vue Estates~Unit#2
DATE PERFORMED: Septembe~_l_~2003
PERFORMED FOR: Bob.eqd _Bobby_Caq_n. on
DEPTH -- Pt.
(feet)
SM Reddish gravelly loam
GP Dark gray somewhat silty sandy gravel
Coarse, dry, many cobbles and boulders
SM Gray-brown silty sand
Some lenses of SP
More densely compacted w. depth
SLOPE
SITE PLAN
10
11
13
Depth to Groundwater Date
-N-~ GroF.ndwater g/17/03__
-_M:_T_._D ry -- '-9/24i03
: ' : ' '5% ' '
SLOTE ~
14 Clock Net Time Percometer Net Drop
Date Reading Time (minutes) Reading (inches)
15 _9D7 5 gal!on_p[esoak i 26 :
Resoak t _25
16 B.H. Add water & start 3:02:22 ~ 23 3/8
- #1 - - ~ _3:04:22 ~ 2-- __19 1/4 4 1/8 .
__Add-water 3;05;~4.. _23.3/8
17- #2 __3:07:14 2 19 114 4 118
__Add_water 3:08 23 3/8
18 - #3 __ .3;.10 2 !9_15/_16 4 1/16.
19--
20-
PERCOLATION RATE.~<~i (minutes/inch) PERC HOLE DIAMETER 6 - 10"
TEST RUN BETVVEEN.~2.§ __ FT AND 3.0. FT
COMMENTS: _~1o .S a n_ al_fi!re r_s ho uld_~;)e __n_e ce s s a fy_due _t0_uqde d_yi_ng _si!ty-san_d _stratum.
PERFORMED BY FLATTOP TECHNICAL SERVICES. I ~_~ ~ __ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: / o/,..~ / ~,..~_
TEST HOLE
FLATTOP TECHNICAL SERVICES
14530 ECHO ST.
ANCHORAGE, ALASKA 99516
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION: __Lot_42~BIock3,_Yalli_Vue Estates.Un t #2
DATE PERFORMED: Septembe[_17,.2003
PERFORMED FOR: Bob_a r)d .Bobby ~Ca_ri. pon
DEPTH -- Pt.
(feet) --
SM Reddish gravelly loam
1-
SLOPE
GP Somewhat silt~ sandy gravel
contaminated w. sewage below 5.5'
7
8
9
10
18
20--
ML Brown sandy silt
Dense, caked
Depth to Groundwater Date
-~N~Groundwater 97;J7/03'__
SITE PLAN
5%
Clock Net Time Percometer Net Drop
Date Reading Time (minutes) Reading (inches)
i I ,
I
i ~
PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETVVEEN FT AND FT
COMMENTS __N.o .morfitor_tubeip. sta edpr_pe[c_test.~on, ducted .because_sewage_co~tamination_f_r. o0~_existing ~rench_encaunltered.
PERFORMED BY FLATTOP TECHNICAL SERVICES. i_~ ~.-~.__ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
~plattop Tec~nicalSert,ices
14530 Bclto $treet, Anchorage, AK99516
Phone (907) 345-1355
Lot 42, Block 3, Valli Vue Estates, Unit//2
10411 Lone Tree Drive
Wastewater disposal system installation
Specifications
1.0 General:
1.1 The scope of the project consists of abandoning an existing septic tank and installing a new
1500ogallon STEP tank that pumps effluent into a 50-foot long soil absorption trench containing a total
of 5.3 feet of sewer gravel.
1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor
deviations from these drawings may be allo~ved or required by the engineer conducting the inspections.
Ali construction procedures and material specifications shall conform to Municipal and State
requirements. All separation distances shall be in conformance with Municipal requirements, unless
specifically waived.
1.3 The contractor shall be responsible to obtain any necessary utility locates, and to work around
any buried utilities.
1.4 The contractor shall provide adequate cover material and rough grading over all system
components to ensure that proper drainage is achieved after settlement and that there are no residual
depressions. Insofar as possible the contractor shall minimize damage to trees and existing lawn areas.
1.5 Unless specifically agreed otherwise, the homeowner shall be responsible for finish grading
after the soil is compacted, as well as placement of topsoil and reseeding all areas disturbed by the
construction.
2.0 Septic Tank:
2.1 The existing septic tank must be properly abandoned by thoroughly pumping, removing the top
and backfilling with soil.
2.2 The new 1500-gallon, 2 compartment STEP tank shall be Municipally approved and shall be set
level on undisturbed soil. Each compartment shall be equipped with a watertight manhole cover and a
4" cleanout. If the tank is buried less than 4 feet, it shall be insulated with 2 inches of approved burial
type, rigid insulation.
2.3 All pipe connections to the tank shall be equipped with waterproof mechanical couplings. The
waste line from the residence to the septic tank shall have a minimum slope of 1/4'" per foot. A
cleanout shall be installed 1 - 4 feet from the building foundation.
3.0 Lift sta'tion:
3.1 The lifl station shall be installed in the second compartment of the septic tank which has an
additional 250 gallon capacity. The lift station package shall be an "Orenco' system as supplied by
Anchorage Tank.
3.2 The contractor shall be responsible to obtain the necessary Municipal electric peimit and
inspection, and shall provide a copy of the electrical inspector's report to the engineer overseeing the
construction of the wastexvater disposal system.
3.3 The lift station shall be equipped with a watertight, insulated manhole riser and cover extending
a minimum of 6" above final grade with positive surface drainage away from the manhole. The
contractor shall be responsible for determining the necessary length of the manhole riser.
3.4 The on, off, and alarm floats shall be set at the elevations specified by the lift station supplier,
and their proper operations shall be verified by the contractor.
3.5 The discharge line from the lift station to the soil absorption system shall be 1.25" dia. Sched 40
PVC.
4.0 Soil absorption system:
4.1 The soil absorption system shall be constructed by excavating a 50-foot long trench to a depth of
7.0 feet belo~v ground level. The long axis of the excavation shall parallel an existing contour
4.2 The bottom of the excavation shall be level. Any compacted or smeared surfaces shall be raked
to allow proper infiltration.
4.3 A total of 7.3 feet of approved sewer gravel shall be placed in the bottom of the excavation with
the perforated distribution pipes laid level such that the pipe inverts are no less than 5.0 feet above the
bottom of the sewer gravel. The distribution pipe shall be 1.25" diameter schedule 40 PVC ~vith 3/16"
diameter holes drilled in the bottom at 18" on center. All pipe connections in the distribution system
shall be glued, and the ends of all pipes capped. Sewer gravel shall be 0.5" - 2.5" screened gravel.
