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HomeMy WebLinkAboutEKLUTNA HEIGHTS #1 BLK 3 LT 7Eklutna Heights Block 3 Lot 7 #051-061-25 Municipality of Anchorage I.-- Community Development Department 3 Page 1 or L Onsite Water & Wastewater Program qq g 015 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http:Uwww.muni.org/onsb • T-7904 (9 4 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP141377 PID Number. 051-061-25 ❑ New ®Upgrade Name. PEREGRINE FALCON ALASKA LLC ABSORPTION FIELD ❑ Deep Trench ® Shallow Trench ❑ Bed ❑ Mound Addresz 21407 SETTLER DRIVE' CHUGIAK, AK 99567 ❑ Other Phone: No. ofeedroonm: Soo aeaa: TMDSAeae anywgna (907) 229-7506 3 1.0 evmsa. R 1 8.0 R LEGAL DESCRIPTION °°""°""`"'"°""°"p1Ypi°" SEE DWG. Q' d phb""" Aw 4.01 R subdivision: Block: Lot EKLUTNA HEIGHTS #1 3 7 Faatltlmro .Wwgrftw amr k,pM SEE DWG. R 45 R O1m8 D: _ nge: _ n' _ aaveiwun: wmeraaar: oYtrwe belwaen alas: 5 R R SEPARATION DISTANCES 450 To WC Abeerption ut Holding Pubu/Pduan From Tank Field Stetlon Tank SasisrLhea 90.R well wA NIA - 25.+ TANK ® Septic ❑ S.T.E.P. ❑Holding ❑ Other surface water 100+ 1001+ - : ANCHORAGE TANK a,.*: 1000 a Lot Line 51+ 101+ _ _ N/A wrmc Numbar"raanpv : STEEL 2 Foundation 5'+ 101+ - _ LIFT STATION Curtain Drain NONE KNOWN arnuavruar. oewub: er Remarks: OLD TANK DECOMISSIONED PER UPC. Twn'awieni'c 'RngalrIm!ft arms F,.ro rrwaaraa.e `.a.mon.o.mmW. PIPE MATERIAL House to tank D-3034 Tank to D-3034 drainfiield Installer ARM SERVICES Drainfield Da034 CO/MT D-3034 Inspector GEG, Ltd. - JODY MAUS BENCH MARK (Assumed elevation) 97.51 Roe,e� Inspection Dates: let 10/10/2014 2nd 10/1112014 3rd 10/1112014 TOP OF GARAGE SLAB NEAR POINT "B" Community Development Department Approval EMMEE" WEAL 60 Conditional approval: Date: P OQ * : 4 ............ ............... p e Gar ess.: QO 9. •, CE-7953 mph Approved: Lt `` oil. '41"r �ApQ4 ` Date: P'Ofesslolla PERMIT NUMBER:/� �+ PARCEL ID NUMBER: QSP141377 A$ -BUILT DRAWING 051-051-25 W O Lu J I— Lu co ------------ _..e -----� EIQUTNA HEIGHTS RT; BLOCK 9, LOT 8 SERVED BY DAWN WATER SYSTEM GARNESS ENGINEERING GROUP, Ltd �.�., CIVIL & ENVIRONMENTAL ENGINR EES PEREGRINE FALCON ALASKA, LLC EKLUTNA HEIGHTS SID AS -BUILT DRAWING OF PHONE NUMBER: PAGE NUMBER: 229-7505 2 OF 3 DRAWN Sr: LOT 7 J.L.M. DATE: SYSTEM 9/3/2015 PERMIT NUMBER: PARCEL IDNUMBER: AS-BUILT DRAWING SP141377 051-061-25 FINAL GRADE = 97.31 STI ST2 2" OF INSULATION (PER CONTRACTOR) TOP OF TANK TOP OF TANK AT INLET = 92.26 AT OUTLET = 92.16 INVERT OF BUNG NEW 1000 GALLON AT INLET =91.65 SEPTIC TANK INVERT OF BUNG AT OUTLET = 91.38 BOTTOM OF TANK IN ST2 = 87.43 ORIGINAL GRADE =95.08 MT1 C01 MT2 CO2 FINAL GRADE =97.51-97.73 TH#1 (HIGHEST POINT) TH#2 FILTER FABRIC 777. ee e e e 0 0 e 0 0 4.01' °e INVERT OF PIPE 91.09 a e e e e e e 0 ~-5. BOTTOM OF TRENCH 87.08 RELATIVE ELEVATION OF BOTTOM OF TEST HOLE #1 = 79.08 TEST HOLE #2 = 78.08 (NO GROUNDWATER) •••. ............... .## GARNESS ENGINEERING GROUP, Ltd *: ; CIVIL & ENVIRONMENTAL ENGINEERS 3701 ETUIXUIS PD, SUITE 101'ANfMORAfE,AKSSS ]'PIpNEOV)33617S-FP ON)335 46-WER6rtE:w gam MwM nMwm •• ......•..••• •••.••• •, A. G ess PREPARED FOR: PHONE NUMBER: PAGE NUMBER: PEREGRINE FALCON ALASKA, LLC (907)229-7506 3 OF 3 := C -953 ♦•�•y r 1 • .., E 1r7 •'•• 1 LEGAL DESCRIPTION: DRAWN BY: EKLUTNA HEIGHTS S/D #1; BLOCK 3, LOT 7 J.L.M. •• • ��� r; TYPEOF WORK: PROFILE AS-BUILT OF SEPTIC SYSTEM DATE: 9/3/2015 On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP141377 Tax Code Number: 05106125000 Work Type: Septic Upgrade Permit Effective Dates: September 15, 2014 to September 15, 2015 Design Engineer: GARNESS ENGINEERING GROUP LTD Subdivision: EKLUTNA HEIGHTS #1 Site Legal Address: EKLUTNA HEIGHTS #1 BILK 3 LT 7 GA461 Owner/Address: PEREGRINE FALCON ALASKA LLC PO BOX 770768 EAGLE RIVER AK 995770768 Site Mailing Address: 21407 SETTLERS DR, Chugiak Lot Size in Sq Ft: 21780 Total Bedrooms: 3 This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Special Provisions: The domestic water service line shall be installed at least 10 feet minimum from the septic system and shall be shown on the final inspection report. Co -*- ( Received By: Issued By: CrIUn 10e� 5W"je. c,/ 4' eWlech'v" - anG eJoeer- �b the f'. yJro/er�7 11"l2-1 /%1/.+/ Date: C Date: �s MUNICIPALITY OF Community Development Department Development Services On -Site Water & Wastewater Program ANCHORAGE Mayor Dan Sullivan Phone: 907-343-7904 Fax: 907- 343-7997 On -Site Sewer/Well Permit Application For A Single Family Dwelling Parcel I.D. 051-061-25 Property owner(s) JEFF JOHNSON Day phone 229-7506 Mailing address 21407 SETTLERS DRIVE * CHUGIAK, AK 99567 Site address 21407 SETTLERS DRIVE * CHUGIAK, AK 99567 Date of Payment: Legal description (Sub'd, Block & Lot ) EKLUTNA HEIGHTS #1; BLOCK 3, LOT 7 Receipt Number: Legal description (Township, Section & Range) Receipt Number: Lot Size Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DEWELLING: (Mall that apply) Initial ❑ Single Family (SF) Absorption Field �i Upgrade Z (w/wo ADU) Septic Tank ®Duplex (D) Renewal ❑ El Holding Tank ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage El 81PAlknoffAl THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FFR:aEP 2014 Distance: — I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees:� Waiver Fees: Date of Payment: f l �� 5l ��I L s Date of Payment: Receipt Number: O�JzZ�i G Receipt Number: CXALI 1311 Permit No. Waiver No. (Rev. 01/11) GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS September 3, 2014 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Proposed Septic System for Eklutna Heights #1; Block 3, Lot 7 To whom it may concern: The existing house is going to be demolished and replaced with a new three (3) bedroom home. The house will be served by a community well and private septic system. We are proposing to install a 1,000 gallon septic tank and a dual 5 wide trench type drainfield. The old septic tank will be decommissioned per UPC and the old drainfield will be abandoned in place. Two testholes were excavated on the property and the drainfields are designed around the 30 foot radii of these testholes. Comments regarding the design are summarized as follows: 1. SOILS: See the attached logs which show the soil classifications, groundwater monitoring, and the percolation test results. 2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications. 3. SURFACE WATERS: There are no surface water concerns. 4. TOPOGRAPHY: As can be seen on the attached topography drawing, the average topography around the proposed drainfield is relatively flat. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. I. E., M.S. <�VtiS t SP .Soil x6v' W,6N pr-c-rAcr-- 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507.1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.gamessengineering.00m V/S�ERVED LUTNA WEST; LOT 14 BY DAWN WATER SYSTEMI EKLUTNA HEIGHTS #1; BLOCK 3, LOT 4 SERVED BY DAWN WATER SYSTEM EKLUTNA HEIGHTS #1; BLOCK 3, LOT 5 � I SERVED BY DAWN WATER SYSTEM EKLUTNA WEST; LOT 15 SERVED BY DAWN WATER SYSTEM I EKLUTNA HEIGHTS #1; BLOCK 3. LOT 6 SERVED BY DAWN WATER SYSTEM I g, EXISTING HOUSE TO BE 't'�:•...,,,, .