HomeMy WebLinkAboutMELINDA VIEW ESTATES LT 5Melinda View
Estates
Lot 5
#017-092-42
Municipality of Anchorage Page 1 of 3
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: SW000047 PID Number: 017-092-42
Name:
IRV & SUSAN WALKER
Wastewater System: ❑ New ■ Upgrade
Y
Address:
14601 JOANNE CIRCLE ANCHORAGE, AK 99516
ABSORPTION FIELD
Phone:
(907) 562-3073/229-7285
No. of Bedrooms:
3
El Deep Trench 11 Shallow Trench ■Bea ❑ Mound ❑other
LEGAL DESCRIPTION
Soil Rating:
0.8
Total Depth from original grade:
*1.57 - 2.31 Ft.
GPD Sq. FL
Lot: Block: Subdivision:
D.pth to pipe bottom from anginal grade:
Gravel depth beneath pipe:
5 — MELINDA VIEW ESTATES
(+)0.30 — (+)1.04 FL
0.51 F.
Township:
Range:
Section:
FII added .Dave anginal grade:
Grovel length:
—
—
—
3.74 — 4.48
a 43
Gravel width:
Number of lines:
Dletanw between Ilnee:
WELL: ❑New El Upgrade
5
3
5 n.
Cl.aificati.n (Print.. Ales):
Total Dep
Cased Ta:
Total absorption area.
645
Pipe maten.l:
ASTM D -3034/F-810
pi
se.
a
Dnller.
.ASS\
le DaDnlled:
Static water Level:
Installer.
FORREST ENT.
Date metalled:
8/9-20/2000
F
Yeb:
Pump Set AL
Casing Height Move Gruuna:
TANK
cPu
Ft
FL
SEPARATION
DISTANCES
. Septic o Holding o S.T.E.P.
To
Septic
Absorption
Lift
Holding
Publicr
NanWoctuno
ANCHORAGE TANK
Capacity in gallons:
1000
From
Tank
Field
Station
Tank
Lin.
Sawar Lines
Well
100'+
100'+
—
—
25'+
Y.bdal:
STEEL
Number of comportments:
2
Surface
100•+
100'+
-
-
-
LIFT STATION
Water
Lot
5'+
10'+
—
—
—
Sze in gallons:
NonNoctureo
P•
Line
"Pump on" Ir:el at:
"Pump o
Hlgh wore, alarm au
Foundation
5'+
10'+
—
—
—
Curtain
Pump Naka
poctdwl Inep.ctione performed by:
Drain
NONE KNOWN
Remarks: *2.1 FEET OF M.O.A. APPROVED SAND
BENCH MARK
Location and D..cnpbon:
FILTER ADDED TO TOTAL DEPTH.
TOP OF FOUNDATION CLEANOUT
b.umed .ovation:
102.47
FL
ENGINEERS SEAL
oo�Op�O
OF
o c�.
o P•. S X00
AWWC, INC.
Inspections performed by: Dates: 1st 8/9/2000
0*� 49TH �r It
................................
2nd 8/20/2000
Q.......:....D
....................
0 : D
3rd s/1s/z000
QO -.Jeffrey A. Gayness:
Department of Health and Human Services pproval
OHO sfe •, CE -7953 ,•c�co0�
��pe"ProfessiO'f'a o
Reviewed and approved by,� X141. / Date: S C� o
]2-01} R.v. 9/91) L 25
PERMIT NUMBER:
ASBUILT DR
AS—BUILT
P 017 ID NUMBER:
017-092-42
�WI�G
oLDON was
ABAPLACE DED IN
II
'
WELL
THE OLD SEPTIC TANK WAS
ABANDONED PER THE UPC
��
— o
1L
II
J�
I
_DIOS
TEST HOLE LOCATION/o
SHOT WITH TOPCON
F� OC,
F�
/ �G
Ap
TOTAL STATION
/ W�
�Y
/
J
DBL' . /�
/�.IT3
i
/
CRETE��
ONCADBL2 C�
N,
//
-_--
MT''
+4p0O�Op �",
NEW 15' x 43'
BED DRAINFIELD
INSULATED
/ NEW 1000 GALLON
A B C
• /�, SEPTIC TANK
j_- - C-
ST1
34.6 8.0 —
K
i
ST2
39.0 12.9 -
- — —
DBL1
41.7 16.0 —
DBL2
42.7 16.8 —
MT1
97.0 — 93.5
MT2
88.0 — 89.3
MT3
124.4 — 128.6
1D' UTILITY EASEMENT
MT4
118.5 — 127.1
- -
C01
126.6 — 131.6
CC3
124.1 — 130.8
20' R.O.W. EASEMENT
C04
121.2 - 129.6
�w�Jv
DATE:
9/18/2000
opb�O�O�
o OF A� X04
w`� i•• 9S
oO
DRAWN
AIASKAN I'ER S NNASTEN :VITR
J A.G.
i �f
tr -' ' '...7gyp
SCALE:
1" = 30'
CONSULTANTS INC.,,
6901 DEBARR ROAD, SUITE 2B • ANCHORAGE. AK 99504 •PHONE (907)337fi19 • FA% (907)330-3246
.
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PREPARED FOR: PHONE NUMBER:
PAGE NUMBER:
IRV AND SUSAN WALKER 562-3073/229-7285
2 OF 2
QO '•. If r v,. arness.:
Q �, �•,l l - S3 •' 00
Op�AP
LEGAL DESCRIPTION:
MELINDA VIEW
ESTATES S/D; LOT s
�• X00
����Oppo��000
TMP
UPGRADE
ASF BUILT OF
SEPTIC SYSTEM
PERMITNUMBER: AS -BUILT DRAWING PARCEL ID NUMBER:
SWO
SW000047 017-092-42
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VSLLR`7 °�R
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G AT T --,5f 1011 - 9-1
S�J✓1^;A1JP N'r5' 10,5
AT 92 C7 GN 8/'7/ OC
__A—
n^.T GO
NSW 1000 GALLON
5�r�c 1"ANK
SAVE Fi.TE�
AT
60T: GM G' fiE2
9/18/2000
DRAWN BY:
:AI aSK-k ANATER R «:ASTERN' rER J.L.M.
CONSULTANTS INC SCALE.
69CI DEBARR ROAD. SUITE 2B • ANCHORAGE. AN 99506 • PHONE (907)357-6179' FAX (907)318-3246 N.T.S.
>REPARED FOR: PHONE NUMBER: PAGE NUMBER:
IRV & SUSAN WALKER 562-3073/229-7285 3 OF 3
_EGAL DESCRIPTION:
MELINDA VIEW ESTATES SUBDIVISION; LOT 5
❑'PE OF WORK:
PROFILE AS -BUILT OF SEPTIC SYSTEM UPGRADE
= 9 25 ' AVG
r
.P •,,f of rey—A. Gayness;'
P 7953
co'o
�QPd rofesso^
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,6h 99L 3„69,£0.0 S
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MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On -Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-4744
fIi :a/O'eO v)
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT CC
Upgrade - (X(na �(L1Z-2
Permit Number: SW000047
Legal Description: MELINDA VIEW ESTATES LT 5
Design Engineer: 0041 AK Water & Wastewater Consultant
Owner Name: Iry & Susan Walker
Owner Address: 14601 JoAnne Cir.
Anchorage , AK 99516-4351
This permit is for the construction of:
,/ Disposal Field v Septic Tank Holding Tank
All construction must be in accordance with:
1. The attached approved design.
Date Issued: Apr 06, 2000
Expiration Date: Apr 06, 2001
Parcel ID: 017-092-42
Site Address: 014601 JOANNE CIR
Lot Size: 52755 SQ. FT.
Total Bedrooms: 3 Permit Bedrooms: 3
Privy Private Well Water Storage
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
(907) 343-4744 ( 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.
aG�lyk% C, k." o�
Received By: (1Cil_Li L,yn L - Date'
Issued By:
Date: 4 —4 —0/�'
ALASKA WATER & WASTEWATER
CONSULTANTS, INC.
August 1. 2000
Municipality of Anchorage
Department of Health & Human Services
Division of Environmental Services
On -Site Services Section
P.O. Box 196650
.Anchorage. Alaska 99519-6650
Ref: DESIGN REVISION. Melinda View, L5. SW000047
To whom it may concern:
Prior to the installation of the subject system it was noted that the groundwater level had rose
significantly since last measured on 3/24/2000. when it was 8 feet below grade. On 7/28/2000
groundwater was measured at 5 feet below grade. which dictates the following design
modifications:
➢ The old bed is encroaching upon groundwater and will have to be abandoned.
➢ The new septic tank will have to be set at a higher elevation, so that gravity flow can be
achieved from the house. This will probably necessitate that the sewer line from the house to
the tank be replaced entirely.
➢ Itwill require that the new bed be place five (5) feet above the groundwater elevation
encountered on 7/28,/00. This will place the bottom of the bed at. or near, existing grade.
The final cover over the bed will be mounded several feet.
➢ We will excavate to a depth of 2 feet (into the SW/GW soil). & install a two feet thick
(minimum) sand filter.
The bed application rate will be changed to 0.7 gpd/sq.fl.. making it 15 feet wide and 43 feet
long. This is an increase of 3 feet over the bed length originally proposed.
If you have any questions, please contact me at 337-6179. Thank you for your assistance.
j�
Sincerely17
l (/
M. S.
6901 Debarr Road, Suite 2-B * Anchoraue_ Alaska 99504
Ph (Q07) 3,37-6179 * Fax (907) 138-31216 * Website ak�c%�c coni
ALASKA WATER & WASTEWATER
CONSULTANTS, INC.