4.4 Monitor tubes shall be of 4" diameter and installed in the locations shown on the design
drawings. The portion of the monitor tube extending through the sewer gravel shall be perforated.
4.5 Approved filter fabric shall be placed over the entire top surface of the sewer gravel. A
minimum of 2 feet of soil cover is to be placed over the filter fabric. If the soil cover thickness is less
than 3 feet, two inches of rigid, burial type insulation is to be placed over the entire top surface of the
gravel, in addition to the filter fabric.
4.6 The top surface of the cover material shall be raised a minimum of 12 inches higher than the
surrounding terrain to allow for subsequent settlement, and shall be graded to smooth contours. Fill
slopes shall be no steeper than 3:1.
4.7 Unless specifically agreed other~%e the homeowner shall be responsible for arranging to have
the site finish graded after the backfill material has stabilized, and for placement of adequate topsoil and
seed to promote rapid revegetation of all areas disturbed by the construction.
5.0 Inspections:
5.1 A minimum of 4 engineering inspections ~vill be required during the course of the project: (1)
initial stakeout with the contractor to establish the location of the system and to discuss the plans;
specifications and construction procedures, (2) after the native material has been excavated to expose the
infiltrative surface to ensure that it is level and at the fight elevation, and conforms ~vith the soil test
information, (3) after the sewer gravel is in place and the distribution pipes have been laid and connected
up to the septic tank, but prior to placement of insulation or filter fabric, and (4) after rough backfill and
grading is complete. The STEP tank requires one inspection after it is set level and the piping
connected, but prior to backfill. This inspection may be incorporated with any of the above inspections.
5.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently far in
advance to ensure the availability of the engineer.
GREA, R ANCHORAGE AREA BORk.
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DIS~'?SAL SYSTEM
SEPTIC TANK:
DISTANCE
FROM WELLL
INSIDE LENGTH
MANUFACTURER . MATERIAL
INSIDE WIDTH LIQUID DEPTH
NUMBER OF
COMPARTMENTS ~'~
LIQUID CAPACITY/~C'~ GALLONS.
TILE DRAIN FIELD:
DISTANCE FROM WELL FOUNDATION
NUMBER OF LINES J/ DISTANCE BETWEEN LINES
ABSORPTION AREA ('~ C ~
DEPTH: TOP OF TILE TO FINISH GRADE
NEAREST LOT LINE
TOTAL LENGTH
OF LINES ~f
TRENCH WIDTH IN. TOTAL EFFECTIVE
SQ. FT. LENGTH OF EACH LINE
DEPTH OF FILTER
MATERIAL BENEATH TILE__(~
IN. ABOVE TILE IN.
WELL: -
TYPE ~>3'"D~' ~
BUILDING
FOUNDATION
CESSPOOL
APPROVED
CONSTRUCTION
NEAREST NEAREST
LOT LINE , SEWER LINE--
OTHER SOURCES
DISAPPROVED REMARKS
DEPTH
SEPTIC SEEPAGE
., TANK SYSTEM_
DISTANCE FROM:
DISTANCES: --
DIAGRAM OF SYSTEM
SEWER LINE DEPTH:
PIPE MATERIAL:
LOT SLOPE:
REMARKS:
DATE ~ APPROVED
t
G.A.A.B.
PERMIT NO. ( 76745 )
RPPLICRNT
LOCRTION
LEGRL
~R~VELLE HRRRIS~
LONE TREE DRIVE
L42 B~ VRLLI VUE EST ~2
~20~ C STREET
276-555t --
LOT SIZE 20520 SQURRE FEET
TYPE OF SOIL. RBSORBTION SVSTEM IS: TRENCH
MRXIM~JM NUMBER OF BEDROOMS = 4
SOIL RRTING
THE REQUIRED SIZE OF THE SOIL RBSORPTION SYSTEM IS:
[)EF'TH=: 12 LENC~TH= 42 G~: R"-,mEL [)EPTH: 6
THE LENGTH DIMENSION IS THE LENGTH <IN FEET) OF THE TRENCH OR DRRINFIELD.
THE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BETWEEN THE SURFRCE OF THE
GROUND RND THE BOTTOM OF THE E:,:;CRVRTION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFRLL PIPE
RND THE BOTTOM OF TRE EXCRVRTION (IN FEET).
F.' E,S-.~J ~ F~:E[:. SEF"-r ][ C TR~-t~:~ S I ZE= 1.25F-_~ ,]iF~LLC,~-~S
'TP~,] (2) I ~SPE~T;-F ~ C~-tS RRE ~:EL:~J I F~ED
BBCKFILLING OF RNY SYSTEM WITHOUT FINRL INSPECTION RND RPPROVRL BY THIS
DEPRRTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTRNCE BETWEEN R WELL RND RNY ON-SITE SEWRGE DI~POSRL SYSTEM
1~0 FEET FOR R PRIVRTE WELL. OR 200 FEET FOR R PUBLIC WELL.
SPECIFICRTIONS RND CONSTRUCTION DIRGRRMS RRE RVRILRBLE TO INSURE PROPER
INSTRLLRTION.
F'EF."~-'I lr T '..."I=IL ir [:. FE, R ~]]~-~E "-,-"ERR FF:C,~-I I SSLIE
I
±:
FORTH BY THE MUNICIPRLITY OF RNCHORRGE.
2: I WILL INSTRLL THE SYSTEM IN RCCORDRNCE WITH THE CODES.
~: I UNDERSTRND THRT THE ON-SITE SEWER SYSTEM MRV REQUIRE ENLRRGEMENT
RESIDENCE IS REMODELED TO INCLUDE MORE THRN 4 BEDROOMS.
SIGNED - ....................
ISSI-IED ou ~-/Z--~--~ L H/~
CERTIFY I'HRT
I RM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET
IF THE
Performed
Leaal
This
2204 Cleveland Anchorage, Alaska 99503
For Harvelle
~escription:
Korm Reoort$
~ Harrison Date Performed .