� DEMOLISHED EKLUTNA WEST; LOT 16 I I-JOTH#2* 3 BEDROOM SERVED BY DAWN WATER SYSTEM i #1 HOUSE & GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS 3701 E MOOR ROLA SURE 101 • W OWZ M 98507 • PHONE (907) J37-6179 • FIX (907) 338-3216 • 'NE6511E: xwN.gartapgnqimeHnq.com PREPARED FOR: PHONE NUMBER: PAGE NUMBER: JEFF JOHNSON 229-7506 1 OF 2 LEGAL DESCRIPTION: DRAWN BY: EKLUTNA HEIGHTS #1; BLOCK 3, LOT 7 PNB E OF WORK: DATE: SITE PLAN 8/14/14 I I EKLUTNA HEIGHTS #1 BLOCK 4, LOT 4A S RVIED BY DAWN WATER S EKLUTNA HEIGHTS #1; BLOCK 4, LOT 5 ERVED BY DAWN WATER SYSTEM I I EKLUTNA HEIGHTS #1; BLOCK 4, LOT 6A J$ S RVED BY DAWN WATER 191 EKLUTNA HEIGHTS #1; BLOCK 4, LOT 7 D BY DAWN WATER SYSTEM I EKLUTNA HEIGHTS #1; BLOCK 4, LOT 8 S RVED BY DAWN WATER SYSTEM EKLUTNA HEIGHTS #1; BLOCK 3, LOT 8 r I V C SERVED BY DAWN WATER SYSTEM I EKLUTNA WEST; LOT 17 I EKLUTNA HEIGHTS #1; BLOCK 3, LOT 9 SERVED BY DAWN WATER SYSTEM L^^� SERVED BY DAWN WATER SYSTEM I H EKLUTNA HEIGHTS #1; BLOCK 3, LOT 10 EKLUTNA WEST; LOT 18 SERVED BY DAWN WATER SYSTEM SERVED BY DAWN WATEREM N I W I J EKLUTNA HEIGHTS #1; SCALE: BLOCK 3, LOT 11 ® " SERVED BY DAWN WATER SYSTEM 1 = 100' V J EKLUTNA WEST; LOT 19 EKLUTNA HEIGHTS #1; SERVED BY DAWN WATER SYSTEM I BLOCK 3, LOT 12 SERVED BY DAWN WATER SYSTEM GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS 3701 E MOOR ROLA SURE 101 • W OWZ M 98507 • PHONE (907) J37-6179 • FIX (907) 338-3216 • 'NE6511E: xwN.gartapgnqimeHnq.com PREPARED FOR: PHONE NUMBER: PAGE NUMBER: JEFF JOHNSON 229-7506 1 OF 2 LEGAL DESCRIPTION: DRAWN BY: EKLUTNA HEIGHTS #1; BLOCK 3, LOT 7 PNB E OF WORK: DATE: SITE PLAN 8/14/14 I I EKLUTNA HEIGHTS #1 BLOCK 4, LOT 4A S RVIED BY DAWN WATER S EKLUTNA HEIGHTS #1; BLOCK 4, LOT 5 ERVED BY DAWN WATER SYSTEM I I EKLUTNA HEIGHTS #1; BLOCK 4, LOT 6A J$ S RVED BY DAWN WATER 191 EKLUTNA HEIGHTS #1; BLOCK 4, LOT 7 D BY DAWN WATER SYSTEM I EKLUTNA HEIGHTS #1; BLOCK 4, LOT 8 S RVED BY DAWN WATER SYSTEM NUMBER OF BEDROOMS: 3 GALLONS PER DAY (GPD): 450+ PERCOLATION RATE/S: <1 MIN/INCH PROPOSED APPLICATION RATE: 1.0 MINIMUM DRAINFIELD SO.FT.: 450 FEET' MAXIMUM DEPTH OF EXCAVATION: 8 FEET WIDTH: 5 FEET LENGTH: 45 FEET M.O.A, APPROVED SAND FILTER: N/A EFFECTIVE: 4 FEET REDUCTION FACTOR: 0.5 ACTUAL SO.FT.: 450 FEET' GEG, Ltd. HAS A B PAGE SPECIFICATION LETTER THAT PERTAINS TO THIS DESIGN. TO OBTAIN A COPY OF THE LETTER CONTACT GEG. BY PROCEEDING FORWARD WITH THIS INSTALLATION, THE ENGINEER, WELL DRILLER, CONTRACTOR AND PROPERTY OWNER AGREE THAT THEY HAVE READ THESE SPECIFICATIONS AND AGREE TO ACCEPT THE TERMS AND CONDITIONS OUTLINED. NOTE: THE CONTRACTOR SHALL HAVE THE SOUTH LOT LINE, AND ALL WELL RADII FLAGGED BY A REGISTERED LAND SURVEYOR PRIOR TO CONSTRUCTION. EKLUTNA HEIGHTS at; BLOCK 3, LOT 6 SERVED BY DAWN WATER SYSTEM PROPOSED CLEANOUTS EKLUTNA HEIGHTS #1; BLOCK 3, LOT 8 SERVED BY DAWN WATER SYSTEM INSTALL FCO GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS 3701 E. 1 IXA R . WOE IDt • MCN WX. W 99W7 • PHONE (907) 337-6179 • FM (W7) 339-3949 • KME: ow.9mrwa gig rli 'REPARED FOR: PHONE NUMBER: PAGE NUMBER: JEFF JOHNSON 229-7506 2 OF 2 .EGAL DESCRIPTION: DRAWN BY: TYPE OF WORK: �- SEPTIC SYSTEM DESIGN UPGRADE JLM DATE: R VISFD 10/10/14 CE - EXISTING DRIVEWAY OLD SEPTIC TANK TO BE DECOMMISSIONED PER UPC EXISTING HOUSE TO BE DEMOLISHED OLD DRAINFIELD TO BE ABANDONED IN PLACE [EXISTING FENCE EXISTING WATER LINE SHEDS MUST 1-5% 10% LL•. PROPOSED BE RELOCATED J DPol WAY y pROPSOT9D DRIVEWAY til PROPOSED 3 BEDROOM S Td% W � THO1�• _ HOUSE & SHOP r �.. a CID z Cs� 1 / 1-5% 10%.... PROPOSED CLEANOUTS EKLUTNA HEIGHTS #1; BLOCK 3, LOT 8 SERVED BY DAWN WATER SYSTEM INSTALL FCO GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS 3701 E. 1 IXA R . WOE IDt • MCN WX. W 99W7 • PHONE (907) 337-6179 • FM (W7) 339-3949 • KME: ow.9mrwa gig rli 'REPARED FOR: PHONE NUMBER: PAGE NUMBER: JEFF JOHNSON 229-7506 2 OF 2 .EGAL DESCRIPTION: DRAWN BY: TYPE OF WORK: �- SEPTIC SYSTEM DESIGN UPGRADE JLM DATE: R VISFD 10/10/14 CE - GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS 3]%ETVWR .SUOE1p1'ANg1JRPGE.M W507' PHONE (WT1 3374ln' FM (SON 33932I8•WEBSITE: w/M•ABmNee,gMse,bp.wm SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION: EKLUTNA WEST#1; BLOCK3, LOT7 PERFORMED FOR: JEFF JOHNSON DATE: 8/22/2014 DEF (fei 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 "Im SW/SP W/ LENSES OF GW TEST HOLE #1 SOIL CLASSIFICATIONS DEPTH TO GROUNDWATER DATE DRY 8/22/2014 DRY 8/29/2014 IIIIIIIII 111!11 =00 %% mum • Roy111111111 ow MWE V", • S�I�NK Sat! DEPTH TO GROUNDWATER DATE DRY 8/22/2014 DRY 8/29/2014 DATE READING CLOCK TIME I NET TIME (MINUTES) I WATER LEVEL READING NET DROP (INCHES) 8/25/2014 ABSORBED 6" OF H2O IN <2 MIN 4X PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 5 FT. AND 6 FT. A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES NO SOILS LOGGED BY: ROB CAMPBELL PERCOLATION TEST PERFORMED BY: ROB CAMPBELL COMMENTS: PERCOLATION READINGS ARE WITHIN 1116 OF INCH. PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS P F RMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS 3701 E TUDORDOAO, SUIM101'ANCHURP E,AKWU7'PHONE (W3 n74179- FM (80n 3333246'WEBSITE: v gamwwMMeN =m SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION: EKLUTNA HEIGHTS #1: BLOCK 3, LOT PERFORMED FOR: JEFFJOHNSON DATE: 8/22/2014 DEPTH (teeO ORG TEST HOLE #2 E 7 6 s 10 11 12 13 14 15 16 17 18 SW/SP W/ LENSES OF GW SOIL CLASSIFICATIONS DEPTH TO GROUNDWATER DATE DRY ,•, •' 8/29/2014 IIIIIIIII IIII"II VZZZA %% NNW • IIIIIIIII - IIIIII1 �MyORO • Y�� 02�V DEPTH TO GROUNDWATER DATE DRY 8/22/2014 DRY 8/29/2014 DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 08/25/2014 ABSORBED 6" OF H2O IN 1.5 MIN 4X 19 PERCOLATION RATE <1 (MIN./INCH) FERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 5 FT. AND 6 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES ENO SOILS LOGGED BY: ROB CAMPBELL PERCOLATION TEST PERFORMED BY: ROB CAMPBELL COMMENTS: PERCOLATION READINGS ARE WITHIN 1/16 OF INCH. PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERF R ED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: �f. PERMIT NO. R APPLICANT LOCATION LEGAL 2510 E. UDOR RD. a ANCHORAGE. Ar. 9 275-2221 /J c3"— S I T E � E W E F z . F fr,'K M I T ,' �%; ISLE YI/'}( lC 7 76099 PAUL MYERS 3209.ROSELLA 333--2579 OFF PIONEER ST L7 83 EKLUTNA HGTS SUED #1 LOT 5I ;;,,,21780.SQUARE FEET TYPE OF SOIL ABSORSTION SYSTEM IS: PIT MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING CSQ FT/BR)= 85 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: 0aEF''TH= L_ER�.{a3TH= a IGt�iA',r�'R= L G7tEP TH= THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF EACH SIDE FOR A,SEePA►3E PIT. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN„THE SURFACE.DF.TME GROUND AND THE BOTTOM OF THE EXCAVRTION CSM:,,..litt THE GRAVEL DEPTH IS THE MINIMUM.: DEPTH OF. )GRAVEL.BETW69N 4” I OUTFRLL PIPE AND THE BOTTOM OF THE EXCAVATION`<IN FEET). F{Er---#U I FREK> ::L la 0 0 I(30-1LL BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION., z s;: MINIMUM DISTANCE BETWEEN A WELL AND ANY :ON—SITE SEWRGE.DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 200 FEET FOR A PUBLIC WELL. SPECIFICATIONS AND CONSTRUCT I CIN DIAGRAMS. ARE gISH3I I AU LET 04SU [R ?►PER INSTALLATION. F EFRM I T 'L,PFiL.. 11> F=QFZ i)NE YEFiFR F=IRCxM I�!SLJFE; I CERTIFY THAT 2: I AM FAMILIAR WITH REQUJIREMENTS`FOR ONESITE SEWERS AND WELLS AS SET, FORTH BY THE MUNICIPALITY OF FiNrutitlRFiGE d . 2: I WILL INSTALL THE SYSTEM I,N ACCORDAN ITHK CODES; 3: I UNDERSTAND THAT THE ON—SIVE SEWEk SY Fx'i „ 12401i I 14t�. ; ...., , T If THE RESIDENCE I MODELED TO .INCLUDE MORE THRN, 3 SEIJROOMS. " fl ) r SIGNED : __... AP L I CANT PAUL .MYERS ISSUED BY---DATE—aF—?� 0 Et E GEO'� :CHNICAL & ®EVEL, )HENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster Earl Ellis 694-2774 SOIL LOG 688-2280 Soils Ft Foundations Land Development Performed for: Name: /7/"/Z 7—OA-1 �xc±AU,e7-1,eI 6 Tel . No. 6YY _ .:z6 /? Mailing Address: q f i 6 7 Legal Description: L07- 7, ;'Lid•, /�%T �iILVTitlf� >��> Death (feet) 0 1 3 r-- 4 k.. 6 Soil Characteristics %cns'_-abs[ . , /e" lor.<1 5� ee4�11N/c S 7 B 9.. 0 13 �3p>✓ruy a � PT 14i 15 16 Ground Water Encountered: Yes— No_ 4-� If Ices, what depth Proposed Installation: Seepage Pit_ Drain Pied Comments:- /'1'7— 4 Performed by: /�--� �� Date: ��. 7, /�/ %-- 2,S-40R,e. YI��,e, MUN I C' I F=Iwl=4L- I -rV OF=" "N0"QFZ"C3F= DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 E. TUDOR RD., ANCHORAGE, AK 99507 276-2221 L4 E= L- L- F='E=- FZ rl I -r PERMIT NO. ( 76139 ) APPLICANT PAUL MYERS 3209 ROSELLA 333-2579 LOCATION PIONEER ST LEGAL L7 B3 EKLUTNA HGTS SUBD LOT SIZE 21780 SQUARE FEET MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM 15 100 FEET FOR A PRIVATE WELL OR 200 FEET FOR A PUBLIC WELL. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PERM I -r %0 F1 L- I E> F= 0 R C) N F= V E: 1=4 FR f= Ft C3 M I !S '-c::; U EE I CERTIFY THAT 1: 1 AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: 1 WILL I -'LL THE _SYSTEM IN ACCORDANCE WITH THE CODES. �p SIGNED:--- ---------- Y APP ICRNT P L Yi S ISSUED BY- ------- DATE - AND WELLS AS SET Municipality of Anchorage +� On -Site Water and Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 051-061-25 1. GENERAL INFORMATION Expiration Date: —I - / 9 Complete legal description Eklutna Heights #1 Block 3 Lot 7 Location (site address) 21407 Settlers Drive, Chugiak, AK Current Property owner(s) Peregrine Falcon AK LLC Day phone 342-5202 Mailing address Real Estate Agent same 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex - ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 7-Z)l AUG 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual Individual Water Storage ❑ Holding Tank ❑ Community Class C Well ❑ Community ❑ Public Water System ® Public Sewer ❑ Received by: Date: 7// 2/ � COSA to be released to the engineer, unless otherwise requested by the engineer COSA Fee $ 5A0 Date of Payment 1)31 10 Receipt Number QAIRtll> Date of Payment Receipt Number. COSA # J15C.1-4! qG2- Waiver #. 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm NorthRim Engineering Phone 694-7028 Address PO Box 770724, Eagle River Engineer's Printed Name Steve Eng Date 6. DSD SIGNATURE t System #1 Approved for System #2 Approved for Disapproved. 3 bedrooms. Stsron W. En- tlj'; bedrooms. F i9 dill, X14 ,,NFES -1�N�+ Conditional approval for bedrooms, with the following By-— ,. _ �--d( Original Certificate Date: ( Z_1 7 The Municipality of Anchorage Devlopment Services Division (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory COSA blue eheet_9-1-12.e N_ X Nitrate Advjsoty Arsenic Adyispryt+,i Other If more than 1 septic system is on the lot: COSA Checklist # of Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: o5, -L. U71—Of I747S -&I S3 L 7 Parcel ID:oS((0CIZS A. WELL DATA PvSGlG "A_IVtZ Well type If A, B, or C provide PWSID # Date completed Sanitary seal (Y/N) Total depth ft. Cased to ft. FROM WELL LOG Well Log (Y/N) Wires properly protected (Y/N) Casing height (above ground) in. AT INSPECTION Date of test Static water level ft. ft. Well production 9.p -m. g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate mg/L Arsenic ug/L Date of sample: B. SEPTIC/HOLDING TANK DATA Tank Type/Material S�/'TlCr,S%EFL Tank size 1000 gal. Number of Compartments Z Collected by: Date installed Cleanouts(Y/N) Foundation cleanout (Y/N) _Y_ Depression over tank (Y/N) N High water alarm (Y/N) Date of pumping Pumper �/Z S C. ABSORPTION FIELD DATA Date installed l0/ Soil rating (g.p.d./ftz or ft2/bdrm) ZD System type 7"_ -%c-L, Length . �/__5 ft. Width ' / ft. Gravel below pipe _ ft. _7 Total depth P ft. Eff. absorption area ftZ Monitoring tube 4— Depression over field Date of adequacy test 2-r / % Results (Pass/Fail) P For 3 bedrooms Fluid depth in absorption field before test (0 in. Water added gal. New depth_ in. Elapsed Time: S min. Final fluid depth d in. Absorption rate >= Sd g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION AJA Date installed "Pump on" level at Datum Size in gallons in. "Pump off' level at Cycles tested E. SEPARATION DISTANCES WELL ON LOT TO: PUB«G Wf►T6� Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer /septic service line Animal containment areas Manhole/Access (Y/N) in. High water alarm level at Meets alarm & circuit requirements? On adjacent lots On adjacent lots Public sewer manhole/cleanout Holding tank Manure/animal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation Property line T` Absorption field r Water main / G y` Water service line / G Surface water /6 G 't - Wells on adjacent lots 166 .f - ABSORPTION FIELD ON LOTTO: Property line Z� rt Building foundations/Q t Water main / 4 rY" ! Water Service line /a it Surface water Q a f Driveway, parking/vehicle storage 0 Curtain drain & K. Wells on adjacent lots 106 f F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name S TOf Date COSA yellow sheet_2-6-15.doc in. - I h N N I 33' 33' f 95 i .•• ' w t LOT 7 L_ V / a I A5PHALT k - • p 00 O Qi 3 I o ORAINF/ELO �� Lo . sy O A FOUND REBAR . RETAINING WALL" O ® ELECTRIC METER Z ` LLJ l w J N89055'20"E 264' 99 OF q�s� *0e i MICHAEL E. MILLER•: LG/SS1V 2 2 McCLINTOCK LAND ASSOCIATES, INC. 16942 NORTH EAGLE RIVER LOOP ROAD EAGLE RIVER, ALASKA 99577-7601 (907) 694-4499 LICENSE No. AECC596 FIELD WORK DATE: B-31-17 PARTY CHIEF: MF DRAWN DATE: 9-05-17 DRAWN BY: JC -OU I /=A I A f -7L -/v/'7 /I A/^IIIA / VL7"L-ll V If L/l V APlP'%/T//"1A/ A/ 7 29.9' z I l UL.