March 27. 2000
Municipality of Anchorage
Department of Health & Human Services
Di\ inion of Environmental Services
On -Site Services Section
P.O. Box 196650
Anchorage. Alaska 99519-6650
Ref: Septic System Upgrade Design for Lot 5, Melinda View Estates Subdivision
To whom it ntav concern:
The existing 3 bedroom house is served by a private well and septic system. The existing septic
system consists of a 1000 gallon septic tank and a bed type drainfield. The existing drainfield is
surcharged and must be upgraded prior to the sale of the house. A test hole was excavated to the
south of the existing drainfield. The proposed septic system NN ill be designed around the 30 foot
radius of the test hole. We are proposing that a new 1000 gallon septic tank and a new bed type
drainfield be installed. Comments regarding the proposed design are summarized as follows:
1. SOILS: Attached is a log which shows the soil classifications, groundwater monitoring. and
the percolation test results. The soils below the organic layers are a S%N' GNC material to a depth
of 6 feet and then transition to a GM material with lenses of silt to a depth of 10.5 feet (bottom of
test hole). Groundw°ater was encountered during the excavation of the test hole at 8.5 feet. The
monitoring tube was checked six days later and found water at 8.o feet. A percolation test was
performed between the depth of 3.0 feet to 3.5 feet which had a percolation rate of <1
minute inch. It is our opinion that the insim sandy soils, and the deeper GNI layer. will act as a
sand filter and that a application rate of 0.8 gallons day ft- should be used.
2. TRENCH DESIGN:
a. Percolation Rate: <1 minutes inch
b. Allowable Application Rate: 0.8 gallons day ft -
c. Number of Bedrooms: 3
d. Design Flow: 450 gallons per day
e. Minimum Absorption Area: 563 ft2
f Total Depth: 3.0 feet (max.)
g. Effective Depth: 0.5 feet
h. Width: 15 feet alfa - CCC..
i. Reduction Factor: N A
j. Minimum Length: 40 feet long
k. Effective absorption area = 600 82
6901 Debarr Road_ Suite 2B -Anchorage, AR 99504 -Ph: (907)'1", -6179 -Fax: (907)3:8-3246
3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed
upgrade.
4. TOPOGRAPHY: As can be seen on the attached topography site plan, the a�eraee
topography of this property is generally flat; in short, there are no slope concerns.
I am unaNyare of any adverse impacts this installation could have on adjacent «ells or septic
systems. If you have any questions, please contact me at 337-6179, or 244-9612. Thank you
for your assistance.
y I�
Jeffr „bb mess, P.E., M.S.
Presi eht
?"OTE. Attached is a site plan dratiring, a design chairing, a topography site plan, a soils lo.-
and
ogand a 7 page construction specification letter irhich are all part of the design package for this
septic system.
6901 Deb= Road. Suite 2B - Anchoraee, AK 99504 -Ph: (907)337-6179 -Fax: (907)338-3246
W LOT 7
LOT 2 MELINDA VIEW EST.
MELINDA VIEW EST.
ry
U
LLJ!
— % /0
LOT 3A
MELINDA VIEW EST. /
I I I I
------ I EPTIC ARtD
LOT 5
MELINDA VIEW EST.
A EXISTING
SEPTIC
SYSTEM
WELL RAD//Us I
+Tfi 1
PROPOSED SEPTIC UPGRADE
LOT 4A — — — — (SEE DESIGN, PAGE 2 OF 2)
MELINDA VIEW EST. EXISTING THREE
UNSUBDIVIDED
NO ENCROACHMENT CONCERNS
3/24/2000
i DRAWN BY:
.Al.ALSKAL «'-TER R NVASTEN ATER SCALE J.L.M.
CONSULTANTS. INC.
6901 DEBARK ROAD, SUITE 2R' ANCHORAGE, A6 99504 • PHONE (907)3376179 • FAX (907)338-3266 1 = 1 DDS
PREPARED FOR PHONE NUMBER: PAGE NUMBER:
IRV AND SUSAN WALKER 562-3073/229-7285 1 OF 2
LEGAL DESCRIPTION:
MELINDA VIEW ESTATES S/D; LOT 5
TYPE OF WORK:
SITE PLAN FOR SEPTIC SYSTEM UPGRADE
m�2
ti J�
p �O
LOT 10, BLOCK 3
EQUESTRIAN HTS
LOT 9, BLOCK 3 -
EQUESTRIAN HTS
TRACT D
EQUESTRIAN HTS
tr 497 'I Nk v;
I
e rej,.,A. ess,�
if Vis .• C�-7953 •' o°<<;
a'�iPO,p�o l e ssio�°�-�=
10' UTILrTY EASEMENT
20' R.O.W. EASEMENT
DATE: oop600p0
!c 'j� 3/24/2000 0 �F
I DRAWN BY:
MASK). «:-TER & «ASTEINATF.R J.L.M. �O �O
CONSULTANTS INC SCALE: 30' .*.. a'(([�!J� ......•'�*.O�D
6901 DEBARR ROAD , SUITE 2B • ANCHORAGE. AK 99504' PHONE (907)337-61]9 • FAX (907)338-3246 I r D
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: J , •..
IRV AND SUSAN WALKER 562-3073/229-7285 2 OF 2 QO .J¢Ffr A. arness; DO
LEGAL DESCRIPTION: O g, —7953 op
MELINDA VIEW ESTATES S/D; LOT 5 Opfer •.,• c�000
TYPE OF WORK: ��eolprofessi00,\��
DESIGN OF SEPTIC SYSTEM UPGRADE ��O0000p��
EXISTING SEPTIC TANK TO
BE COMPLETELY ABANDONED.
EXISTING BED TO BE USED
AS A RESERVE SITE.
100' WE �� RADIUS
I
o
L — — — J
/
INSTALL FLOW
_
DIVERTER
# 1
-0TH
Co CO
/
MT M
oT a
ICO
[co
[co
MT MT
INSTALL DOUBLE
c FnNOUTS
BFS�Ti
o, < do
_ GSF 0
FCO
PROPOSED DRAINFIELD UPGRADE.
— — —
EXCAVATRE A BED THAT IS 3 FEET
PROPOSED
1000 GALLON DEEP MAXIMUM BY 15 FEET WIDE BY
SEPTIC
TANK
40 FEET LONG. PROVIDE A SAND
LEVELING COURSE AS REQUIRED.
ADD 0.5 FEET OF CLEAN,
WASHED SEWER DRAINROCK.
10' UTILrTY EASEMENT
20' R.O.W. EASEMENT
DATE: oop600p0
!c 'j� 3/24/2000 0 �F
I DRAWN BY:
MASK). «:-TER & «ASTEINATF.R J.L.M. �O �O
CONSULTANTS INC SCALE: 30' .*.. a'(([�!J� ......•'�*.O�D
6901 DEBARR ROAD , SUITE 2B • ANCHORAGE. AK 99504' PHONE (907)337-61]9 • FAX (907)338-3246 I r D
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: J , •..
IRV AND SUSAN WALKER 562-3073/229-7285 2 OF 2 QO .J¢Ffr A. arness; DO
LEGAL DESCRIPTION: O g, —7953 op
MELINDA VIEW ESTATES S/D; LOT 5 Opfer •.,• c�000
TYPE OF WORK: ��eolprofessi00,\��
DESIGN OF SEPTIC SYSTEM UPGRADE ��O0000p��
w
J
U
h
of
U2
p
LOT 2 U
w
LOT 7
MELINDA VIEW EST.
0JQ
, e'
MELINDA VIEW fST. Z
Z
Q
0
J�
o�
LOT 1Z—,BtOCK 3
EQUESTRIAN HTS
LOT 3A
-'._
MF,UNDA VIEW EST.
LOT 6 ✓
MELINDA VIEW EST. L
--
LOT 9, BLOCK 3 _
EQUESTRIAN HTS
i'.
W RtDIUS
i
A
LOT 4A--
M NDA VIEW ES �"-�•
TRACT D
EQUESTRIAN HTS
�-AI,AS
WATER AND-WASTEWATER: CONS
, IIYC.
/6901 DEBAAR ROAD, SUT�:---28. ANCHPRAGE, 9504
BNEiFE: (907-) i�179 F 907 -3246
GAL DESCRIPTION:
MEtNDA VfEW/S,l7 (VISION; ;' LPT 51/
-
TYPE OF WOR< i
0GR-APpI /
TO GAL RAVjfNGi ! �� _- -----
-
PREPA FOR: /
V�NV AN/V✓ CKSft
/ . P E NU
7�883��-�
-
i
7E:
BY:
�,,
��; i
��100'
�2QO0/
K.D.W.
��1
F 1
��
ALASKA WATER & WASTEWATER CONSULTANTS, INC.
SOIL LOG - PERCOLATION TEST
LEGAL DESCRIPTION: MELINDA VIEW ESTATES S/D; LOT 5
PERFORMED FOR: IRV AND SUSAN WALKER
DATE PERFORMED: 3/18/2000
DEPTH feet TEST HOLE 1
kk
ORGANICS
~ s
7-
8— . GM WLENSES
OF SILT
91 1n
s.o.x
11
12
13
14
15
16
17
18
19
20
DEPTH TO
DATE
GROUNDWATER
r 1
8.5'
3/18/2000
2�
3/24/2000
SOIL
CLASSIFICATIONS
PROPOSED
GW
ORG
3
EXISTING THREE
G
GP
ML
SITE PLAN
_
sw/cw
GM
CL
• '�;
—
4-
GC
OL
_
I
SW :I
MH
5
SID ��
CH
' :; '•
SM
OH
SC
~ s
7-
8— . GM WLENSES
OF SILT
91 1n
s.o.x
11
12
13
14
15
16
17
18
19
20
DEPTH TO
DATE
GROUNDWATER
r 1
8.5'
3/18/2000
8.0' ----
3/24/2000
DATE
EXISTING
EP
SYSTEM
WELL R/5Dq,S
r 1
WATER LEVEL
READING
L — J+TH#1
3/23/00
PROPOSED
SEPTIC
UPGRADE
EXISTING THREE
G
BEDROOM HOUSE
SITE PLAN
I" = 100'
SORB
P0
DATE
READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
3/23/00
G
SORB
P0
PERCOLATION RATE
TEST RUN BETWEEN
<1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
3.0 FT. AND 3.5 FT.
COMMENTS: THE INSITU SANDY SOILS SHOULD ACT AS A SAND FILTER.