L o t ._z~._~._B 1 o c k._~.~S u b d i v i s i o n~~
Soils Loq TF~Q Percolation Test
~enth
Feet
Soil Characteristics
2--, Topsoil.._.._._ ,,
Sandy Gravel, (GP) Moist
to a Graaelly Sand (SP)
10--
12--
14--. Silty Sandy Oravel(OP-GM) Moist
16--
18-- Bobtom of Test Hole
20--
Was Ground Water Encountered? No
I~ Yes, At what Denth?
NO BEDROCK ENCOUNTERED
I Readinq Date Gross Time Net Time Depth to H20 Net Dron
I
I ''
I
Percolation Rate Minute
Prnposed Installation: Seenaoe Pit Drain Field
De~th of Inlet Depth To Bottom Of Pit Or
C~m~ENTS: 125 Sq. Ft. of Drainage Area Required per Bedroom
Trench
Test Performed By//~)~ Data Certified BY: Jim Mask
Date: 9-10-76
RuSI* ? �s
•
MUNICIPALITY OF ANCHORAGE
Development Services Department - Phone: 907-343-7904
On-Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On-Site Systems Approval
Parcel I.D. 015-322-21 Expiration Date: 5- 7-2_152_0
1. GENERAL INFORMATION
Complete legal description Valli Vue Estates #2 Block 3 Lot 42
Location (site address) 10411 Lone Tree Drive, Anchorage, AK 99507
Current property owner(s) Andy Ming Day phone 312-3462
Mailing address 10411 Lone Tree Drive, Anchorage, AK 99507
Real estate agent Laney Stapley Long Day phone 907-350-7984
2. TYPE OF DWELLING:
[ Single Family (w/wo ADU)
Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: Four
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Private Well ❑ Private Septic x
Water Storage ❑ Holding Tank I
Community Well 0 Community ❑
Public Water System [ Public Sewer U
Waiver request for: Distance:
Received by: Date:
COSA to be released to the engineer.unless otherwise requested by the engineer.
COSA Fee $ � Waiver Fee $
Date of Payment 5/-4111 Date of Payment
Receipt Number 01/6i9D Receipt Number
COSA# C1q I 1 ) 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. I acknowledge that On-Site staff may visit the site to verify the information submitted.
Name of Firm Forge Engineering Phone 907-522-7773
Address 1399 W. 34th Ave Suite 101, Anchorage AK 99503
Engineer's Printed Name Michael E. Anderson, P.E. Date 5/6/2019
OF 44 44
• ••••teu!,s
• 6')' s •
tai
• 49th• _i •„,.i
6. DSD SIGNATURE i �e
•
MMI%.M.N.NMfl Stfl Y.r11..tM..11.l.}�''
Ltz
System#1 Approved for 4 bedrooms MICHAEL E. ANDERSON 1 i`C=
CI I. No. CE-4381
System#2 Approved for bedrooms •ivfF,p'%,,O5/03/19.� s* � )
Disapproved •�NI' *S=;$10"•••••
Conditional approval for bedrooms, with the following stipulations:
olY fOFANcr/rr
Z5 ON SITEco
WATER AND
T--"o WASTEWATER (Si:,
PROGRAMo
�F�'SER\0 �
Bi Original Certificate Date:L 7-1
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the
representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is
not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA Checklist blue sheet
COSA Checklist
Legal Description: Valli Vue Estates#2 Block 3 Lot 42 Parcel ID: 015-322-21
If more than 1 septic system on lot: COSA Checklist# of Structure served by this system
A. WELL DATA
❑Well log is filed with Onsite (or attached) Well production at time of test gpm
Date drilled Water storage tank volume gallons
Total depth ft Well disinfected for coliform test? ❑ Yes ❑ No
Cased to ft ❑ Coliform bacteria is Negative
❑ Sanitary seal is functioning correctly Nitrate mg/L ❑ Nitrate less than MRL (ND)
❑Wires are properly protected Arsenic ug/L ❑ Arsenic less than MRL (ND)
Casing height (above ground) in. Collected by
Date of flow test for COSA Date of Sample
Static water level at beginning of test ft.
Comments Class A Water System - COMMUNITY WELL
B. TANK DATA C. LIFT STATION
Age of tank(s) 16 years 0 Required maintenance completed
Tank type/material STEP/Steel Age of lift station 16 years
Measured operating fluid level in septic tank NA Lift station material Steel
El Standpipes/foundation cleanout per record drawing Comments: MOA Inspection completed by A+
Date of pumping Annual maintenance done 8/20/18 on 4/30/19
•
D. ABSORPTION FIELD DATA Deep Trench
Which system tested (date installed) 12/11/13 Adequacy test date 4/29/19 •
El ALL standpipes present per record drawing Results ❑✓ Pass For 4 bedrooms
Total measured depth from grade 7.5 ft(max) Fluid depth prior to test 6" in
Measured depth to pipe invert from grade ft(min) Water added 910 gal
® N/A—pressurized field New depth 10 in
El Monitor tubes go to bottom of effective. If not, state Elapsed time 1440 min
depth into effective
■❑ Code-required soil cover over field Final fluid depth 5.5 in
Absorption rate >600 gpd
❑ System presoaked None
(Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months)
date of test)
Gallons introduced gallons If yes, enter date
Comments/Deficiencies:No CO on the trench,only MT.
COSA Checklist yellow sheet
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well)
Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100'
n Yes if No ft M Yes if No ft
Neighboring Tank > 100' 0 Yes if No ft Private Sewer/Septic Line > 25' ❑✓ Yes if No ft
Absorption Field on Lot > 100' p Yes if No ft Holding Tank > 100' 0 Yes if No ft
Neighboring Absorption Fields > 100' Animal Containment > 50' 0 Yes if No ft
0 Yes if No ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' 0 Yes if No ft —✓0 Yes if No ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10' 0 Yes if No ft Surface Water> 100' 0 Yes if No ft
Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots:
Absorption Field > 5' 0 Yes if No ft Private Wells > 100' ✓0 Yes if No ft
Water Main > 10' 0 Yes if No ft Community Wells > 200' 0 Yes if No ft
Water Service Line > 10' 0✓ 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' p✓ Yes if No ft If absorption field is under driveway comment below
Property Line > 10' 0✓ Yes if No ft Wells on Adjacent Lots:
Water Main > 10' 0 Yes if No ft Private Wells > 100' ❑✓ Yes if No ft
Water Service Line > 10' 0✓ Yes if No ft Community Wells > 200' El Yes if No ft
Surface Water> 100' 0 Yes if No ft
F. ENGINEER'S COMMENTS
G. ENGINEER'S CERTIFICATION .•�� ois•>t4,+�•
• ......... "f
I certify that 1 have determined through field inspections and review +••'`P:.••'.•.. '••.. •j
of Municipal records that the above systems are in conformance with 2 /1.N.