//l/L//V /Vl% /—I. / A5PHALT ro DRIVEWAY W O ' o 29.41 O 11 ^ O LL I l,� /L.nT iJ—� i Jn I 3L06K VN/NG WALL 1 Ou '.I -•OVA —U — I /lT h A;JI AT R.". "_1 L_ l/ / aJLJI /'l (r I J—vV.. I AS -BUILT I hereby certify that I have, or someone under my supervision has, inspected the property described as: LOT 7, BLOCK 3 EKLUTNA HEIGHTS SUBDIVISION, ADDITION No. 1 (PLAT No. P -215A) Anchorage Recording District I The improvements situated thereon are within the property lines and do not encroach or overlap onto adjacent properties, nor do any improvements from adjacent properties encroach or overlap onto this property, except as indicated hereon. Ib lot corners have been set. The property dimensions shown are from the record plat old are not necessarily as we may have measured. The Improvement locations ore approximate and hove been determined only to the extent that enables us to determine if there are any encroachments onto or off of the lot. Drafting and reproduction my produce graphic inconsistencies; therefore scaling should not be attempted to determine unshawn dimensions. This drawing is not adequate for additional construction or for determining the exact [mat ion of property lines. Only easements frcn the recorded subdivision plot noted above are shown hereon and it is the responsibility of the owner to determine if any other easements, covenants, or restrictions exist. C McClintock Land Ase=!else, Inc. (MLA) 2017 This document is copyrighted and is authorized to be used for one real property transaction or project only. Any copy Is to be considered unauthorized unless It bears an original surveyor's signature(usually in blue Ink) or a stamp showing recorder's office data. Copyright restri clions `but not re—use restrictions) are waived if this document has been officially recorded. Lending institutions may also make additional copies for their own records. Liability to MLA is limited to fees received for this project. FIELD BOOK: 461-32 PLOT SCALE: 1"-40' GRID: NW1461 DWG NAME: AB17-196 JOB NO: 17-196 A5Pl-/ALi DRNEWAY LOT 7 L_ V / a I A5PHALT k - DRNEWAY re CONCRETE BARR/ER5 oe, s I ORAINF/ELO �� RETAINMG WALL . sy A FOUND REBAR . RETAINING WALL" 99 OF q�s� *0e i MICHAEL E. MILLER•: LG/SS1V 2 2 McCLINTOCK LAND ASSOCIATES, INC. 16942 NORTH EAGLE RIVER LOOP ROAD EAGLE RIVER, ALASKA 99577-7601 (907) 694-4499 LICENSE No. AECC596 FIELD WORK DATE: B-31-17 PARTY CHIEF: MF DRAWN DATE: 9-05-17 DRAWN BY: JC -OU I /=A I A f -7L -/v/'7 /I A/^IIIA / VL7"L-ll V If L/l V APlP'%/T//"1A/ A/ 7 29.9' z I l UL.//l/L//V /Vl% /—I. / A5PHALT ro DRIVEWAY W O ' o 29.41 O 11 ^ O LL I l,� /L.nT iJ—� i Jn I 3L06K VN/NG WALL 1 Ou '.I -•OVA —U — I /lT h A;JI AT R.". "_1 L_ l/ / aJLJI /'l (r I J—vV.. I AS -BUILT I hereby certify that I have, or someone under my supervision has, inspected the property described as: LOT 7, BLOCK 3 EKLUTNA HEIGHTS SUBDIVISION, ADDITION No. 1 (PLAT No. P -215A) Anchorage Recording District I The improvements situated thereon are within the property lines and do not encroach or overlap onto adjacent properties, nor do any improvements from adjacent properties encroach or overlap onto this property, except as indicated hereon. Ib lot corners have been set. The property dimensions shown are from the record plat old are not necessarily as we may have measured. The Improvement locations ore approximate and hove been determined only to the extent that enables us to determine if there are any encroachments onto or off of the lot. Drafting and reproduction my produce graphic inconsistencies; therefore scaling should not be attempted to determine unshawn dimensions. This drawing is not adequate for additional construction or for determining the exact [mat ion of property lines. Only easements frcn the recorded subdivision plot noted above are shown hereon and it is the responsibility of the owner to determine if any other easements, covenants, or restrictions exist. C McClintock Land Ase=!else, Inc. (MLA) 2017 This document is copyrighted and is authorized to be used for one real property transaction or project only. Any copy Is to be considered unauthorized unless It bears an original surveyor's signature(usually in blue Ink) or a stamp showing recorder's office data. Copyright restri clions `but not re—use restrictions) are waived if this document has been officially recorded. Lending institutions may also make additional copies for their own records. Liability to MLA is limited to fees received for this project. FIELD BOOK: 461-32 PLOT SCALE: 1"-40' GRID: NW1461 DWG NAME: AB17-196 JOB NO: 17-196 L_ V / a I I O Kiri-�i:lnl LEGEND A FOUND REBAR ® ELECTRIC METER N L.L LLJ oma, SEPTIC VENT w J % I Or TELECOMMUNICATIONS r PEDESTAL Q I oa UTILITY POLE XX XX XX RRECCORPD ATEA PER (w I PLATO 2 BLOCK NUMBER - -ou- - - OVERHEAD UTILITY LINE —x—x— WOOD FENCING ® CONCRETE RETAINING WALL 99 OF q�s� *0e i MICHAEL E. MILLER•: LG/SS1V 2 2 McCLINTOCK LAND ASSOCIATES, INC. 16942 NORTH EAGLE RIVER LOOP ROAD EAGLE RIVER, ALASKA 99577-7601 (907) 694-4499 LICENSE No. AECC596 FIELD WORK DATE: B-31-17 PARTY CHIEF: MF DRAWN DATE: 9-05-17 DRAWN BY: JC -OU I /=A I A f -7L -/v/'7 /I A/^IIIA / VL7"L-ll V If L/l V APlP'%/T//"1A/ A/ 7 29.9' z I l UL.//l/L//V /Vl% /—I. / A5PHALT ro DRIVEWAY W O ' o 29.41 O 11 ^ O LL I l,� /L.nT iJ—� i Jn I 3L06K VN/NG WALL 1 Ou '.I -•OVA —U — I /lT h A;JI AT R.". "_1 L_ l/ / aJLJI /'l (r I J—vV.. I AS -BUILT I hereby certify that I have, or someone under my supervision has, inspected the property described as: LOT 7, BLOCK 3 EKLUTNA HEIGHTS SUBDIVISION, ADDITION No. 1 (PLAT No. P -215A) Anchorage Recording District I The improvements situated thereon are within the property lines and do not encroach or overlap onto adjacent properties, nor do any improvements from adjacent properties encroach or overlap onto this property, except as indicated hereon. Ib lot corners have been set. The property dimensions shown are from the record plat old are not necessarily as we may have measured. The Improvement locations ore approximate and hove been determined only to the extent that enables us to determine if there are any encroachments onto or off of the lot. Drafting and reproduction my produce graphic inconsistencies; therefore scaling should not be attempted to determine unshawn dimensions. This drawing is not adequate for additional construction or for determining the exact [mat ion of property lines. Only easements frcn the recorded subdivision plot noted above are shown hereon and it is the responsibility of the owner to determine if any other easements, covenants, or restrictions exist. C McClintock Land Ase=!else, Inc. (MLA) 2017 This document is copyrighted and is authorized to be used for one real property transaction or project only. Any copy Is to be considered unauthorized unless It bears an original surveyor's signature(usually in blue Ink) or a stamp showing recorder's office data. Copyright restri clions `but not re—use restrictions) are waived if this document has been officially recorded. Lending institutions may also make additional copies for their own records. Liability to MLA is limited to fees received for this project. FIELD BOOK: 461-32 PLOT SCALE: 1"-40' GRID: NW1461 DWG NAME: AB17-196 JOB NO: 17-196 MUNICIPALITY OF ANCHORAGE' DEPARTMENT OF HEALTH & HUMAN SERVICESg ,o ' �1'"JDivision of Environmental Services'.,,. ; "T"' t, v` r.