PERFORMED BY ALASKA WATER & WASTEWATER. I, JEFFREY A. GARNESS, CERTIFY THAT THIS
WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON
DATE:
I
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
II ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME G -
IG`1E,; I�eV�lo�'n1et�{-
PHONE
L/ 1 8o
NEW
❑UPGRADE
MAILING ADDRESS
j=, C3 , ho 1I - ? G £i `fi Itn�ly. e r, 6e -i
LEGAL DESCRIPTION -
M E. (oi do. V i C L c- � rj � [- E 1 l 2- j\J IZ-
LOCATION
N0. OF BEDROOMS 41
U y
DISTANCE TO:
Well
/tpi- j n
Absorption area
{ I
Dwelling
Vl b' i 1
PERMIT NO. _
E� z{ Ci . b
1-- Q
w�
Manufacturer /^�
r� ne!-tc,-rte^ L_
Material
5"�--z-� (
No. of compartments
�-
co
Liq. capacity in gallons
-2- S C)
IF HOMEMADE:
Inside length
Width
Liquid depth
Z
DISTANCE TO:
Well
Dwelling
PERMIT NO.
= Z F
Manufacturer
Material
Liquid capacity in gallons
J =
w
DISTANCE TO:
Well
Vt u {- In
Foundation , n
Nearest lot line ��
PERMIT NO. (i J
J u. z
zw
a — �
No. of lines •fir
Length of each. line
2 3
2 �
Total length of lines
� � �
Trench width
;_)i �, inches
Distance bet en lines
6
f
O
Top of tile to finish grade N
"'CxieLnel Lp�el
Material beneath tile f
6 inches
Total effective absorption area
G(G. r
LU
c�
Length
Width
Depth
PERMIT NO.
Qa i- -
W
Type of crib
Crib diameter
Crib depth
Total effective absorption area
LU
DISTANCE TO:
Well
Building foundation
Nearest lot line
J
-
W
ClassX,, C/
Depth
Driller
Distance to lot line
PERMIT NO.
�
DISTANCE TO:
Building foundation
Sewer line
Septic tank
Absorption area (s)
OTHER
PIPE MATERIALS
(t V [
SOI L TEST RATI Nye
� ina i3
INSTALLER
f
0�
3
3
REMARKS
s 3%n
®
Lcp bII ..LLde�cte.
tr,�-4 1/1$tiIcJ,!` Lam`. %,n&c,kkv,�flw1
1�
,.{ M CIA 11 CL pie
ev 4 j
i�
l
APPROVED - DATE LEGAL
IZ 3/,61f Me1„\JIL V.tw LrA_5 $ec3:'Tj2NR--AL/
Z -V i 0 1 nuv. 0/761
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION RIIEPORT
NAME Fe
je.`; I -eve �U�%f�er'1�
Pic!
zvv
)GRADE
MAI LING ADDRESS
P. v , lea 11 - a G b `f Anchors e It q S-1 I
LEGAL DESCRIPTION -
Me-uoJo, V (e -,vv Lot S Sec. -3 12-iJ I?-;
LOCATION
JD grtfie- 4�_;rcle-.
NO. OF BEDROOMS
't
DISTANCE TO:
�
Well r1 oA i vj
Absorption area
1 �
Dwelling
�l
PERMIT NO, 6 _
�J 4 f� �i
O
Vt U'� +
_Y
F- Q
Manufacturer /�
A r\ I1 o rc� ^
Material
S
No. of compartments ^^77
w F
C_ �_
vim•
ti
Liq, capacity in gallons
-L
IF HOMEMADE:
Inside length
Width
Liquid depth
�—'
DISTANCE TO:
Well
Dwelling
PERMIT NO.
Zh
Manufacturer
Material
Liquid capacity in gallons
D
DISTANCE TO:
Well
not` in
Foundation
h;,•}- "n
Nearest lot line7.
�J
PERMIT NO. D d 6
8
Lu
U
uj u Z
No. of lines 5
Len th of eac .line
Total length of lines
Trench width
Distance bet en lines
f z Lu
2 z 3 1(j
I b
I inches
6
Top tile to finish
Material beneath
CCF.
of grader
tile /
Total effective absorptionarea
aroLoul LewI
Inches
612. E7
Length
Width
Depth
PERMIT NO.
w
t7
Q F-
Type of crib
Crib diameter
Crib depth
Total effective absorption area
Lu a
w
W
DISTANCE TO:
Well
Building foundation
Nearest lot line
Class
%V
Depth
Driller
Distance to lot line
PERMIT NO.
r
O c
w
�
DISTANCE TO:
Building foundation
Sewer line
Septic tank
Absorption area(s)
OTHER
PIPE MATERIALS
SOIL TEST RATI%j
_
INSTALLER `'. eyes V2�ck-�mtz,t EK H`f G�•,
-HO
F
REMARKS
f7zSr h SV S 61 Ji x --jD we.tjcr Iz_ j r t l n
in+�e W ins�lcd-c'dr,:. �'� ,`ns�ti«`h'o:
� ` ®�
y+
L iLL
APPROVED DATE LEGAL
12/,/B I I"\ek„\dw �,c 35 rjZNP-;I'
�_.s
WELL LOG
Date Drilledi 7••30-S
Lor. 5 0
Melinda View
37-fFrt to 43 (rev clnv r
�I.
_[,F�, fFet to 83 CrPyy1xy. hrEVPl
t
33 frit to _170 nearnrk
MUNICIPALITY
FNVIRONt,4 pp�EgLNHHORAGE
Hefty Drilling oNnnerNTAL PROrecrloN
S.R.A. Box 1553 H : JAN 9 1989
Anchorage,Alaska. PECE( l ED
99507
P1,4A�`lni ncAp a rit > Route r6 650
x v= ANCHORAGE, ALASKA 99502-0650
a ate
�. (907) 7.04-111
ARic horage 10 NY KN0VILFS,
-� MAYOR
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
Permit #: 840863
January 31, 1985
TO: Permit Applicant
SUBJECT: Lot 5 Block NA Melinda View Estates Subdivision
A permit issued by this Department for an individual well
and/or on-site sewer system has expired as of December 31,
1984.
Permits are issued on a calendar year basis by authority
of Municipal Ordinance. A new permit must be obtained from
this Department for any well and/or on-site sewer system not
installed by the expiration date.
If you have drilled the well, a well log needs to be sent
to this Department for documentation of the installation
and to close the permit.
If a private engineer inspected the installation of the
on-site sewer system, the original as -built inspection report
and the yellow copy must be sent to this office for review
and approval, and for documentation.
If there are any further questions, please call this office
at 264-4720.
Sincerely, Ft,_�Su
Keith E. Band� or
P
Environmental Engineering Program
KEB/ljw
enc: Copy of Permit
SwP/057
^
][ F,����][ � �^ Ell
. DEPARTMENT OF HEALTH AND ENV IRQNMEN~�L PROTECTION
825 L STREET, ANCHORAGE, AK 99501
264-4720
^�=
���—�1 �� �WW�� � ����� ��������� `
PERMIT NO: 840863 ENGIE—
ED DESIGN
DATE ISSUED: 10/11/84
^
APPLICANT: FEJES DEVEL8PMENT~
ADDRESS.. PO BDX 11-2009 �� ^s
'ANCHORAGE, AK 99511
CONTACTpHONE: 349`8O11
LEGAL DESCRIP: SUBDIVISION: MEL'INDA VIEW ESTATES LOT: 5` BLOCK: N/A
SECTION: 35 TOWNSHIP: 12N RANGE: 3W
LOT SIZE: 52755 (SQ.FT. OR ACRES)
I certify that: �
1" I am {amiliar with the requirement fit '
�o'th by the Municipality 6' Anchosa o'(on�s e sewe's and weYls as set
2" I will install the syste� in a�co ' ge �UH| and the State o| Alaska,
and in compliance with the desi roance wzt� all MOA codes and regulations,
gn criteria of this permit
3. I will adhere to al lMOA and State o| Alaska requirements^for the set back
distances from any existing well, ' astewate��isposal system or public
sewerage system on this or any adjacent or nearby lot" `
IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES
THEN (1) AN ELECTRICAL PERM�
IT AND �NSPECTION MUST B� OBTAINED; (2) �
AS B�uILTS
W1.1.1. NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTI~N REPORT; AND (3)TE
ELECTRICAL WORK MUST BE DONE Bv A LICENSED ELECTRICAN" n
SIGNED
`DA]E:
~�-._��_�~�.
�APPLICANT: FEJES m ~~~
_
ISSUED BY ^
�^ � DATE:
^..... ..... �~..... ..... ....��~�-���__
ALASKA 07dROWI]TAL CONROL SCI ufUS, Inc.
Cngineerinq & Enuironmental Studies
SPECIFICATIONS FOR ALTERNATIVE WASTEWATER TREATMENT SYSTEM — MFLINDA
VIEW SUBDIVISION, LOT 5
1.0 GENERAL
1.1 THE DRAWINGS, SHEETS 1 THRU 2, SHALL BE PART OF THIS
SPECIFICATION.
1.2 ALL MATERIALS AND WORKMANSHIP SHALL MEET THE
REQUIREMENTS OF ANCHORAGE DEPARTMENT OF HEALTH AND
ENVIRONMENTAL PROTECTION PERMIT.