\7' v.
MOA COSA guidelines in effect on this date. 1 49th �� • �t
00 ...5
MICHAEL E. ANDERSON j
*167J % No. CE-4381 �•2i
•, •.••••0.05/03/19,.••' �,�i
ir
COSA Checklist yellow sheet .14:14°.. p ' PL •
� � MUNICIPALITY OF ANCHORAGE
! y04
Development Services Department Phone Fax:9.0-3*3rr 3 77991
On-Site Water&Wastewater Section
trft Station/Pump Vault
Maintenance Log
Owner _ A _ Street Address__.
Les-dal DeSc._ -
Phone � PID__
$eptic_Tank:
-Sludge level 2. inches -Pumping' required st' -Pumping completed yes_ .i4
t_ift e_fati0n:
-Pump basket cleaned es rya -Effluent fitter cleaned
tea
-Control floats cleaned`xe -4 -Proper float settings confirmed C
-Operation satisfactory
Alarm System:
-Dedicated electrical alarm circuit + '_AQ -Audible and visual alarm inside dwelling
CID
-Alarm system operation ac ory, notsatisfa.S1Q!
Manhole Rts�L
-Ground water intrusion at riser to tank connection y.- ,C1
negations eT -Weep hole functional yF-:r nn
-Ground water intrusion around pipe penetrations lL-_
-Manhole lid. Functional (� Insulated ( 2 Properly Secured 8)..2:
-All manufacturer required inspections and maintenance completed no
Comment%
Maintenance Provider
Technician I.0..0-9 134. tis Date of maintenance31(
Company lq �.\t1S , oY/e :cer -"
Signaturec Date-� �
MaiQnq
Address;P.O.Box 196650 Anchorage.Alaska 99519-6650'vAvw.muni.org III
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Parcel I.D. 015-322-21
Certificate of On -Site Systems Approval
Expiration Date:
Legal description VALLI VUE ESTATES #2 BLK 3 LT 42
Site address 10411 LONE TREE DR Anchorage AK 99507
Current property owner(s) JOHN LEACH & KELLY MAXSON
X The On-site system(s) is/are approved for 4 bedrooms
Conditional approval for
Comments or advisories:
M
bedrooms, with the following stipulations:
Original Certificate Date: 2 `7 20
This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
system(s) is/are in substantial compliance with municipal code. The Municipality of
Anchorage, Development Services Department (DSD) issues COSAs based upon
representations provided by an independent professional engineer. The Municipality of
Anchorage is not responsible for errors or omissions in the professional engineer's work.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory
Tank Age Advisory _ Arsenic Advisory
Other
COSA Approva"une 2022
MUNICIPALITY OF ANCHORAGE
o
Development Services Department
P P i' r� Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 015-322-21
Complete legal description VALLI VUE ESTATES #2 BLOCK 3 LOT 42
Location (site address) 10411 LONE TREE DRIVE, ANCHORAGE, AK 99507
Current property owner(s) JOHN LEACH & KELLY MAXSON Day phone
2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS
3. TYPE OF WATER SUPPLY: ❑ Private Well ❑ Private Well serving 2 dwelling units
❑ Private Well serving 3+ dwelling units ® Community Well or Public
❑ Water Storage
4. TYPE OF WASTEWATER DISPOSAL: ® Private Septic ❑ Private Septic serving 2 dwelling units
❑ Holding Tank ❑ Community Septic or Public Sewer
5. SEPTIC TANK: ® Steel ❑ Plastic ❑ Concrete ❑ Fiberglass
Age 20 - See advisory if steel older than 20 years 1500 -GALLON STEEL STEP TANK
6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ® Deep Trench ❑ Wide Trench ❑ Seepage Pit
Waiver request for:
Expedited review requested: ❑
Distance:
By applying for this entitlement, this property is subject to inspection by municipal On-site staff
to verify the accuracy of the information provided.
COSA Fee $ Waiver Fee $
Date of Payment 1, / 5 / ZO L 3 Date of Payment
COSA # D S G'
23 11 2.3 Waiver #
COSA Application.doc
COSA Checklist.docx
COSA Checklist
Legal Description: VALLI VUE ESTATES #2 BLOCK 3, LOT 42 Parcel ID: 015-322-21
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____
A. WELL DATA - PUBLIC &/OR CLASS “A” WATER - #210605
Well log is filed with Onsite (or attached)
Date drilled Total depth ft
Cased to ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) in.
Date of flow test for COSA
Static water level at beginning of test ft.
Well production at time of test gpm
Water storage tank volume NA gallons
Well disinfected for coliform test? Yes No
Coliform bacteria is Negative
Nitrate mg/L Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by
Date
Comments __________________________________________________________________________________
B. TANK DATA
Measured operating fluid level in septic tank NA
Date of pumping 5/1/2023
Required maintenance completed, if AWWTS
Comments: NA - TANK FLOATS - SEE REPORT
C. LIFT STATION
Required maintenance completed
Age of lift station 20 years
Lift station material STEEL
Comments: SEE STEP MAINTENACE REPORT
D. ABSORPTION FIELD DATA
Which system tested (date installed) 12/11/2003
ALL standpipes present per record drawing
Total measured depth from grade 7.8 ft (max)
Measured depth to pipe invert from grade ft (min)
N/A – pressurized field.
Per record drawings, field is insulated.
Monitor tubes go to bottom of effective. ASSUMED
If not, state depth into effective
Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced gallons date
Any rejuvenation treatment (past 12 months) N
If yes, enter date
Adequacy test date 5/1/2023
Results Pass
Fluid depth prior to test 11 in
Water added 660 gal
New fluid depth 17 in
Elapsed time 1440 min
Final fluid depth 10 in
Absorption rate 600 gpd
FIELD STATUS – POST RECOVERY
Effective depth (per record drawings) 60 in
Effective depth used 10 in (ED)
Effective depth remaining 50 in
Comments/Deficiencies: ED assumed per visual observations and MOA inspection report / file. Field has approximately 2.9’
of cover & per the owner & MOA file there has been no known freezing or frost issues. Measurements show ED is
approximately 4.9-5’. Per past asb surveys & COSAs the STEP is partially under the deck at grade & the abandoned trench
still exists & could be reconnected to in the future.