��� • ��� �d �'f" On�Slt9 Services Sectlon f?J 0 �9 PA tBox 196650 WAhchorage, Alaska Y'99518 6650 a „'7 r l.by x i qtr 'tl r - "tti � 343-4744 ",-CERTIFICATE OF, HEALTH AUTHOR ,��, ITYxw�„ .��l; ci;``x(1ttt'APPROVAL'FOR A SINGLE FAMILY DWELLING Parcel I D #. 051-061 25 T HAA # HA960115 1. GENE"LINF ti RMATION r, Complete legal descript(on'` Lot 7 Block 3 Eklutna Height's #1 r�•.—. q 21407 Settlers, Drive Chugiak, Alaska Location (siteaddress or directions) ``_1 1a )qy - 'a� �}O y+�,k+ t Jam.`; dx 3.2fl F�i[LF:ii )) '..,;�i �.#��{,�•. tj r, ,3 �Y "' �•""'I7 Property,owner `Julie RM s` Grizzle y Pt! 688 t1126' Da one „L Mailing address ° PC Box `4670692` Chugialc`i Alaskay99567a --- �, u„ R A�.. �L r l t �`r� y ;Holding tank uu``ii��x��> (V'>jY pw� 1 -.. t� {+' i'i W'�•Tlpyi [ ( �' i ��' xF ?l il'1 IR ,aCom►?ar�lty on.s(te " PubIIb sewer _� nt ii1 cx1 '�3 t�G 3L�hr r� fGx� 0- , NOTE '` If wastewater systemi 'provide written conf' on from State ADEC N comm�inity 'pat attesting to the legality and s6ibs of system, � R21 72A25 (Rev. 1/91Front MOA ;€ S ` yq0g r 04AN IOU 91 9BvjOqou-V;tO:-14jjadj1 IOU OP SHHO 10 . seep I jay�q �s sewoq jo siesupind ofAselm luepuedepul ue Aq QAOqV iq f4jjoqInV L0164H sanbsI (SH i�nb8jGjVjSPula izw vow 4028 MwASH)930-al 3' ;ejojd e4j U q o ' Isalwo jo sjoije jol ejqjsuodsej k V ... 'A" I l - a. suol;bedsul 46npuoo 66/`6Ai4jePj6 ui suoiAiiiui 66ipuei jima Pula 16-914jS k1l U! pajoisl6ei jeeluiBue pauolsseloid Jai:Jai: eqj'uddnV;Aj'U1iO P,990q S91931JI]JO0 J9AojddV v -jUGL41;a6d%BaJ'd', ouy jO.AIjjvdjojunVq eq.L �AV V4� 9661 'TT jTjdv "IOU f "yr :A 13 "A' 0 AT t k 141 v dot ..LAI . . . . . . . . o t. -7 b4utf LULUO� lrUOII!Ppv ST. f U'VI letqr -cli �b'f" J '44 mopIndi4s" 6611oveq4 am"'S woojpeq J01 L'ItaAbidde lBuol4!puo0 -p9Aojddvsj(3 ,swoojpeq JOI, P6AojddV'-XXX 3un.LVNE)IS SHHa 9 6,61 01' ;Eqqui9-4d9S , v E Ell -41e go-ujo a no -[Teo asipat1'd -tUVa,56Tcj"s;9DTA.19S '94TS--7U0 'SHHC[ IS '91TJ uo sr.,,4u9umoop:lSTT4�'40 aiiii •9 or.; j o sHHa MR�luT•;'RTT; P;1Rlq- 1VU-TbT:E0 ino uio:Ej Du ST ST74LL elsa 14eu6is sdel LLS66 a -L eS 60Z 9-4Tns apleoa aoou TRAT-d ejDPa VEOLT Ss9JPPV -,6L6Z S,,,tuAA 10 GLUBN -V69 tluuLld..�,:-' bul-1919uT ua:. !j Tl uolloeldsul 8141 tqo, elep Uo 408119 Ul 1juln Bei pug 'Geougulpio �lolunV4 Alddns apoo GIBIS putjBqjjm9pUgijdwo6ujsjI 94sxv jesod I alsem J01pue Jejum q11s-Uo eqj 'uopedsu puv"uo1j46jjSGAU(A W04 pug sel!j 86 1. ou to AjjjBdjojunjN eqj wojlpeulBlqouoilTawjoluieqluo,pesuqllaqlAjliGAjoqljnil-ulojeqpeilaolpuioinjoniisIoedAIpuya swoojpeq to jaqwnu eqj jol apanb epa : pue jeuolloun j lojes sj,w9jjA' a 1996dalp jejemetsem jo/pue Alddns jalem ells-uo eqj jeqt smogs uoitpoliddia JVA6jddVlAjj16qjnV q11vqH SjqjjQ,U0jjvBjjqqAUj Aw 11341 A41J9A I #14o," q' oqS GJBp UO11Bpjj9A 0 §j IBBS A Lul Aq peippeo sV ' U33N19N3tJA8,N01133dSN1 d0,INM3MS *9 Parcel I.D. 051-061-25 x�f B4i Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 a s> r e r r A Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Expiration Date: /- 1 .5--- ;), 0 / Complete legal description EKLUTNA HEIGHTS #1 BLK 3 LOT 7 Location (site address) 21407 SETTLERS DR., CHUGIAK, AK 99567 Current Property owner(s) HUD Mailing address Real Estate Agent 2. TYPE OF DWELLING: Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 2 Day phone Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual 171 Individual Water Storage ❑ Holding Tank ❑ Community Class A Well 0 Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: NONE nistnnrsr --- Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $ ��� 2 Waiver Fee $ Date of Payment 3 Date of Payment Receipt Number (5 CI(O-1 A Receipt Number COSA#-_ 05c. t 31 dl h Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm SPURKLAND ENGINEERING Phone 279-3916 Address 203 W. 25TH AVE.,STE.202A, ANCHORAGE, AK 99501 Engineer's Printed Name LARS SPURKLAND Date 1/16/2013 ��49T'► �;� :Y' i�f 6. DSD SIGNATURE System #1 Approved for bedrooms S E SFUgKLAND, c` System #2 Approved for _ bedrooms /t �' )' 1 0 Il �'FO.) Ib i�.•�i�r� Disapproved\� 4 ESS!C",. Conditional approval for bedrooms, with the following stipulations". zq gy: Original Certificate Date: The nicip An a 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 COSA M. sheet S - :, c Other I ' " If more than 1 septic system is on the lot: COSA Checklist # 1 of 1 Structure served by this system 1 Certificate of On -Site Systems Approval Checklist Legal Description: EKLUTNA hEIGHTS #1 BLK 3 LOT 7 A. WELL DATA Well type CLASS A If A, B, or C provide PWSID # 213750 Date completed – Sanitary seal (Y/N) - Total depth ft. Cased to - ft. FROM WELL LOG Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform _ colonies/100 mL ft. Parcel ID: 051-061-25 Well Log (Y/N) Wires properly protected (YIN) Casing height (above ground) in. AT INSPECTION 'i1 g.p.m. g.p.m. Nitrate _ mg/L Arsenic ug/L Date of sample: -- B. B. SEPTICIHOLDING TANK DATA Tank Type/Material SUNSET/ FIBERGLASS Tank size 1000 gal. Number of Compartments Foundation cleanout,(YIN? Y Depression over tank (Y/N) N Date of pumping 2 `' / Pumper JR's PUMPING C. ABSORPTION FIELD DATA Collected by: -- Date Date installed 9123/1976 Cleanouts (Y/N) Y High water alarm (Y/N) N Date installed 9/23/76 Soil ratio d./ft2 or fe/bdrm 85 System TRENCH 9 (9�P ) 9 type Length 37 ft. Width 3 ft. Gravel below pipe 5 ft. Total depth 9 ft. Eff. absorption area 296 ftz Monitoring tube Y Depression over field N Date of adequacy test 1/15/2013 Results (Pass/Fail) PASS For 3 bedrooms k Fluid depth in absorption field before test 2 in. Water added 500 gal. New depth 50 in. Elapsed Time: 15 min. Final fluid depth 5 in. Absorption rate >= 450 9 p d Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed "Pump on" level at Datum Size in gallons Manhole/Access (Y/N) iii. "Pump off" level at in. High water alarm level at — in. _ Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot NA Absorption field on lot NA Public sewer main NA Sewer /septic service line NA Animal containment areas NA On adjacent lots NA On adjacent lots NA Public sewer manhole/cleanout NA Holding tank NA Manure/animal excrete storage areas NA SEPTIC/HOLDING TANK ON LOT TO: Building foundation 'S Property line 'S Water main >101 Water service line >10' Wells on adjacent lots >200' ABSORPTION FIELD ON LOT TO: Property line 1 Building foundation >10, Water Service line >10' Curtain drain >50' (N.O.) F. COMMENTS 'WAIVER ON FILE G. ENGINEER'S CERTIFICATION Absorption field >5' Surface water '100' (N.O.) Water main >10 Surface water >100' (N.O.) Driveway, parkin gNehicle storage >10' Wells on adjacent lots >100 P-iVAte I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name LARS SPURKAND Date 10/16/12 COSA brown sheet 10-10-12.doc i f , _ PURKLAND:K;0' 1�+V1X.pS��P��C AZunicipali of AncIiorage.� Development Services Department ' Building Safety Division}' `tea On -Site Water and Wastewater Program 4700 South Bragaw St. s P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I. D. OS/- Orio/-,7_S HAA Expiration Date: _ GO GENERAL• INFORMATIOW'� Complete legal iie§criptian ': tKLNTN.4 F}E(G TS I L0T 7 gtceJC 3 Locatipn (site address or directions) _ S 1►i07 �ETTL F_ - 7>i2 Current Property.owner(s) _DGS: LD RELG H1_4 E4A0e_ Day phone �oBP- oyy9 Mailirigaddress 21y0'7 S��LE/GS Dc� GHUCTiAK., AK 9856-7 Lending agency Day phone - 4,1.. 