1.3 ALL EXCAVATIONS AND DEPTHS ARE ADVISORY AND ARE TO BE
VERIFIED IN THE FIELD BY THE CONTRACTOR.
2.0 THE LIFT STATION (NOT USED)
3.0 SEEPAGE BED
3.1 THE GRAVEL FOR THE BED SHALL BE SCREENED TO THE SIZES
INDICATED; 0.5 TO 2.5 INCHES.
3.2 THE BOTTOM OF THE EXCAVATION SHALL BE RAKED WITH THE
BACKHOE BLADE TO INSURE THAT THE BOTTOM HAS NOT BEEN
COWACTED DURING EXCAVATION.
3.3 TWO OBSERVATION PIPES SHALL BE PLACED AS SHOWN IN THE
DRAWINGS. THEY SHALL BE RIGID PVC, ASTM 3003 D-3034.
THE SECTION SHOWN WITH HOLES MAY BE EITHER DRILLED 0.5"
HOLES @ 6 INCH CENTERS ON OPPOSITE SIDES OF THE PIPE
OR A SECTION OF REGULAR PERFORATED SEWER PIPE MAY BE
CLAWED TO THE SOLID SECTION WITH A NO HUB COUPLING OR
SOLVENT JOINT. A RUBBER RAIN—CAP (JIMCAP OR EQUAL)
SHALL BE PLACED ON THE TOP OF THE PIPE.
3.4 INSULATION,IF ANY SHALL BE DOW EXTRUDED BLUE STYROFOAM
BOARD OR EQUIVALENT.
3.5 THE TOP AND SIDES OF THE BED SHALL BE PLANTED WITH A
WHITE CLOVER AND RED FESCUE MLX OR BLUE GRASS.
3.6 THE SEPTIC TANK OF BED IxVST NOT BE CLOSER THAN 100 FT.
TO ANY EXISTING PRIVATE WELL OR BODY OF WATER AND SHALL
BE NOT CLOSER THAN 150 FEET FROM EXISTING CLASS C WELLS
OR 200 FT FROM ANY CLASS A OR B WELL.
3.7 THE DISTRIBUTION PIPE SHALL BE 4 INCH RIGID PVC OR
POLYETHYLENE. THE PIPES SHALL BE LAID LEVEL.
3.8 THE BERM AROUND THE SEEPAGE BED SHALL BE CONSTRUCTED OF
IMPERPEABLE MATERIAL, AND ON A SLOPE OF 1 FOOT VERTICAL
TO 3.0 FEET HORIZONAL.
3.9 THIS DESIGN WILL REQUIRE TWO (2) INSPECTIONS BY AN AECS
ENGINEER TO ENSURE OUR RECOMMENDATIONS OF DESIGN HAVE
MUNICIPAUTY OF ANCHORAGE BEEN FOLLOWED. IF AECS DOES NOT INSPECT THIS
DEPT. OF HEALTH & INSTALLATION, AECS WILL NOT BE RESPONSIBLE FOR ANY PART
ENVIRONMENTAL PROTECT10" OF THIS DESIGN.
OCi 41984
REC�`V ED.
1200 West 33rd Auenue, Suite B • Anchorage, Alaska 99503 • (907) 561-5040 P J �/ �/
�.JJNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
1�
• $25 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG — PERCOLATION TEST
PERFORMED
LEGAL DESCRIPTI
1
2 ®_ •
R
3
•
4
5
6
7
a
11
t
12
13-
14-
15-
16-
17
31415 16 17 �.••
18-
19
8 19 a
Ft ie--
)N:
e->N:c, leW hit S�% iew G.ot S
SLOPE
0 crslar.ic So t
C'W nice �l t -AV Q 1
'42-o en q-'�- 4
ML 5i1�—��,.
ov. Ci -Irk- �uN
LOP0 C. Reid, Jr.
'•� No. 2251•E
ti
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Elm
❑ PERCOLATION
TEST
DATE PERFORMED:
7 H•�
lit
SITE PLAN
1
R
Rea
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
UISu AL•
�' T ' V�
20 r
PERCOLATION RATE �,.•.,:�f;niautes/inch)
v ,
^ ( 1 TEST RUN BETWEENSOT AND
V"'L-Ei
COMMENTS SO�� l,••`^''.'1. -aa i� r/.�T� if tat 'Up
PERFORMED BY: ��` M0p i 9 y o) i CERTIFIED BY: i DATE
72.008 (6179) / - ''. 1,.. • • •' • ,' .
a.
�° y�y
ALASKA ENVIRONMENTAL
'CONTROL SERVICE INC.
1200 West 33rd Avenue\-�uite B
ANCHORAGE, ALASKA 99503
Phone 561.5040
JOB LOi S /ill diad;: (/,'Ci✓
SHEET NO. OF 2
CALCULATED BY —aDATE
7 1�2'7'
CHECKED BY DATE
SCALE IV/S
61nEs✓ IK. Coln km 0:47I.
pay
?a'
61nEs✓ IK. Coln km 0:47I.
pay
ALASKA ENVIRONMENTAL
'CONTROL,SERVIC[ 'NC.
1200 West 33rd, Avenue— -.uite B
ANCHORAGE, ALASKA 99503
Phone 561-5040
JOB InC 11%-Id,yilt, (Ut 5 -
SHEET SHEET
OF
2 -
CALCULATED BY 2 at, DATE
CHECKED BY
DATE
MUNICIPALITY OF ANCHORAGE
I
Development Services Department A' Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel 1. D. 017 092 42
1. GENERAL INFORMATION
Expiration Date: ^ 2D
2-0
Complete legal description MELINDA VIEW ESTATES LOT 5
Location (site address) 14601 JOANNE CIRCLE
Current property owner(s) Meyer Day phone
Mailing address
Real estate agent Day phone
2. TYPE OF DWELLING:
El Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY:
Private Well
Water Storage
Community Well
Public Water System
Waiver request for:
TYPE OF WASTEWATER DISPOSAL:
El
Private Septic
0
❑
Holding Tank
❑
❑
Community
❑
❑
Public Sewer
❑
Received by: Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ 566
Date of Payment i lg lao
Receipt Number N54gb
COSA# (5C ag6/60 5
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
Distance:
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 C&M ENGINEERING
Address 20182 TULWAR
Engineer's Printed Name CHARLES BALZARINI
6. DSD SIGNATUREiref
System #1 Approved for 3 bedrooms �V+
IN
System #2 Approved for bedrooms
Disapproved
Phone 8545558
Date 1/4/2020
Qoes
TH
CHARLES G BALZARIHI '0'
6, CE -13854
,W,F PROFESSIO*
Conditional approval for _ /f bedrooms, with the following stipulations:
IVGkU"J -/� D�eClc
n
' .moi• t � ;i/ � � ,
CL�s� J `1411-�l7r p
01,47P
%G � Jr'Srtr. 6
Original Certificate Date:
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the
representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is
not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA Checklist blue sheet
Legal Description: Melinda View Estates Lot 5
If more than 1 septic system on lot: COSA Checklist # 1 of 1
A. WELL DATA
❑ Well log is filed with Onsite (or attached)
Date drilled 7/85
Total depth 170 ft
Cased to 83 ft
❑ Sanitary seal is functioning correctly
❑ Wires are properly protected
Casing height (above ground) +12 in.
Date of flow test for COSA 1/3/20
Parcel ID: 017 092 42
Structure served by this system 1
Well production at time of test +1.65 qpm
Water storage tank volume NA gallons
Well disinfected for coliform test? ❑ Yes ❑ No
❑ Coliform bacteria is Negative
Nitrate 1.74 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L ❑ Arsenic less than MRL (ND)
Collected by C.Balzarini
Date of Sample 12/26
Static water level at beginning of test 62 ft.
Comments well casing/hole volume provides up to approximately 150 gallons of water storage.
B. TANK DATA
Age of tank(s) 19 years
Tank type/material steel
Measured operating fluid level in septic tank 49.5"
❑ Standpipes/foundation cleanout per record drawing
Date of pumping 4/15/19
D. ABSORPTION FIELD DATA 2000, Bed
Which system tested (date installed) 812000
❑ ALL standpipes present per record drawing
Total measured depth from grade 4 ft (max)
Measured depth to pipe invert from grade 3.5 ft (min)
❑ N/A — pressurized field
❑ 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
C. LIFT STATION
❑ Required maintenance completed
Age of lift station years
Lift station material
Comments: no lift station
Adequacy test date 1/3/20
Results ¢❑Pass For 3 bedrooms
Fluid depth prior to test 0 in
Water added 450 gal
New depth 0.5 in
Elapsed time 10 min
Final fluid depth 0 in
Absorption rate 450 gpd
Any rejuvenation treatment (past 12 months) na
If yes, enter date na
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 +5
Community Sewer Manhole/Cleanout > 100'
1747 Yes
if No
ft
Yes
if No ft
Neighboring Tank > 100' 174-1 Yes
if No
ft
Private Sewer/Septic Line > 25' Yes
if No ft
Absorption Field on Lot > 100' Q Yes
if No
ft
Holding Tank > 100' F Yes
if No ft
Neighboring Absorption Fields > 100'
Water Main > 10'
Q
Animal Containment > 50' a❑ Yes
if No ft
M Yes
if No
ft
Water Service Line > 10'
Yes
if No
ft
Manure/Animal Excreta Storage > 100'
comment below
Community Sewer Main > 75' M 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'
❑ Yes
if No +5
ft
Surface Water > 100'
Q Yes if No ft
Property Line > 5'
Q
Yes
if No
ft
Wells on Adjacent Lots:
Absorption Field > 5'
Yes
if No
ft
Private Wells > 100'
Q Yes if No ft
Water Main > 10'
Q
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' El Yes if No ft If absorption field is under driveway comment below
Property Line > 10' M Yes if No ft Wells on Adjacent Lots:
Water Main > 10' Q Yes if No ft Private Wells > 100' E] Yes if No ft
Water Service Line > 10' Yes if No ft Community Wells > 200' 0 Yes if No ft
Surface Water > 100' Q Yes if No ft
F. ENGINEER'S COMMENTS
The deck posts appear to be supported by deep foundations.