COSA Checklist.docx
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) - NA
Septic Tank/Lift Station on Lot > 100’
Yes if No ft
Neighboring Tank > 100’ Yes if No ft
Absorption Field on Lot > 100’ Yes if No ft
Neighboring Absorption Fields > 100’
Yes if No ft
Community Sewer Main > 75’ Yes if No ft
Community Sewer Manhole/Cleanout > 100’
Yes if No ft
Private Sewer/Septic Line > 25’ Yes if No ft
Holding Tank > 100’ Yes if No ft
Animal Containment > 50’ Yes if No ft
Manure/Animal Excreta Storage > 100’
Yes if No ft
N/A – Served by Community Well (not on lot) or Public Water
From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required)
Building Foundations > 10’ Yes if No ft
Tank to Property Line > 5’ Yes if No ft
Field to Property Line > 10’ Yes if No ft
Water Main > 10’ Yes if No ft
Water Service Line > 10’ Yes if No ft
Surface Water > 100’ Yes if No ft
Wells on Adjacent Lots:
Private Wells > 100’ Yes if No ft
Community Wells > 200’ Yes if No ft
If tank or field is under driveway comment below
F. ENGINEER’S COMMENTS
G. CERTIFICATION & 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, indicates that the on-site water
supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation, unless noted otherwise.
Name of Firm FIRST WATER CONSULTING Phone 907-350-9566
Engineer’s Printed Name CURTIS HUFFMAN, PE Date 5/10/2023
Comments: This investigation was completed in compliance with MOA guidelines, regulations,
and best industry practices / methods. 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 in land use,
local soil characteristics, groundwater levels that may fluctuate during the year, quality of
construction (workmanship & materials), the water usage of the family being served by the
system and maintenance. 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, any or NO estimate of how long a system will function satisfactory
for current or future occupants or guarantee that no unseen encroachments, deficiencies or
discrepancies exist can be given by First Water Consulting &
5/10/2023
Septic 'Tank Advisory
Certificate of On -Site Systems Approval # OSC231123
Subdivision: Valli Vue Estates #2 Block:3, Lot: 42
The septic tank for this property is 20 years old. The average life of an asphalt
coated steel septic tank is 20 years. Typical replacement costs are $10,000 or more,
not including engineering, surveying or MOA permitting fees.
This advisory must be attached to all copies of the subject Certificate of On -Site
Systems Approval.
This is an example of what the metal of a 30 year old steel tank MAY look like.
Mailing Address ,P O Box 196650 *Anchorage, Alaska 99519 6650 *www muni org
Municipality of Anchorage
Development Services Department
Building Safety Division
~,{~1~.O On-Site Water and Wastewater Program
4700 South Bragaw St.
· Box 196650 Anchorage, AK 99519-6650 ~
_ ~, · . ' www.ci.anchorage.ak.us
1~1~' (907) 343-7904
"' CERTIFICATE OF HEALTH AUTHORITY APPROVAL '
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 01~-32-2~',~t
Expiration Date:
1. GENERAL INFORMATION
Complete legal description . Lot 42, Block 3, Valli Vue Estates Subdivision No, 2
HAA# ~Ao ~o~,~
Location (site address or directions) 10411 Lone Tree Ddve
Current Property owner(s). Bob and Bobby Cannon Day phone 351-9014
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
10411 Lone Tree Drive Anchora,qe, AK 99516
Day phone
Day phone
Un/ess otherwise requested, HAA will be held by DSD for pickup.
NUMBER OF BEDROOMS: Four {4),
TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class _.A 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 Health Authority
Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil
engineer registered In the State of Alaska. Certificates of Health Authority Approval are required for lhe 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 less than 30 days old. (Certificates may be reissued for a period of up to one year with
valid water samples.) Cedificates 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.
.Name of Firm Anderson Enqineerin.q ' '
Address P.O. Box 240773 Anchoraqe, AK 99524
Engineer's Printed Name Michael E. Anderson, P.E.
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
site water supply and/or wastewater disposal system is(are) safe, functional and .a~cLuate for the number of
bedr6oms and. .type of structure indicated herein. I further verify that based on the'Inf6~ti,on obtained from the
Municipality~.~of~Anchorage files and from my investigation and inspection, the on-~ t~'w~t su and/or
-~ ..~. ~,, ..... ~ PPY
wast?water~d~sposal system is(are) m comphance with all apphcable Mun cipal and state¢~:odes, ordinances
and regulations in effect at the t'me of 'nstallabon. ~ . :i',, '
Phone 522-7773
Date .12/12/2003
DSD SIGNATURE
Approved for /7/
Disapproved.'
Conditional approval for
bedrooms, wit~ the following stipulations:
Additional Comments
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
X
Maintenance Agreements
Supplemental Engineer's Report
Other
By:. ~'~. ·
(Rev. 12~)
Odginal Certificate Date:
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.cLanchorage.ak.us
(907) 343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: ..Lot 42, Block 3, Valli Vue Subdivlsion No. 2
A. WELL DATA
Well type
IfA, B, or C provide PWSID #.
Date completed
Sanitary seal (Y/N)
Total depth ft. ...---Cased to 'ft.
FROM WELL LOG
Date of test
Static water level ft.
Well production
WATER SAMPLE RESULTS:
Coliform colonies/100 mi.
l~ate of sample:
SEPTIC/HOLDING TANK DATA
g.p.m.
Nitrate mg./I.
Collected by:
Tank Type/Material STEP/Steel
Tank size 1,500 gal. Number of Compartments 3
Foundation cleanout (Y/N) Y
Date of pumping.
Depression over tank (Y/N) _N
Pumper New ConstructiOn
C. ABSORPTION FIELD DATA
Date installed 12/1112003 Soil rating (g.p.d./ft2 or ft2/bdrm) t.2 GPDISF
Parcel ID: 015-322.21
Well Log (Y/N)
Wires properly protected (Y/N)
Casing height (above ground)
AT INSPECTION
ft.
g,p.m.
Other bacteria
irt.
Date installed 12111/2003
Cleanouts (Y/N) Y
High water ~larm (Y/N) Y
ft. Width 3 ft.