4. Mailing address Real Estate Agent _GL.tUP[A MOOTGyMF-P--tr Dayphone_G8g-85oo Mailing Address _ifoUn1TX V JeE;4 L -T y Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: a 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site (]' Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System 2 Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given In paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below. I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on- site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Eagle River Engineering Services Phone 6991 - Si9S Name of Firm 1042. Address Eagle River AKS 99F77 Engineer's Printed Name CH,elsToloNE4 Q ��D Date June lam_ a+RtsTOPPER R. WOOD 5. DSD SIGNATURE CH077 LZ Approved for bedrooms. Disapproved.ss(o Conditional approval for bedrooms, with the following stipulations: Additional Comments Attachments: NAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date: v _ *bZ— (Rev OIM2) Municipality of Anchorage ." ' Development Services Department ' "m..:. Building Safety Division " On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: FwrCW TNI4 ffEICM TS Wr /� L 7 B 3 Parcel Ib: OS/ — 061— 35' A. WELL DATA I Well type If A. B, or C provide PWSID # _ Well Log (YIN) Date completed _ Sanitary seal (Y/N) _ Wires properly protected (Y/ Total depth ft. Cased to ft. Casing height (a ground) in. FROM WELL LOG EA,T I CTION Date of test Static water level ft. 0� ft. VIM Well production g.p.m. 9 - p.m -WATER SAMPLE R S: Colifor colonies/100 ml. Nitrate mg.A. Other bacteria colonies/100 ml. rsenic: _ mg./l. Date of sample: _ Collected by: B. SEPTIC/HOLDING TANK DATA TankType/Material SUNSET/69EX&t,4Ss Date installed 9/.23ii�7b Tank size 1,000 gal. Number of Compartments s Cleanouts (®N) IBES Foundation cleanout Y N) JIS Dgpression over tank (Y& _,6(a High water alarm ��0 Date of pumping '►/A9/ O&1 Pumper fl, rS Aw4pi.✓6r C. ABSORPTION FIELD DATA Date installed 9/2a/316 Soil rating (g.p.d./it=or I r System type 7-pezaGH Length 31 ft. Width 3 ft. Gravel below pipe 4 ft. Total depth _.Z. b ft. Eff. absorption area a1& ft2 Monitoring tube Y65 Depression over field Date of adequacy test f/3 JOS Results ag, ail) A. -Ey For A- bedrooms Fluid depth in absorption field before test 0_ in. Water added y" gal. New depthlU in. Elapsed Time: 0 min. Final Fluid depth _0 in. Absorption rate >= 416'0 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y®8 type) A/0 If yes, give date A//A D. LIFT STATION Date installed 'Pump on' level at _ in. E. Size in gallons 'Pump off' level at _ in. ManhoWAccess(Y/N) High water alarm level at Datum Cycles tested Mets alar, ►, �,t,<d SEPARATION DISTANCES 00 SEPARATION DISTANCES FROM WELL ON LOT TO*tffiXo% Septic tank/iift station on lot On adjacent lots _ Absorption field on main /septic service line On adjacent lots Public sewer manhole/cleanout Holding lank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation '+'S r Property line 1'5* Absorption field S r Water main 410, Water service line +10, Surface water + 100 Wells on adjacent lots -0100, SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: r Property line *` I Building foundation +10 r Water main + 1 O Water Service line +'101 Surface water -* 1040, Driveway, parking/vehicle storage /00 Curtain drain + SO Wells on adjacent lots t 100' F. COMMENTS -0- G. ENGINEER'S CERTIFICATION 1 certify that 1 have determined through field inspections and /nq review of Municipal records that the above systems are /n conformance with MOA HAA guidelines in effect on this date. OWSMR Engineer's Printed Name COX iSIVAIMR: X. 60ADo Date (0 1 3 3 /OS HAA Fee $ ` ?10 d Date of Payment 1 44'i Receipt Number Z)7005- (Rev, )005(Rev. 12/01) VU U Waiver Fee $ Date of Payment Receipt Number 0 L4 w N O m A Z -4 0 f0 070 ��G� 0i + O� i D m N mmNOZ� N > a O �0 �rDco� m E u m W = p r- Z N o coil D W 0 ? to z A rr,xc crn�—IZA Z D N+Xzvv�rm no0m 0 czi coo'�zA-,omm m zo (1) Z Zzr=•���-< rr,Z O D zm0 zN--I�m0m r'r � '9 rri X i X m-0- v� 0 A co 0m ONO+ M Ooc ;Dmz Z 0 C K;omx oxo --4 X O 000 -4 co NO S Ln 0 ;u zxC)zr-11�°D°D-' VI z -<, o O -i A :C m Oo - -+ o 0 (hozm C)m2 gXz ozo-qm D = rn -I XX CLf)::: -i-iZm V I m C O D= O ZOc)c0=zm� �� D =1 m=a :5- m 2 r�r++ttO—yA f�7 D ZZZ0ONmpZ m0 <zOr^���I m mn O> Z C 0 O� X O rn my �O z -I O z z 0 x z 0 m O C z 0 U W a M M D A m^ G) m z 0 z(1) SETTLERS DRIVE N 00'05'10"W 82.5' (REC N 00'02'17"W 82.43' (MEAS a SHED 141' 48.1' 43.6' z m o 4 I M 0 n An Y r§ 0 9 `p. H z 0 C 0 z 0 0 r� L14 w z 0 m 0 io 47 1 N N rn rn L4 a o + � I m v C7 N 00'04'40"W 82.58'(MEAS) 82.5' (REC) La—x N 00'04'40"W 626.90' (REC) 627.50' (MEAS) LA W L1 BASIS OF BEARING L4 ROCK PTARMIGAN STR 0 r z O m --4 C7 O x (m_^) V 0 -� �U) D"I C rn 'r Q D m0 < on - �0 WZ 0 r z O m --4 C7 O x nb/07/2005 16:18 9071:'"9821 JRs Pumping PO Box 773415 Eagle Raver, AK 99577 (907)694-6454, BIINnO Mfontyl�lon - ' •3 Don BaMaAumsur '--- 21407 Samara Drive Chu9lek, AK 09%7 (007) 632-0440 [J ob SIN In►ormitlon tion •- _ .. 21407 Settlers Drive Chugisk, AK 09567 (907) 632-0440 Service Type Same Day Call Out Fee Septic Service Additional Loc"On Commants: 200ft from Fire Dept heading South PIPas behind house JR$ SEPTIC Job Description: 10000 P.O. Number: PAGE 82 Service Agreement Number: 014010 Order Date; 29,1u1•2004 Service Date; 20,1u1-2004 12:00 am TeMnlcian: Ph;1 Terms: Net 30 Salewep: Mkole Map gook: Job Typo Repeat —j Crosa Street";Map Grid; 23 - . tbmastcad Road Job Comments: Leat eaivlce 12/p6i01 t000p –' ... —. Checked and pumped tank -cleared clog from do Tax Portant I I 0 OtY Price Each x 2 Man 1 530.00 No No _- Extension Actual 1 5120.00 Diagram: I No No 530.00 Gallons Planned: EstimatedCAarpes: NonTaxable Total 111150.0() 1000 Gallons Actual: ��— Hose Length; Double Tank: [ J Pump System: N �` 831160 Inlet:.] games Outlet Taxable Too# Tax Total 50.00so.00 Grand Totalalso 00 Actual Charges; Customer agrees to pie NrmS and eorbhtana pinted on the back. THIS IS A BINDING A GREEMENT. and Tdie of Customer Accepted by JRaPumping For Your added eomanlenee wo aeeept; Amerlmn E DateData Acca—�� Express. DlCovar, VRa and Master Card payments over the phone. After 30 02VS accounts win be turned over to Conacgo n. 525.00 For NSF Chocks Returned. . Municipality of Anchorage -- Department of Health and Human Services ' Division of Environmental Services On -Site Services Section 825 V Street Room 502 P.O. Box 196650 Anchorage, AK 94519.6650 www.cLanchorage.ak.us (907) 343.1744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FORA SINGLE FAMILY DWELLING Parcel I.D. 051-061-25 HAA# U O Q % 5172 Expiration Date: GENERAL INFORMATION Complete legal description Lot 7, Block 3, Eklutna Heights Subdivision 91 Location (site address or directions) 21407 Settlers Drive Current Property owner(s) HUD Day phone Mailing address Lending agency Day phone Mailing address Real Estate Agent Gallery Homes/Scott Stroud Dayphone_ 441-8829 ...Mailing Address 3120 Denali strre buize O *%TICI{VL� Unless otherwise requested. HAA will be held by DHHS for pickup. HAA picked up to 2. NUMBER OF BEDROOMS: 2 rz/y=•/oa 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site Individual Water Storage ❑ Individual Holding Tank ❑ Community Class —A—well ® Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Department of Health and Human Services (DHHS) 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 the transfer of title (except between spouses) on properties served by a single family en -site wastewater disposal and/or water supply system. DHHS also issues HAAs upon request to home owners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a piivate or Class C well and may be reissued with newwater sample7eiults less than 30 days old. Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. rtastruv o1.TM- S. STATEMENT OF INSPECTION SY ENGINEER As certified by fry seat affixed hereto and as of the validation date shown below, I verify that my investigation based on procedures outlined in the Health Authority Approval Guldelines for the Health Authority Approval application show 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. further verify that based on the Information obtained from the Municipality of Anchorage tiles and from my Investigation and Inspection, the on-site water supply and/or wastewater disposal system is In Compliance with all applicable Municipal and State codes, ordinances, and regulations In effect at the time of Installation. S d s ENGINEERING Name of Firm1; :: Ccfe r::rcr Loop Road No 24t Phone G rl Y - % -7c/ Address E'-' ° f - r, Alaska 99577 Engineer's Printed Name Robert C. Cowan Date 12-73 L7.,0 6. DHHS SIGNATURE • �""'`OM OWAtr r � � ROCCti C. towAH Approved for bedrooms. C"E"- 0801 el%% •et11Disapproved. Conditional approval for bedrooms, with the following stipulations. Additional Comments Attachments: HAA Checklist Maintenance Agreements Septic System Advisory. Supplemental Engineer's Report Well Row Advisory Other Original Certificate Date: _/2 -e 2= eo Expiration Date: / 2 - .2 09;L. - O / Reissue Date: 72-02s ta.k a+AOI- Municipality of Anchorage Department cf Health and Human Services i DfvWm of Environmental Services on-She Services Seddon 825'1.' Street Room 502 P.O. Box 196650 Anchorage, AK 99519-61150 rvww.d.anct rage.ak us (907) 343-474 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: .f O� T -,t- &,!x1. 3' &ZiffNA 14TS rt--o Parcel I.D.: Qrz I GY./-2S A. WELL DATA Wen type 6"A or C provide PWSID # Wei Log Date completed Sanitary seal Wires property protected Total depth It Cased to it Casing height (above ground) In. FROM WELL LOCI AT INSPECTION. Date of test Static water level ft It Well produdlon g•p•m . 9-p.m WATER SAMPLER S: Coliform colonies/100 ml Nitrate mg/I Other bacteria colonies/100 ml Date of sample: Collected by: 8. SEPTIC/HOLDING TANK DATA TankType/Material ��PTi(c�ICI-�6� SCS Date Installed _ Tank size /j= gal Number of Compartments Ciearwutsy_&-�Foundatlon cleanout y's Depression over tank OV0 High water alarm Date of pumping 1Z, 2 Pumper 0 z lS C. ABSORPTION FIELD DATA _ Date installed _�� Soil rating (g.p.dltt2 or h2bdrm) Z-&-41System type Length L;'r tt Width �ft Gravel below pipe --4--tt Total depth ff_-60R Effective absorption aJ-2?kftz Monitoring tube Depression over field N O Date of adequacy test f� Results (Pass/Fan} .4s For�faj� bedrooms / M Fluid depth In absorptioneeldefore test � In Water added•�� gal. New depth L in. Elapsed Time, ia0 min Final fluid depth _� In Absorption rate >z j 3 g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN a type) gtbu✓ KJV r If yes, give date 73 oas (IW. 01M*1' MOA 2020 D. UFT STATION Date installed a in gallons 'Pump on" level at In "Pump ofP level at in Datum Cydes tested E. SEPARATION DISTANCES Manhole/Access High water alarm level at in Meets alarm & circuit requirements. SEPARATION DISTANCES FROM WELL ON LOT TO: NSA a.44S A Septic tankAift station on lot On adjacent lots Absorption field on lot lob r•%- O kris Public sewer maim Public sewer manhole/cleanout Sewer /septic service lie Holding tank SEPARATION DISTANCES FROM SEPTIC11401:944 TANK ON LOT TO: Building foundation _ j /� Property line 5 /•� Absorption field 5 /•,- Water mai _ /00 11" Water service line _ /C� **f- Surface water /001+ Drainage 00rd- Drainage ^rZJ8 Wells on adjacent lots csCTD '•r 6ZAys p) SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO. Property fine -;w I/ Building foundation /D � Water main _ Al Water Service Nne / 0 It- Surface water /" / i- Driveway, parkingNeNcle storage / O t - Curtain drain /�2dG Wells on adjacent lots lyh (ZAD',f- 6eAo-* .4) F. COMMENTS 0. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and;C/ review of Municipal records that the above systems are in conformance with MOA HAA guidelines In effect on tis date. AN Engineer's Printed Name 144" -wt-- Cost.✓ r�C1 CE.ROU�8e0ot .il! Date I X/%-A,/00Ctill f%r= =:" ":••. HAA Fee $ f Date of Payment Receipt Number' nota rare ovooi• �• Waiver Fee $ Date of Payment Receipt Number GREATER ANCHORAGE AREA BORuUGH c� Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 �7 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME/,y/ /h %/*' ICS MAILING ADDRESS 32V I/pJ n 5 clle PHONE LOCATION1If P'" '«/l' 157 LEGAL DESCRIPTION,/c T" %/-?lira' J' ZIA ffe 7-v 7-t' SEPTIC TANK: DISTANCE _ NUMBER OF FROM WELL -MANUFACTURER ,11,v+r7MATERIAL F - 9�•' COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY A_1r GALLONS. SEEPAGE PIT: % 1 /j rl NUMBER OF PITS DIAMETER OR WIDTH LENGTH_, DEPTH •J -• LINING MATERIAL Yr / CRIB SIZE: DI AMETE R_DEPTH:�: DISTANCE FROM: WELL TOTAL EFFECTIVE BUILDING FOUNDATION_, NEAREST LOT LINE . ABSORPTION AREA (WALL AREA) SQ. FT. ADDITIONAL ABSORPTION WELL: e v f+T /vl v Al TYPE CONSTRUCTION DEPTH DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION , LOT LINE , SEWER LINE , TANK , SYSTEM. CESSPOOL . OTHER SOURCES APPROVED DISAPPROVED REMARKS DISTANCES: INSTALLED BY: PIPE MATERIAL: • / / •C LOT SLOPE:�� REMARKS: DIAGRAM OF SYSTEM DATE ,_I - •A 7 - r A A MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # DL,� aS HAA #J 1. GENERAL INFORMATION Complete legal description Lot 7; Block 3; Ektutna He ight.6 Subdiv i,6 ion 4 J Location (site address or directions) 21407 Setteeits D4,ive AK Property owner JuUe M. G4,izzte Day phone Mailing address P.O. Box 670692 Chug.iak, AK 99567 Lending agency Mailing address. Agent Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water 2 \, XXX Day phone Day phone 688-1126 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 writtenePon firmation from State.,ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 5. 