It does not appear that the tank location impacts the stability of the deck
G. ENGINEER'S CERTIFICATION
l 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. 1/10/20
COSA Checklist yellow sheet
c�: OF A/,co
��is�l
AQ •. ��
CHARLES G BALZARINI
��cisTF�• C 5 •����,�'
��1�F�PROFESS\* N*
Ph: 907-854-5558
RE: Conditional COSA for Melinda View Estates Lot 5
Mr. Ecklund,
The above referenced property is served by an onsite septic system. We performed well and septic
adequacy testing and submitted a COSA application. During your department's review, it was noted that a
deck foundation post encroaches on the septic tank location.
We are requesting approval of a conditional COSA, with the stipulated condition being the removal or
relocation of the offending deck post. Alteration of the deck structure will require a permit. We intend to
submit a permit application on the owner's behalf as soon as engineering calculations and plans can be
finalized.
The proposed scope of repair is to re -locate the deck post and install a new sonotube foundation in a
manner that bearing forces could not act on the tank. The new support will either be more than 5' from the
tank, or will distribute bearing forces into the ground below the tank.
The department has suggested a completion date of 6/1/2020, which is a reasonable timeframe for
completion of the work.
The existing deck structure is small and has redundant supports which would prevent it from collapsing if
the tank collapsed before the repairs could be made. The deck support is also unlikely to damage the
tank due to the low magnitude of loading at the post in question when compared to the loads that a buried
septic tank is designed to withstand. There is no depression or signs of leakage that would indicate the
tank is structurally compromised. The encroachment has also been present since before the previous
COSA and survey were completed in 2016.
For those reasons, we have determined that the current configuration does not present an immediate risk
to health or safety.
It is understood, that should the new owners decide to replace the steel septic tank, a permitted and
approved tank replacement would also satisfy the stipulated condition.
Please do not hesitate to contact me at 907-854-5558 or by email cgbalzarini(a)gmail.com with any
questions or concerns.
Sincerely,
Charles Balzarini, PE
Loan #RANC055935
ESCROW HOLDBACK REQUEST
Borrower: Katriina M Timm Date: 1/15/20
Property: 14601 Joanne Circle, Anchorage, AK 99516
Due to the time of year and current weather conditions, it is not possible to complete the
following required items:
Per Conditional COSA-Structural remedication for removal
of support over 20 _year
old septic tank (deck posts over septic to be moved).
No Money will be released until MOA approval.
Itemized bid for completion of above items (Bids Attached):
Highest Bid:
From: Muni
Amount: $5,000
5,000.00
Request approval of 1.5 times (2 times if well/septic item) to be escrowed at closing:
Bid x 1.5= $ n/a
Re -inspection Fee $ n/a
Total Escrow
To be paid by:
$ 5,000
Buyer x Seller
Loan Originator/Processor: Cecilia Jarvis
Lorne Pinkley
Underwriter L a 1/14/2020
_Patdciff Brown Date
Approved Escrow Amount: $ 5,000.00
Work to be completed by: 06/01/2020
Escrow Holdback Request
Rev 01/19
/ ti 3
�`o/ �101(Q
SEP 2 ®2016
a #c s o
1• '�
Municipality of Anchora =�
On -Site Water and Wastewater Program
(907) 343-7904 <
ZOl�4�9
Certificate of On -Site Systems'Approval /
Parcel I.D. 017-092-42 Expiration Date:
1. GENERAL INFORMATION
Complete legal description
Melinda View Estates Lot 5
Location (site address) 14601 Joanne Circle
Current Property owner(s) Steve and Athena Clapp Day phone
Mailing address 14601 Joanne Circle Anchorage, AK 99516
Real Estate Agent
2. TYPE OF DWELLING:
El 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
TYPE OF WASTEWATER DISPOSAL:
E
Individual
0
❑
Holding Tank
❑
❑
Community
❑
❑
Public Sewer
❑
-Received by:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ Sa& Waiver Fee $ _
Date of Payment Date of Payment
Receipt Number ��J?G�� Receipt Number.
COSA # 06C Waiver #
5. STATEMENT t 1NSPjCTION 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 Certfficate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater
disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that
based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply
and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at
the time of installation.
In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA
guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test,
and separation distances measured to readily identifiable features. The operational fife of all wells and septic systems depend on the local soil
condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions -
are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future
performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty
for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed
above.
Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218
Address P.O. Box 100217, Anchorage A. 99510
Engineer's Printed Name Steven R Pannone
6. DSD SIGNATURE
System #1 Approved for a_ bedrooms
System #2 Approved for bedrooms
Disapproved
Date 09/15/2096
Conditional approval for bedrooms, with the following stipulations:
QOriginal 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 engineers work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory -
Septic System Advisory Arsenic Advisory "
Well Flow Advisory Other
COSAbluesheet t !., c
1
N more than 1 septic system is on the lot-
COSA Checklist # + of +
Structure served by this system 1
Certificate of On -Site Systems Approval Checklist
Legal Description: Melinda View Estates Lot.5 Parcs"D_ 017-092-42
A. WELL DATA
Well type Private If A, B, or C provide PWSID # Well Log (Y{N) YY
Date completed 7/30/1985 Sanitary seal (Y/N) Y Wires properly protected (Y/Hy Y
Total depth 170 ft. Cased to 83 ft. Casing -height (above ground) .12+ in.
FROM WELL LOG AT INSPECTION
Date of test 7/30/1985 9/9/2016
Static water level 58 ft. 64 ft.
Well production 2 g.p.m. 11+
g.p.m.
WATER SAMPLE RESULTS: L ,
Coliform colonies/100 mL Nitrate mg/L �^'
Arsenic /J, 6 ug/L Date.of sample: V -w I (a Collected by: P G S
B. SEPTIC/HOLDING TANK DATA . .
Tank Type/Material Septic/Steel Date installed 8/9-20/2000
Tank size 1,000 gal. Number of Compartments 2 Cleanouts (Y/N) Y
Foundation cleanout (Y /N) Y Depression over tank (Y/NY N High water alarm (Y/N) N
Date of pumping. 9/8/16 Pumper A+ :Home Services
C. ABSORPTION FIELD DATA
-
Date installed 8/9-2012000 Soil rating (g.p.d./ftp or#t2/bdrm) 0.8 GPD/SF System type Bed
Length 43 ft. Width 15 ft. Gravel below pipe 0.5 ft.
Total depth 4.1 . ft. Eff. absorption area 645 ftz Monitoring tube Y Depression over field N
Date of adequacy test 9/9/2016 Results (Pass/Fail) Pass For 3 bedrooms '
Fluid depth in absorption field before test 0/3* in. Water added 471 gal. New depth 0/4*in.
Elapsed Time: 150 min. Final fluid depth 0/3 in. Absorption rate >=450+ g:p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date
D. LIFTSTATION
Date installed Size in gallons Manhole/Access (YM)
"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 LOTTO:
Septic tank/lift station on lot 100+ On adjacent lots 0D+
Absorption field on lot 100+ On adjacent lots 100+
Public sewer main 75+ Public sewer manhole/cleanout 100+
Sewer/septic service line 25+ Holding tank 100+
Animal containment areas 50+ Manure/animal excrete storage areas 100+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5+ Property line 5+ Absorption field 5+
Water main10+ Water service line 10+ Surface water 100+
Welis on adjacent lots 100+
ABSORPTION FIELD ON LOT TO:
Property line 10+ Building foundation 10+ Water main 10+
Water Service line 10+ Surface water 100+ Driveway, parking/vehicle storage -10+
Curtain drain 50+ Wells on adjacent lots 100+
F. COMMENTS
*Southeast monitor tube had water. All other monitor tubes were
out entire test.
G. ENGINEER'S CERTIFICATION
I certify that f have determined through field inspections and
review of Municipal :records that the above systems are in
conformance with MOA COSA guidelines in effect on this date.-
Engineer's
ate:Engineer's Printed Name Steven Pannone
Date 9/17/2016
COSA canary sheet -2-6-1 5.doc,
f
PLAT NO, ;.
MELINDA VIEW ESTATES SUBDIVISION
LOT 5
a
M
Fx-
20' ROW FSW.
(BK 1 Z3, PG 93)
N 89aa8'"% 331.26'
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BUILDING DETAIL
=v. 1 "-2Q'
1fi
MABUSHNG BOUNDARY OR
ANCHOWE RECORD= " al ALAS
INOTE.u M MONERST"I'SDATE
ar�a
o
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a'^rear• Y r ♦1 aY rMrit� .
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P ��i wr«its j/Yj isir"5�,
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES 41
Division of Environmental Services dhi2,
On -Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
(907) 343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILLY DWELLING
Parcel I.D. # --C92-42 HAA #�-
1. GENERAL INFORMATION
Complete legal description VF; "7F 'I I; N
Location (site address or directions)
Property owner �AN Day phone = --_-- --
Mailing address �oAN'NF C'RC' _ �C5
Lending agency Day phone
Mailing address
Agent - �. __ _ - -_,. :�� <=,�-x = Day phone --_-
c�
Address ==- `= _-',7
Unless otherwise requested. HAA will be held for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual well .Al
Community well
Public water
NOTE: If community well system, provide written conr-irmation from State AGEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
Individual cn-site
Hclding Tanis
Community on-site
Public sewer
NCi I E. If CCmmunity 'NaSte'lJater S VsrCm. -IC `'.ade vin :an CCni �C :,ariCn --cm, Stag.-' E t'_-
:he I�'!'�li' 1 sand S'2[ -1'S Cf SyS er7'.
ev. ',ICA e_,cn
Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $1,270.00 at,
or prior to, closing for the engineering services provided.