Elf. absorption area 500 ft2 Monitoring tube Y Depression over field N
colonies/100 mi.
System type Deep Trench
Gravel below pipe 5
Length 50
Date of adequacy test J Results (Pass)Fall)
Fluid depth in absorption field before test in. W~ter added gal.
Elapsed Time: min. Final fluid depth, in. Absorption rate >=
Any rejuvenation treatment (past 12 mo.) (Y/N & type) ~1 If yes, give date
ft.
For bedrooms
New depth in.
g.p.d.
D. LIFT STATION
Date installed. 12/1112003
"Pump on" level at 42 in.'
Datum Boffom of Tank
E. SEPARATION DISTANCES
Size in gallons 250
"Pump off" level at 42 in.
Cycles tested NewConst.
SEPARATION DISTANCES FROM WELL ON LOT TO: ,
Septic tank/lift station' on lot >100'
Absorption field on lot >100'
Public sewer main NIA
Sewer/septic service line >25'
Manhole/Access (Y/N) ,Y
High water alarm level at 44
Meets alarm & circuit requirements? Y
On adjacentlots >100'
On adjacentlots >100'
Public sewer manholelcleanout N/A
Holding tank N/A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO;
Building foundation. >5'
Water main N/A
Wells on adjacent lots >100'
. Property line >5'
Water service line >10'
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line >10'
Water Service line >10'
Curtain drain NoneNoted
COMMENTS
Building foundation. >10'
Surface water >100'
Wells on adjacent lots >100'
Absorption field >5'
Surface water >100'
Water main >10'
Driveway,. parking/vehicle storage. >25'
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 HAA guidelines in ef[ect on this date.
Engineer's Printed Name .. Michael E. Anderson, P.E.
Date '12/'12/2003
HAA Fee $ ~'~ ~, '~'~
Date of Paym(~nt.
Receipt Number
(Rev. 12/00)
Waiver Fee $
Date of Payment
Receipt Number
in.
MUNICIPALITY OF ANCHORAGE
DIVISION OF ENVIRONMENTAL HEALTH
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE
1o General Information
Application Date
(a) Legal Description (include lot, block~ subdivision, section, township, range)
Location (address or directions)
(b) Applicants Nam~ ~.r<~ t~
Applicants Address I ~11 ~O~m ~
(c) Applicant is (check one) Lending Institution
Buyer ; Other21ll(explain);
(d) Lending Institution ~)~7~
Address
Telephone - Home
Business
Owner/builder ~;
Telephone
(e) Real Estate Coo & Agent --
Address
Telephone
(f) Mail the ~ to the following ~dress:
2. T~ype of Residence
Single-Family~
Number of Bedrooms
3o Water Supply
Individual Well~-[
Multi-Family~
Other (describe)
Community~ Public~--~
Note: If community well sys~em~ must have v£itten confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
4. Sewage Disposal
Onsite~ Public~ Community~ Holding Tank~--~
Note: If community well system, must have written confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
[Page 1 of 2]
Engineering Firm Providing Inspections~ Tests~ File Sear~h~ Data and Information
As certified by my seal affixed hereto and as of the validation date shown below, I
verify that my investigation of this Health Authority Approval shows that the on-site
water supply and/or wastewater disposal system is safe, functional and adequate for
the number of bedrooms and type of structure indicated herein. I further verify that,
based on the information obtained from the Municipality of Anchorage files and from my
investigation and inspection, the on-site water supply and/or wastewater disposal
system is in compliance ~th all Municipal and State codes, ordinances, and regula-
tions in effect on the date of this inspection.
Name of Firm
Address
Telephone
Approved ~/ Disapprove nditional
Tetnns of Conditional Approval
CAUTION
THE MUNICIPALITY OF ANCHORAGE DEPARTMEb~ OF HEALTH AND ENVIRONMENTAL PROTECTION
(DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT-
ATIONS 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 REQUIRE-
HENTS. 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.
(DHEP SEAL)
RR4/ej/D18
[Page 2 of 2]
7-19-84
'/~-~ '~ MUNIClPALI~ OF ANCHORAG~
DEPT. OF HEALiH
ENVIRONMENTAL P,qC Fi:CI'ION
MONICIP Z OF (MO )
H~ ~O~TY ~PROV~ (~) J EB 2 [~ 1985
C~CKLI~ - FEBRU~Y 1984
, ECEIVtzD
Well Classification dk~5~ ~ If A, B, or C, D.E.C. ~oved(X~)
Well ~ ~esent (Y~) Date ~leted Yield
T~tal ~p~ Card to ~pth of Grouting
Static Water ~ ~t~.. ~
Casing ~ight . ,~ ~ ~ ~OU~C[ ~sing (Y~)
Elec~ical Wi~ head (Y~)
T0 ~a~est Ed~ / ' -
To Newest Pul ,~
Clean,t/Ma, 1~ D~ R ~~ ~t
Water S~le (
Water S~le q
Con, rents
B. SEPTIC/HOLDING TANK DATA
Date Installed d~-T lqlb size I~o No. of Conl0a~tm~nts T u~,O
Standpipes (Y/N) ON~ Air-tight Caps (Y~) ~ Foundation Cleanout (Y~)
~ession o~ Ta~ (Y~) ~ Date ~st P~d
P~ing~aintenan~ Con~act on File (Y~)~/~ ; for
Holding Ta~ High-Wate~ Ala~ (Y~) N/~ Te~rary Holding Tank Permit (Y~) ~/~
Sep~ation Distan~s ~ ~ptic~olding Tank:
To Building Foundation _~
To Disposal Field IO
TO Stream, Pond, lake, o~ Major D~ainage
To Water-Supply Well ~ ~
To Property Line .~0 ~'
To Water Main/Service Line lOve
Course N o N/~
Receipt ~
Date Paid:
Amount:
[Page 1 of 2] 2-15-84
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed (~' 197~
Width of Field
Square Feet of Absorption A~ea
Depression over Field (Y/N)
Results of Last Adequacy Test
[~ Type of SystemDesign
Length of Field ~;
Depth of Field /.~ '
Gravel Bed Thickness ~ '
Standpipes Present (Y/N)
N Date of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well ~ + To Property Line I~
To Building Foundation_ ~ To Existing or Abandoned System on
Lot ~ .__; On Adjoining Lots ~ ~
To Water Main/Service Line I0 4' TO Cutbank(if present) ~
To Stream/Pond/Lake/or Major Drainage Course ~H~
To Driveway, Parking Area, or Vehicle Storags Area ~O~
Com~.nts
D. LIFT STATION NO N~-
Date Installed
Size in Gallons
"Pump C~" Level at
High Water Alarm Level at
Tested for
Electrical Co,es(Y/N)
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test.
Mine ts MOA
Cor~aents
~* Check Permitted Bedrocm Rating Against HAA Request
I certify that I have checked, verified, or conformed to all MOA HAA Guidelines in effect
on the date of this inspection.
!
KB1/d5/s
Date
MOA No.
[Page 2 of 2]
2-15-84
DEPT. OF ENVIRONMENTAL CONSERVATION
ANCHORAGE/WESTERN DISTRICT OFFICE
437 "E" STREET, SUITE 303
ANCHORAGE, ALASKA g9501
BILL SHEFFIELD~ GOVERNOR
Telephone: (907)
Address:
274-2533
To Whom it May Concern:
According to records on file in this office the ~/~
_~_~ A~' ater System is in compliance-with the State Drinking
Water Regulations
Sincerely,
APPLlt-'NT FILLS OUT UPPER HAt % ONLY
. ~' ~. .. Phone
PropertyOw~e Michael C~ Dize
UailingAddress SPCA. BOX 28W, Anchoraqe, .zL~. ZipCode 99507 349--6165
Buyer None
Address Zip Code
Phone
Lending Institution
None
Address Zip Code
Phone
Realty Co. &Agent Coldwell Banker Jack White Co. (Clair Ramsey)
Address 3201 C St., AnchoraGe, akl ZipCode 99503 297--155~
LegalDescription LOt 42, Block 3, Valli Vue Estates #2
Street LocaUo~0Z/// Lone Tree Dr.
Type of Residence , :., - .... ~
~1 Single Family
[] Multiple Family No. of Bedroon~s 4
[] Other
Water Supply
[] Individual ATTACH WELL LOG. A well Icg is required for all wells drifted since June 1975.
~) ~- For wells drilled prior to that date, give well depth (attach Icg If available).
Community
[] Public Utility
Sewer Disposal
~ Individual Year Individual Installed: 79
(~ 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
Date Date Date ~ Dat~_ ~ ~ ~,--~--~
Inspector Inspector Inspector Inspector
Field Notes:(~r'"~N ~ DEPT. OF H~ALTH &
ENVIRONM?NTAL P~OTECTION
MAY 3 -
REEEIVED
(~) APPROVED BEDROOMS *CONDITIONS OF APPROVAL
/~9 ~ Well toTank ~Afr~, ~,.. SeptioT~k Size /~S'~
'7203 W. 15th AVE "C" SUITE 203
ANCHORAGE, ALASKA 99501
TELEPHONE: (907) 279-3916
· PETER JARRATT
HERITAGE HOMES
207 E NORTHERN LIGHTS BLVD.
ANCHORAGE, ALASKA 99503
FEBRUARY 27,1985
SEPTIC SYSTEM ADEQUACY TEST
LEGAL:
LOCATION:
OWNER:
RESIDENCE:
WATER SYSTEM:
SEPTIC SYSTEM:
DATE OF PUMPING:
DATE OF TEST:
TEST PROCEDURE:
TEST RESULT:
Lot 42, Block 3, Valli Vue Estate
10411 Lonetree Drive
Single Family, Four Bedrooms
Class A Community System
FROM MUNICIPAL RECORDS:
TANK: Greer Steel tank,
Compartments, 1250 gal.
ABSORPTION SYSTEM: Trench
ABSORPTION AREA:612 sq. ft.
SOIL RATING: 125
INSTALLATION DATE: June 1976
Two
July 12, 1983. NOTE:Residence has been vacant
since June 1983
June 17, 1983
Unknown, Information found in Municipal file.
Satisfactory.
The operational life of all septic systems
depends on the local soil conditions, ground-
water levels that may fluctuate during the
year, and the water usage of the family being
sereved by the system. These conditions are
outside the control of the evaluator of this
septic system. We can therefore not give any
estimate of how long the system will continue
to meet the operational requirements of the
Municipality and State.
ALASKA IUIROI IlleI TAL COF/TROL
SEHUIC S, IrIC.
JUNE 17 1983
JACK WHITE COMPANY/ATTN
3201C STREET
ANCHORAGE AK 99503
CLAIRE RAMSAY
SELLER - MICHAEL DIZE BUYER-TRANSFER COMPANY
SUBDIVISION-VALLIVUE #2 BLOCK-3 LOT-42
ADEQUACY TEST FOR SEWER SYSTEM
THE TYPE OF ABSORPTZON SYSTEM IS A TRENCH WITH AN AREA OF 612 SQFT.
THE SYSTEM IS CAPABLE OF ACCEPTING 600 GALLONS OF WATER PER DAY.
THE SURGE CAPACITY OF THE SYSTEM IS 481 GALLONS.
BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A
4 BEDROOM HOME.
SEPTIC TANK ADEQUACY
THE EXISTING SEPTIC TANK VOLUME OF
THIS 4 BEDROOM HOUSE.
1250 IS ADEQUATE FOR
1200 ~Jcsl 33rtl Aucnue, Suite B ,,/~nehor~§e, /~lasJ(d 99503 · (907) 276-1361
June 7, 1~83
Michael C. Dize
SPJA Box
Anchorage, AK 99507
Subject: Lot 42, Block 3, Valli Vue Estates 92
Approval for the individual sewer and water facilities cannot
be granted until the following items have been completed:
o ~he septic tank pumped with a receipt submitted to this
departmen~o
o An adequacy test needs to be ~rformed on the existing
leaching area° This test will determine i~ the system is
adequate according to ~ational Standards° A listing of
private firms performing the test is enclosed. This report
needs to be submitted to this o~fice for our review.
Please notify this Department for a reinspection when the
noted discrepaacies have been corrected. If there are any
further questions, please call this office at 264-4720.
Sincerely,
tlobert C. Pratt
Associate EnvironIaental Specialist
Enclosure
RPI6/ej/E2
I _~'~ ~UNIClPALITY OF ANCHORAGE
MUNICIPALITY OF ANCHORAGE DEPT. OF I!EALTH &
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTI~VIRONMENTAL P~,O£ECTION
825 L Street - Anchorage, Alaska 99501
ENVIRONMENTAL ENGINEERING DIVISION JAN 2 c, 1979
Telephone 254-4720
.o. o.