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply and/or
wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of
structure indicated herein. I further verify that based on the information obtained from the Municipality of
Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater
disposal system is in compliance with all Municip l and State codes, ordinances, and regulations in effect
on the date of this inspection. 1
Name of Firm ALASKA WATER 8 WA'SrrEWAirER CONSULTANTS INC._ Phone 907 337_6179__
Address 6901 DEBARK ROAD,S�+l• E k6 Rt HORAGE ALASKA 99504
Engineer's Signature 7 ✓ _Date�r C (t. _ _
In conducting this evaluation, AWWC, l a i pled to provide a thorough, conscientious engineering analysis of the
system in accordance with ADE C and OA D HS Guidelines & Regulations. The reported results described the
performance of the system under the conditions encountered at the time of the test, and separation distances
measured to readily identifiable features. The operational life of all wells and septic systems depend
on the local soils condition, ground water levels that may fluctuate during the year, and the water
usage of the family being served by the system. These conditions are outside the control of
the evaluator of the system. Satisfactory test results do not guarantee future performance o OF :4'
of the system, nor do they guarantee that there are no hidden defects or encroachments. O ��•' %J �.
AWWC, Inc. can therefore not provide any warranty for future estimate of how long the ��l
system will continue to meet the operational requirements of the ADEC or MOA DHHS.° .:. i, , • • • • , , , : ?, :.
The content of this report is for the sole benefit of the owner listed above. Any
reliance upon or use of this report by any other person or party is not authorized, / . L ..... ..
nor will it confer any legal right whatsoever. O�� _c
NIr n as/
6. DHHS SIGNATURE 9. I'•. l CL -795
p sf
Approved for 3 bedrooms �p o
�t\a Pr o f e s sio`oo
Disapproved
Conditional approval for
Additional Comments
bedrooms, with the following stipulations:
By: I% /� ._, ��/, I �c �'� ----Date- Q C
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of
homes and their lending institutions in order to satisfy certain federal and state requirements. Employees or
DHHS do no[ 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.
724)25 (Rev_ 1/31) Hack MOA ,.`21 Computer Version
Municipality of Anchorage RECEIVE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Environmental Services Division $Fp 2 5 2000
825 "L' Street, Rm 502 Anchorage, Alaska 99501 (907) 343-47aa
ik
MUNICIPALITY OF ANCHORAGE
Health Authority Approval ChecklisP01144VOENTAL SERVICES DivisioN
Legal Description: MELINDA VIEW ESTATES S/D; LOT 5 Parcel I.D.: 017-092-42
A. WELL DATA
Well Type PRIVATE If A, B, or C, attach ADEC letter. ADEC water system number N/A
Log present (Y/N) YES Date completed 7/30/85
Total depth 170' Cased to 83' Casing height (above ground) 19"
Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES
FROM WELL LOG AT INSPECTION
Date of test 7/30/85 3/20/2000
Static water level
Well production 2.0 g.p.m. 0.50 g.p.m.
WATER SAMPLE RESULTS:
Coliform p Nitrate 0.500 mg/L Other bacteria 0
Date of sample: 9/15/2000 Collected by: A.W.W.C., INC.
B. SEPTICIHOLDING TANK DATA
Date installed 8/9-20/2000 Tank size 1000 Number of Compartments 2 Cleanouts (Y/N) YES
Foundation cleanout (Y/N) YES Depression (YM) NO High water alar (YM) N/A
Date of Pumping NEW Pumper
C. ABSORPTION FIELD DATA
*BELOW FINAL GRADE. 2.1 FEET OF M.O.A. APPROVED
SAND FILTER INSTALLED BELOW TOTAL DEPTH.
Date installed 8/9-20/2000 Soil rating 4iii�or ft2/bdr) 0.8 System type BED
Length 43' Width 15' Gravel thickness below pipe 0.51' Total depth *4'-5'
Effective absorption area 645 SQ. FT. Monitoring Tube present (YM) YES Depression over field (Y/N) NO
Date of adequacy test NEW Results (Pass/Fail) — For 3 Bedrooms
Fluid depth in absorption field before test (in.); — Immediately after --gal. water added (in.): —
Fluid depth — (ins) Minutes later.
Peroxide treatment (past 12 months) (YM)
724Y26 (Rev. 3196r C Puoer version
Absorption rate =
If yes, give date —
D. LIFT STATION
Date installed
Manhole/Access (Y/N)
High water alarm level at'
"Datum
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot 100'+
Absorption field on
Public sewer main
Sewer/septic service line
Size in gallons
"Pump off" level at'
adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cleanout N/A
Lift station
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
A
Foundation 5'+ Property line 5'+ Absorption field 5'+
Water main/service line 10'+ Surface water/drainage 100'+ Wells on adjacent lots 100'+
SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+
Surface water
Curtain drain
F. ENGINEER'S
I certify that I
of Municipal n
with MOA HA,
Signature
Engineer's
Building foundation 10'+ Water main/service line 10'+
NONE KNOWN
f3C�
HAA Fee $ �
Date of Payment S- 0L)
Receipt Number b (n -5q(- ��q
72-028 (Rev. 3/98)' Computer Version
Driveway, parking/vehicle storage area 50'+
spections and review
7s are in conformance
date.
Wells on adjacent lots
Waiver Fee
Date of Payment
Receipt Number
100•+
r
8 A. �ng,,s:
-7953 �O
••.. ..••' E°o'er
Prof e s slon°a
MUNICIPALITY OF ANCHORAGE
• DEPARTMENT OF HEALTH & HUMAN SERVICES y
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. # Q- Li_A HAA # __ kA Pk q 'SCC (
1. GENERAL INFORMATION
Complete legal description rr)t-g• Mal inrla lie, > t_tQdivas.
Location (site address or directions) 14601 JnAnne ci rrl a An hor Qe, Al As a
Property owner Lori Reesman Day phone 345-2273 hm
272-7515 wk
Mailing address 146017nAnne CircleAnrhorageg Alaska Qg516
Lending agency Day phone
Mailing address
Agent Day phone
Address
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
3 V
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site xxx
Holding tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1/91) Front MOA N21
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm S & S ENGINEERING Phone
17034 Eagle River Loop KOad No. 204
Address Eagle River, Alaska 99577
Engineer's signature
6. DHHS SIGNATURE 3�J
i c Approved for bedrooms.
Disapproved.
Conditional approval for
Additional Comments
.,
0
7umr
Date 2 — — 3
jN,
ryj 3,
i3
J
??#So?36A1R41cs'tera?�. o
bedrooms, with the following stipulations:
Date
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in 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 (Rev. 1/91) Back MOA 1121
Municipality of Anchorage
Department of Health & Human Services _
HEALTH AUTHORITY APPROVAL CHECKLIST D
Legal Description: &TrjAJllu%iA- Lgw_ + Parcel I.D.
A. WELL DATA
Well type IOA-7E If A, B, or C, attach ADEC letter. ADEC water system number J/A
Logpresento/N) LJFS Date completed 3O 85 Driller �IwI�L
Total depth Po Cased to (63 Casing height (�1
Sanitary seal (Y/N) YES Wires properly protected/N) I
FROM WELL LOG AT INSPECTION
m
Date of test 30 �c 7Z 7,
0
Static water level yl n m b
Well flow a g.p.m. J.o 9.p. P.G.
I
Pump level 11�Ic a � 1>
to � s z
SEPARATION DISTANCES FROM WELL TO: ®
/ rJ rn m
Septic/holding tank on lot �3O On adjacent lots ���
Absorption field on lot I y� ' ; On adjacent lots loo ri
Public sewer main N/4 Public sewer manhole/cleanout /J/4
Sewer service line Petroleum tank OPS /UOwi
WATER SAMPLE RESULTS!
'JJ rn QT
Coliform 0 Nitrate vL �� t `e Other bacteria
Date of sample: a - ar2,- � 3 Collected by: S� E CN&G"s&fQIy,-
B. SEPTIC/HOLDING TANK DATA
Date installed ��-�- �( Tank size (,kL- Compartments
C�
Cleanouts (ON) Foundation cleanout&/N) Depression (Y/(!P f "o
High water alarm (Y/0I Alarm tested (Y/N, /\.J!//h
Date of pumping o�-� Pumper A+ lids Sl�VIcr_-S
SEPARATION DISTANCES FROM SEPTICAq5104NG TANK TO:
Well(s) on lot 1110 On adjacent lots /�0 l / Foundation
To property line 161 Absorption field Water main/service line
Surface water/drainage (00'4
72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE
T STATION
Date insta fV
Size in gallons
Vent (Y/N) _ "Pump " level at
High water alarm level
Meets MOA electrical codes (Yl
Manufacturer
Manhole/Access (Y/N)
SEPARAT-FO-N DISTANCE: FROM LIFT STATION TO:
Well on lot On adjacent lots
D. ABSORPTION FIELD DATA
mp off" level at
Cycles tested
Surface wa
Date installed --Ph , Soil rating �n� S ��f�R System type
Length Width Gravel thickness Total depth _
Total absorption area — 6 (a SF J Cleanouts present 6_1A �%y
Depression over field (Y/6I)
N1)
Date of adequacy test 2
Results (Paas/fail) L S for
Peroxide treatment (past 12 months) (Y,f M6 r kNowl If yes, give date
bedrooms
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot On adjacent lots ��0 r Property line /O _
NIATo building foundation r _ � 3 To existing or abandoned system on lot
On adjacent lots Cutbank N�/� Water main/service line �6 _
Surface water ICiO 'f Driveway, parking/vehicle storage area Sd
Curtain drain 900w,1.
E. ENGINEER'S CERTIFICA'T'ION
I certify that 1 have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
5 °t 5 E-NGiNEERtNG
17034 U gle Rivev Loop Road No. 204 � � �l'
Signature fi, � fir,
a_9 a liar, ` ag R 99577 JJll
P tl rl j -i 3a�l'�
Engineer's Name
Date
HAA Fee $
Z 0, -
2- :- q-5
Date of Payment Z_ 1� C,�%
Receipt Number 2 yL'C� Ot ` �
72-026 (Rev. 3/91) Back MOA 21
Waiver Fee: $
Date of Payment
Receipt Number
�' o L:IJ
`l<Cj,)�i pe�o"ac f
e{r.,� c':z ri
MUNICIPALITY OF ANCHORAGE
• -� Department of Health & Human Services
DIVISION OF ENVIRONMENTAL SERVICES r}t
343-4744
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
Parcel l.D.# (LI�I—��a'�i HAA# 14Ar✓_4iall
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include lot, block, subdivision, section, township, range)
Lot 5; Me?,inda View Subd.Lvi.6ion;
Location (address or directions)
14601 Joanne Count
(b) Property owner Von Gaineb Telephone: (home) Business
Mailing Address 14601 Joanne Count Anchoaage, A.2a6ka
(c) Lending Institution NATIONAL BANK OF ALASKA Telephone
Mailing Address C Stneet 9 Nonthenn Ljght6 AnchonaQe Alaska
(d) Real Estate Company and Agent Re/Max Pygpontim ATTN: ChahP.otte
Sch2oahtein
Address 2600 Co�%drrva SttLeet Suite 100, Anyhoaage, Alz 99503
Telephone
(e) Mail the HAA to the following address: (or check here P< if hold for pick up.)
List contact person and day phone number below:
S & S ENGINEERING
17034 Eagle River Loop Road NO 204
Eagle River, Alaska 99577
2. TYPE OF RESIDENCE
Single -Family rbc
3. WATER SUPPLY
Individual Well Cox
Number of bedrooms 3
Community ❑ Public ❑
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to th legality and status.
4. SEWAGE DISPOSAL
On-site Wx Public ❑ Community ❑ Holding Tank ❑
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legailty and status.
72-025 (Rev. 7/88) Page 1 of 2
5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this
Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe,
functional .and adequate for the number of bedrooms and type of structure indicated herein. I further verify that
based on the information obtained from the Municipality of Anchorage files and from my investigation and
inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and
State codes, ordinances, and regulations in effect on the date of this inspection.
Name of Firm Telephone
Address 17034 Eagle River Loop Road No. 204
Eagle rver,
Date -5 � 3 0 �� v
THE DEPRESSION AROUND THE WELL HEAD HAS BEEN
FILLED TO DIRECT SURFACE WATER AWAY FROM THE
WELL AS PER CONDITIONAL APPROVAL DATED
MARCH 2, 1990.
6. DHHS APPROVAL
I*IVAXIWw s -
Approved for % —bedrooms by �6Hr l St-%cv-H Date
Approved Disapproved Conditional
Terms of Conditional Approval
CAUTION- r-
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval
cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer
registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections
or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions
in the professional engineer's work.
72-025 (Rev. 7/88) Back Page 2 of 2
r
MUNICIPALITY OF ANCHORAGE (MOA)
• Health Authority Approval (HAA)
r CHI=&kb,0T - FEBRUARY 1984
�,i43-4744
Legal Des
/gription: _ S t�.Iil'J V&
A. WELL DATA
X-)" J1
Well Classification If A, B, C, D.E.C. Approved (Y/N) a/�
Well Log Present (?N) _ Date Completed Yield
Total Depth (10 Cased to f� Depth of Grouting
Static Water Level 570 Pump Set At
Casing Height Above Ground 12-)— Sanitary Seal on Casing(ON) V ,
Electrical Wiring in ConduitdVN) Depression Around Wellhead(MN) !/
SEPARATION DISTANCES FROM WELL:
To Septic/Holding Tank on Lot �&2 t ; On Adjoining Lots I G:;C� %+
To Nearest Edge of Absorption Field o Lot 1 ;'On Adjoining Lots ��l-4'
To Nearest Public Sewer Line NA. To Newest Public Sewer Cleanout/Manhole f1 p
To Nearest Sewer Service Line on Lot
Water Sample Collected by S�J�—• ; Date
Water Sample Test Results"T �_C�
Comments!! .)?—�'�n')rJ � li'
B. SEPTIC/HOLDING TANK DATA
Date Installed 42-72-6 'Size No. of Compartments
Z
Standpipes49N) 4 Air -tight Caps<(YDN) i_ Foundation Cleanout (VN) ;
Depression over Tank (YiNp Date Last Pumped
Pumping/Maintenance Contact on File (Y/N) ,- ; for
Holding Tank.High-Water Alarm (Y/N) Q Temporary Holding Tank Permit (Y/N) d
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK:
To Water -Supply Well `� To Building Foundation 7Z
To Property Line r To Disposal Field 1 l
To Water Main/Service Line I i=> t
To Stream, Pond, Lake or Major
Comments
Course ) C;14 -->l +
72-026 (Rev. 7/88) Front Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata —Type of System Design)
Date Installed _ `–�� Length of Field
Width of Field _ 1�� Depth of Field2-/
Gravel Bed Thickness
Square Feet of Absortion Area �!�12� Statndpipes Presen(:ZSYN)
Depression over Field (Y/(N r Date of Last Adequacy Test
Results of Last Adequacy Test
SEPARATION DISTANCI= FROM ABSORPTION FIELD:
To Water -Supply Well — 1�� To Property Line
To Building Foundation �� To Existing or Abandoned System on
t
Lot. ; On Adjoining Lots
To Water Main/Service Line t� To Cutback (if present) A
To Stream, Pond, Lake, or Major Drainage Course
I�
To Driveway, Parking Area, or Vehicle Storage Area
Comments _�%�y�`� �' �2' Z8 —`70 Sri s
D. LIFT STATION f�
Date Installed
Si Gallons
"Pump On" Leve
High Water Alarm Level at
Tested for —
Meets MOA Electrical Codes (Y/N)
Comments
Dimensions
Manhole/Access (Y/N)
**Check Permitted Bedroom Rating Against HAA Request"
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test.
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this
inspection.
Signed 5 & S ENGINEERING
17034 Eaglo River Loop Road No. 204
Company :a 99477
Date
MOA No. —�
Receipt No.
Date of Payment
Amount: $
Receipt No.
Waiver Fee: $
Date of Payment
72-026 (Rev. 7/88) Back Page 2 of 2
G
M
ROBERT SHAFER, P.E.
ROGERSHAFER
CIVIL ENGINEERS
(907) 694.2979
FAX 694-1211
Manch 1, 1990 MUNICIPALITY OF ANCHORane,
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
HEALTH AUTHORITY
APPROVALS
"'-••� �:. I�,�
Municipatity o4 Anchorage RECEIVED
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ATTN: John Smith
SEWER&WATER
825 L Street
MAIN EXTENSIONS
P.V. Box 196650
Anchaaage, Ataska 99519-6650
REFERENCE: Lot 5; McPinda View Estates
SEWER & WATER
INSPECTION
Dean. Jahn,
Pet yout tnaumittal sheet n.esponding to out %equest 4on a Heatth
Awthon ity Appn.ovat on the n.e4en.eneed pnopenty, additional work has been
ENGINEERING STUDIES
AND REPORTS
en[
1� Uonmed.
The cleanout ,ins.ta ted a4ten the septic tank was excavated. We 4aund
the tine to have settled a tittle causing water to sit ,in the bottom o4
cleanout. This ,Pine was na.ised to et m.inate the bow .in the tine.
WELLINSPECthe
&FLOW TESTTION
The existing mon ton.i.ng tube within the teach4,ietd which consisted o4 a
sotid 4" PUC pipe was excavated and replaced with a pnopen moniton.Cng
tube consisting o4 a 4" piece o4 pe44onated pipe extending into the
gravel bed and sotid pipe extending above ground level.
SITE PLANS
A gnoundwatet monitot ing tube was lnstatted appnox.imately 10 4t. 4nom
.the absonpti.on bed. A4tet mon.itoning the -tube we 4ound gn.oundwaten at
9.8 4t. below gaaund level at the newly .instatted leaeh4.ield ground
level. The bottom a4 the leaeh4.ield is at 4.2 4t.. below the same
ROAD DESIGN
4e4en.ence point. Thene4oae, the vent.iea.l sepan.ati.on distance between
the bottom o4 the absorption bed and the gn.ound water, level is 5.6 4t.
We also pen.4onmed an adequacy test on the teach4.ietd on Febtuany 28,
SOILTEST
1990. Water was added to the system while water .levet measurements
were taken 4n.om the leaeh4,ield moni,toning tube. Fn.om this test we
4aund the system cunnently capable o4 absonb.ing in excess o4 the
nequ,ined 600 gallon/ pet day 4on a 4 bedroom hawse,.
PERCOLATION
TEST
Also attached 4o4 yout nev,iew ate cunnent coti4o4m bacteria and nitrate
watet sample aesutt6 4on the wett located on the n.e4enenced pnopenty.
STRUCTURAL&
MECHANICAL
INSPECTIONS
ON SITE
WASTE WATER
DISPOSAL SYSTEM
DESIGN
17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577
Page Two
Lot 5; McUnda View Estates
Manch 1, 1990
With this additi.onat .inbonmati.on we %eque3t you i.6,sue a Heatth
Authority Appxova2.