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1, PROPERTY OWNER I PHONE
I
MARTIN RoGERs
MAILING ADDRESS
]04l] Lone Tree Anchoraqe, Alaska
PROPERTY RESIDENT (If different from above) PHONE
Same as Above
'2. BUYER PHONE
Michael C. & Joanne S. Dize 404-457-8452
MAILING ADDRESS
5137 Lakesprinqs Court Dunwood, Ga. 30338
3. LENDING INSTITUTION PHONE
UNITED BANK ALASKA 276-1911
MAILING ADDRESS
2600 Denali Street Anchoraqe, Alaska
4. REALTOR/AGENT PHONE
Totem Realty~ Im;. Robert E. Baer 272'0571
MAILING ADDRESS
724 East 15th .AV.e.n~e Anchoraqe, Al.as. ka 99501
5. LEGAL DESCRIPTION
Lot 42, Block 3, Valli Vue Estates
TREET LOCATION
]04]] Lone Tree
6. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] One rYcl Four
[] SINGLE FAMILY [] Two [] Five
[] MULTIPLE FAMILY ' [] Three [] Six
[] Other
7, WATER SUPPLY
[] INDIVIDUAL* * ATTACH WELL LOG. A well Icg is required for all wells d[illed
[~ COMMUNITY since June 1975. For wells drilled prior to that date, give well
[] PUBLIC UTI LITY depth (attach Icg if available.)
8. SEWAGE DISPOSAL SYSTEM
~( INDIVIDUAL/ON-SITE*'
[] PUBLIC UTILITY
**If individual/on-site, give installation date
If system is over two (2} years old an adequacy test is required
by this Department.
NOTE: THE INSPECTION FEE MUST AccoMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010(3/78)
THIS SIDE FOR OFFICIAL USE ONLY
DATE RECEIVED
INSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
INSPECTOR INSPECTOR INSPECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FiVE [] OTHER
[] MULTIPLE FAMILY [] TWO [~ FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[] I N D] V l DUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY
Connection Verified INSTALLER
E}Septic Tank or []HoldingTank
Size: If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCESwELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line
Absorption Area to nearest Lot Line
5, COMMENTS
~APP ROV ED FOR ~ BEDROOMS
[] CONDITIONAL APPROVAL (letter most accompany certificate)
[] DISAPPROVED
DATE BY (Title)
LEGAL DESCRIPTION
72-010 (Rev. 3/78)
GREATER ANCHORAGE AREA ~OROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date Received March
Time of Inspection
Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
Conv.
]. Approval requested by: Alaska National Bank
Mailing Address: Pouch 7-010 99510 Phone:
2. Property Owner: Roger Bates/Richard Mathews Phone:
Mailing Address: 3201 c Street
7 , 1977
10:00 a.m.
3-7-77 Mndy
Kennedy
278-4581
276-5551
3. Legal Description: Lot 42 Block 3 Valli Vue Estates #2
4. Location: 10411 Lone Tree Drive
5. Type of facility to be inspected
6. Well Data:
A. Type Community
C. Construction
Single Family
No. of bedrooms 4
Sewage Disposal System:
A. Installed
C. Septic Tank:
D. Seepage Pit:
B. Depth
D. Bacterial Analysis
On-site system, Permit 76745
1976 B. Installer
l. Size 2. Manufacturer
1. Absorption Area 2. Material
Total length of l~nes
, Absorption area
, Other contamination
, Absorption area
E. Disposal Field:
Distances:
A. Well to: Septic tank
Nearest lot line
B. Foundation to septic tank
, Sewer Lines __
C. Absorption area to nearest lot line
EQ-034 (1/74) Page 1 of two pages
Page 2 of two' p~ges Re st for Approval of Individual 'er & Water Facilities
Legal Description Lot 42 Block 3 Valli Vue Estates #2
Comments
Approval Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
certify that the information contained in this request for approval to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED
Date
EQ-034 (1/74)
3330
DEPL OF ;I~ALTN
G~E~FE~, AHCHORAGE ARE/, BOROUGH
Department of Environmental Quality
"C" St., Anchorage, Alaska 99503 - 27q-q561
RECEI_ .ED
REQUEST FOR A~PROVAL OF
~ND]V~DUAL S~W~R & WATER FACiLiTiES
Type of Inspection: ' CMRO VA
2, Property Owner: Roger Bates & Richard Mathews
Mail ing Address: 3201 c Street
3. Name of Buyer: M.F. Rogers, Jr. & Phoebe J. Roj~ers
Mailin~j Address: O~ Phone
6. Name of Lending Institution: ALASKA NATIONAL BANK
Mailing Address: Pouch 7-010 Anchorage, Ak. Phone
FHA C0 NV xx
Phone 276-5551
Name of Realtor or Agent: Clair Ramsey-Jack White Co.
bailing Address: 3201 C Street Phone
278-4581
277-5551
6. Legal Description: Lot 42 Block 3 Valli Vue Estates #2
Locati on: 10411 Lone Tree Drive Anchor~e, Alaska 99507
7. Type of Facility to
8. Water Supply
Type of Supply: Public
If Individual, numbe'r of
If Individual, depth
9. Sei.~age Disposal'System
be inspected:
single-family NO. r q --~¢ ,
-- dwelling
Utility Individual x (Community
dwellings presently served
of wel 1
Type .of System: Public Utility
If Individual, date of installation
PLEASE SUBMIT BACTERIAL ANEYSIS OF LAST W-ELL SAMPLE.
Individual (on-site) X
Claudia Jonas
Mortgage Loa~ Processor
~'HY. ,dl,t, Fad.
SCALF
~": ~0'
30'
43
TOP OF FOUNDATION WALL ELEVATION~ ~ ~
PREPARED FOR,
JXOrv~JJ~-//arr/$~n
PlOT
PLAN
DATE _ _
IT SHALL SE THE RESPONSIBILITY OF THE BUILDER
OR OWNER TO VERIFY THAT DUILDINrJ LOCATION
SHOWN MEETS ALL SUBDIVISION COVENANTS AND
LOCAL ZOHINO COOES AND ORDINANCES.
LOT ¢2, BLOCK
Y~LLI-YU~ £.~I,41£$ ADD.