Ig you %equilte additi.onaE in4onmati.on go.% your review, ptease contact
U-6.
cc: Cha4totte Schtosstein-Re/Max P-copeAti.es,Inc.
MUNICIPALITY OF ANCHORAGE
• Department of Health & Human Services
DIVISION OF ENVIRONMENTAL SERVICES M}1
343-4744
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
Parcel I.D. # CJ / %— LIU 7 HAA # 7 ��
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include lot, block, subdivision, section, township, range)
LUT 5; MELINDA VIEWF'014M
Location (address or directions)
14601 Joanne Count
(b) Property owner �OUj Gaines Telephone: (home) Business
Mailing Address 14601 Joanne Count Anchorage, Alaska
(c) Lending Institution NAITONAI RANK OF ALASKA Telephone
Mailing Address ,
(d) Real Estate Company and Agent RE/MAX PROPERTIES ATTN. Chaktotte SchZos3tein
Address 2600 r'oAdava S moot Quito 100 Ancha1ECCge,—A4aAC a 99503
Telephone
(e) Mail the HAA to the following address: (or check hereXXXf hold for pick up.)
List contact person and day phone number below:
5 & S ENGINEERING
17034 Eagle River Loop Road Ne 40_4
Eagle River, Alaska 99577
2. TYPE OF RESIDENCE
Single -Family M<
3. WATER SUPPLY
Number of bedrooms 3
Individual Well QX Community ❑ Public ❑
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to th legality and status.
4. SEWAGE DISPOSAL
On-site IKX Public ❑ Community ❑ Holding Tank ❑
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legailty and status.
72-025 (Rev. 7/88)
Page 1 of 2
5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMA
rY. an�2b y�i
As certified by my seal affixed hereto and as Of the validation date shown below, I verify that my investigate
Health Authority Approval shows that the on-site water supply and/or wastewater disposal system.
functional .and adequate for the number of bedrooms and type of structure indicated herein. I further venfyA,.
based on the information obtained from the Municipality of Anchorage files and from my investigation a,_
inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal nk
State codes, ordinances, and regulations in effect on the date of this inspection.
Name of Firm *.}r
d� Telephone
Address 17034 Eagle River Loop Road No. 2
04
Date
GLAD I T cry � lr� �t�- (fie � or -51✓
b-� 7
'���-1L ` `}p• .: +_'ter �{
6. DHHS APPROVAL
W,
;AA
Uaaew as 'Bonen � a.,•
�eeaa. ).reM rr,,W, eaapa�.
M1 ANG Yfi i
'e• Q�9. �i:tir•*�
• ✓��jr�
t(O rare r•eelh"
Approved for bedrooms by __ -JoHt4 Sr-, I -r -H Date 3 Zz/qo
Approved __ Disapproved Conditional
Terms of Conditional Approval DRAiwP4*F A -F w6�,L_ cq�/„,6 m
6S C64,z,=-c-rFr�,
Q� JuL_jE ISJ 19cl0,
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval
cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer
registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending
institutions in orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections
oranalyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions
in the professional engineer's work.
72-025 (Rev. 7i88) Back Page 2 Of 2
MUNICIPALITY OF ANCHORAGE
• Department of Health & Human Services r
DIVISION OF ENVIRONMENTAL SERVICES •�i
343-4744
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
Parcel I.D. # ����'^�7, - 7 L HAA #
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include lot, block, subdivision, section, township, range)
Location (address ordirectio.ns)
(b) Property' owner, QED �'� Telephone: (home) Business
Mailing Address
(c) Lending Institution Telephone
Mailing Address
(d) Real Estate Company and Agent Agent
Address
Telephone y� Lslo�
(e) Mail the HAA to the following address: (or check here ❑, if hold for pick up.)
List contact person and day phone number below:
2. TYPE OF RESIDENCE
Single -Family Number of bedrooms 3
3. WATER SUPPLY
Individual Well. Community ❑ Public ❑
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to th legality and status.
4. SEWAGE DISPOSAL
On-site Public ❑ Community ❑ Holding Tank ❑
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legality and status.
72-025 (Rev. 7/88) Page 1 of 2
ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this
Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe,
functional .and adequate for the number of bedrooms and type of structure indicated herein. I further verify that
based on the information obtained from the Municipality of Anchorage files and from my investigation and
inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and
State codes, ordinances, and regulations in effect on the date of this inspection.
Name of Firm
Telephone 2,75�SSs3
Address
4Z-
Date
zDate I7J7,Y
F AL,Q
P• • 'P
4
TH '• fy4
s * /J
40
06
CE -2251
e OPmf
6. DHHS APPROVAL
Approved for bedrooms by --- Date %% /Mg
Approved—;4--Disapproved Conditional
Terms of Conditional Approval
11 Mr,
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval
cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer
registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending
institutions in 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 (Rev. 7/88) Back Page 2 of 2
A. WELL DATA
Well Classification
Well Log Present &(N)
Total Depth x.70 Cased to
Static Water Level
MUNICIPALITY OF ANCHORAGE (MOA)
Health Authority Approval (HAA)
CHECKLIST - FEBRUARY 1984
343-4744
r A"K/E�>,��ra ✓lr�J
�jz.✓ ;23rd 5� � 3.5'
Legal Description
- Date Completed
Y3 Depth of Grouting
r
Casing Height Above Ground
Electrical Wiring in Conduit (Y N)
SEPARATION DISTANCIS FROM WELL: i
If A, B, C, D.E.0
'd�� Yield
Pump Set At
A proved (Y/N)';/,4
07111 1,36 _—
Sanitary Seal on Casing((Y N)
Depression Around Wellhead (Y&
To Septic/Holding Tank on Lot /ev ; On Adjoining Lots %a %— _
i
To Nearest Edge of Absorption Field on Lot �� "� ; On Adjoining Lots ADO
To Nearest Public Sewer Line 4A To Nearest Public Sewer Cleanout/Manhole
To Nearest Sewer Service Line on Lot Z�/�
Water Sample Collected by&e5 14, ; Date
Water Sample Test Results
%L - ifComments A61i, I:?t
31V- .T- --s- "J/rle� �%
V/
B. SEPTIC/HOLDING TANK DATA
Date Installed �_Size /Z ED No. of Compartments 71-
Standpipe s�Y�{N) Air -tight Cap (Y% ) Foundation Cleanout
Depression over Tank (Y�fv Date Last Pumped&414 WE -IJ Ilzn0E1
Pumping/Maintenance Contact on File (Y/N) '`� ; for
Holding Tank High- Water Alarm. (Y/N) % Temporary Holding Tank Permit (Y/N)
SEPARATION DISTANCI=S FROM SEPTIC/HOLDING TANK:
To Water -Supply Well 1' To Building Foundation
To Property Line, ��' �� To Disposal Field
r
To Water Main/Service Line 16 4'
To Stream, Pond, Lake or Major Drainage Course
Comments C 5L nem c, 0,
7z-026
L5- )V/ IWAA V//&57,d
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata Type of System Design
Date Installed . �Z _3 Length of Field /
Width of Field / d _ : Depth of Field
Square Feet of Absortion Area
Depression over Field (Y(9
Results of Last Adequacy Test
& /2 -
Gravel Bed Thickness
Statndpipes Presen (Y )
Date of Last Adequacy Test
le,k5ee .f�✓�y�epli-1
SEPARATION DISTANCE FROM ABSORPTION FIELD: /
i
To Water -Supply Well /&V i `t To Property Line
To Building Foundation 95 To Existing or Abandoned System on
Lot 4,4 ; On Adjoining Lo11 ts fa 't"
To Water Main/Service Line %0 t To Cutback (if present)
To Stream, Pond, Lake, or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area f0
Comments A 37&r- A114ehW C`o'
/z u e6- ✓�ieif/A lkwe- eeAW&-Mzb 70 -
LIFT
LIFT STATION
D stalled
Size in Gallon
i
"Pump On" Level at
High Water Alarm Level at
Tested for
Meets MOA Electrical Codes (Y/N)
Comments
Dimensions
Manhole/Access (Y/N)
"Check Permitted Bedroom Rating Against HAA Request"
"Pump Off" Level at
Vent(Y/N)
Pumping Cycles during Adequacy Test.
I certify that I have checked,, verified, or conformed to all MOA and HAA gui
inspection.
'
4040
Signed
Company
4
/
AV
or
Date
Z ��
0m*
MOA No.
Receipt No.
Receipt No.
Date of Payment / a '� 3
Waiver Fee: $
Amount: $
D
/ 7 n
Date of Payment
72-026 (Rev. 7/88) Back Page 2 of 2
%effect on the date of this
��4nk,
• Fgineer's Seal
memmmm emom°e
a �
mememee • •'0
s LER C. REID, JR. ,
CE • 2251 e+
CERTIFICATE OF OCCUPANCY
Municipality of Anchorage
• .� BUILDING SAFETY DIVISION
3500 East Tudor Road
ISSUE DATE: November 17 1988
This Certificate issued pursuant to the requirements of Section 307 of the Uniform Building Code certifying that at the time of
issuance this structure, or portion thereof, was in compliance with the various ordinances of the Municipality regulating
building construction or use, for the following:
Building Permit No. 84-3297
Melinda View
Lot: 5
Blk: -- Subdivision:
1st Federal Bank
Site Address:
14601 Joanne Circle
Owner:
813 W. Northern L�Ots,
Anchorage __ State: AK Zip99503
Street Address:
11-16-88 By Welloncf
FINAL MECH: -16-88 By MOrri "On
FINAL STR:
FINAL ELEC:
11-16-88 By Jameson
FINAL FIRE: N/A BY --
FINAL PLBG:
11-16-88 BY Mnrri snn
FINAL ZONE:N/�, n BY --
- r (
PREPARED BY: BMJ AUTHORIZED OFFI
84-003 (11 7) -