6. By: 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 C c 1 _ 3 6i 71/ 17034 Eagle ver Loop Road No. 204 Address Eagle River, Alaska 99577 Engineer's signature DHHS SIGNATURE yApproved for bedrooms. Disapproved. Conditional approval for Additional Comments Date � °'� IfT ROBERT C. COWAN CE -0)x0.7 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 #21 MUNICIPAu l I I:NNIRONMENTAL$tkYil.cS i.IYIJIVIV Municipality of Anchorage �R ®7 DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division( E V E D 825"L" Street, Room 502 • Anchorage, Alaska 99501. 907) 343- Health Authority Approval Checklist L11- Legal Description: 1� 0-r IY� - 12j e4 -,100A I& sI PdIrcel I.D.: 0 S- / 0 6 1 - a S A. WELL DATA Well type A If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Total depth Sanitary seal (Y/N) Date of test Static water level Well production WATER SAMPLE TS: Coliform D to of sample: Date completed Cased to FROM WELL LOG B. SEPTIC/HOLDING TANK DATA Nitrate g.p.m. Casing height (above Wires Collected by: (Y/N) AT INSPECTION Other bacteria Date installed 9 3 -7G Tank size 100o Number of Compartments Z Cleanouts&)--.�— Foundation cleanout ON) Depression (Y& N High water alarm (YN Date of Pumping 3 - 2 9 - 9 Pumper T-2_ 604 f j. �t C. ABSORPTION FIELD DATA Date installed q - a 3'71/' Soil rating (g.p.d./ft2 or ft2/bdrm)(//1- System type %aGµ Length .3-71 Width 3 Gravel thickness below pipe T/ Total depth 9 Effective absorption area ? 54 I Monitoring Tube presentQ`N)__Y_ Depression over field (Y/Q _ .l Date of adequacy test 4-1-9(o Results a s Fail) Pi -6S For $- bedrooms Fluid depth in absorption field before test (in.); D Immediately after-2VO gal. water added (in.): � Fluid depth d (ins.) Minutes later: / Absorption rate = 300 4- g.p.d. Peroxide treatment (past 12 months) (YW If yes, give date 'J/,d D. LIFT STATION Date installed Manhole/Access (YIN) High water alarm level at* E. SEPARATION DISTANCES Size in gallons "Pump on" level at* *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main u li On adjacent lots On adjacent lots sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: off' level at* Building foundation S} Property line 1 0 1 Absorption field b i Water main/service line /o ' Surface water/drainage t od t h Wells on adjacent lots 200 ' + SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation 10 i + Water main/service line /a 14 - Surface 4 - Surface water /00 14- Driveway, parking/vehicle storage area 3• i Curtain drain q Wells on adjacent lots 7iDo i ~ Property line F. ENGINEER'S CERTIFICATION S �/N tG�R– >�ticiJJ Esq. I certify that I have determined thru field inspections and review of Municipal records t aP�l�'s are in conformance with A /Hd%dy guideli es in effect on this date. ,�Q.�,,.N••• • ••.,, �rZQp� Signature t th Engineer's Name f�10!l�.t i C ca 14,1 / �j fir„ 1ti ROBERT C. COWA14 i c - Date 2/3 3 19 6 4 0' •. CE - 8G01 HAA Fee $ ofm r OT Date of Payment—r�3� Clo ) Receipt Number/ 7/ / 7 a E;y Rev. 8/95 OSS: haa.wk.doc Waiver Fee $ e Date of Payment Receipt Number 1 ` � �• .I nN � 1 J tt'1 t•� � f �� � D �� � r , , �' ✓O l ! • r4 r , �"' .z<y7[�+o,•,�, ••r'� .` :E 1 L. `Y,� fi..(r :.c }t ', I q � '�,� (}� i ,^,•�•,+ti.: � 1\ � �' ' , 11 j' ( r r rayl. • J'T.Tf" � A'. `�./4'4 H. e^ fw.. 1T� � •. 4 ', •1}' ., I 1 t.. .ryj. ww G.. • 1n tr - 1.I1 , I�,+f-' </ , � 1 - ` � � � Q 01'u�(/M� ''� r ��<j« <II t„rr� � wl�� r ) w • I � 11 • ,y`° r j 1_ --••�. t : i jr••TGr• ! , t t r 1" e r ` 1 .,rr +S. 1. ,•' < I .I ♦.- I < t ', r + r 1. 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I3.�.4-C�.Lj <i'• !/ '• 'r �.1. ;5 Yt�.,1µy�a!!y•�1.. ; \<)i�� y Y .•<I Ir - E r! •.J'r } 1' •t• <I'rCl>. v ��'%�,if'.' }.4virt�' 1 �iCr/ r i �.-•�: `+4iF.�' a I<i:Ij1 1 ` ': And 6rnR01 r�99dCSt(lljt': BCJSiZtt;�'laalCa, 'und'wthdtc�he%'. -^ t :°I T)olG�.�Ii°", /.�x♦ •b �� i w „ '' I.1 t' ` t r i `•` I mprO.Ygmen I situated thtre6'Y pXe'. V/it4l,th&1b w �y. E �. rylf Jt. A •.nC,\ ,h 1 K t '} r i ♦ �, r by 'lines." awl, I y 7 r { f and not •dver�a�a or. enrru�Ch a khe"}�Yd��yj �r L. y „ 'lying'adjaeaat'therktt t` q►';nb, im avemertts;on''pro �� +¢27 It i!iJ , rG •x •�('! ' ( i I d� tCf {T wt , ��rr r pp 1 Y• Wng:adjatenirtheYeto'encroach"Onth 'pTemtseg ln, UeAtian%and thatWere!are.-no m�dw>ryxgtrgasxalswptti' tiry c. sV� t� I i �1 '' , , C: t Iknea olr.:oth�s vlatb2a easatttentS oft saiQ pyopezt� es�9t,"I �5 • MM•bH►,��ty I ,M Mw• + ! r I -i .l I -♦yq fI Ob9lt.Yw'rr.i0 h mmnta( ry )5•j_ , + llr�a.4 r, }t w+. Yr• • '\.� ^ 9 1 �. I •' ; y % '''41itOG{ rh^i • ,x• "�, w ' uYa1 !•�' zf. < tv r r 111 ,e{I I ! $1: 'IF[rL I tr. {Iws�'tl°f vg't47Tr ty"'f'TI!.}',�' j�t,'�(,•C•tt44� ��S e C�n �Iw: 't't �' '.'.l♦ i . .. ty \ l( r. < tri ..r"} A4 It*, 'x"I.111 J-7 1• e t . . :j AT.x , ltkR�Btored t� lm iauxt"]i i%OIl .b AoTc t6A ' Al ka- n ;Vm_ '� ••ri July 31, 1995 To whom this may concern, I understand that local property requirements state that septic systems and their vents be a specified distance from adjacent lots. I am the owner of Lot 6, Block 3, Eklutna Heights Subdivision Addn. #1. 1 do not object to the location of the existing septic vent pipes for Lot 7, Block 3, Eklutna Heights Subdivision Addn. #1. In the future, when the owners of Lot 7 upgrade or replace their septic system, request that it is constructed in the proper location with the venting located appropriately. Sincerely, John E. G G� raybill Jean M. Graybill v / x Municipality of Anchorage i Department of Health and Human Services 825 "L" Street Rick Mysrrom, P.O. Box 196650 Anchorage, Alaska 99519-6650 Mayor April 11, 1996 Robert C. Cowan, P.E. S & S Engineering 17034 Eagle River Loop Road Suite 204 Eagle River, Alaska 99577 Subject: Waiver Request for Lot 7 Block 3 Eklutna Heights Subdivision #1 Waiver Request #WR960010, PID #051-061-25, HA960115 Dear Mr. Cowan: Your request for a waiver of the required 10 foot separation between an on-site wastewater disposal system and a lot line has been approved. The waived separation is 1 foot. This approval applies to the existing septic system lot line separation only. Any future upgrade to the septic system will require all separations be met or another approval from this department. If there are any questions, please call our office at 343-4744. Sincerely, Daniel J. Rooth Civil Engineer On-site Services Program DJR/ljm cc: John E. Graybill f MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR#+ PID# L )� _,-�`) HA# J ` \{ Permit # Date Received: _Pn,i _?) Legal Description: (RCA 1 NaS -2) � O `x �nr Engineer: (A�1.� Applicant: \�aQ,i Cn Waiver Requested: 11 U_r�� - Criteria: 1. Geology: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Points: Waiver is Granted: x Waiver is NOT Granted: List Conditions or Reasons for. above: S,EE EA41NFAE,6 G� `p /#A/D /idJv/ov/NG Pj?aPERrY dGNEIQS LF_1T6✓Z oN AiGAi-D13dEcTio.y Date: ¢-10 '-9` By: Poe�& Name of Reviewer Rec #:'nnn Amount: $ \\ CLQ Date Paid: S& ROBERT C. COWAN, P.E. ROBERTA. SHAFER, P.E. April 1, 1996 CIVILENGINEERS 79 RECEIVED FAX ( 694-29 FAX (907) 694-4- 1211 APR 3 1996 HEALTH AUTHORITY Municipality of Anchorage APPROVALS MUNICIPALITY OF ANCHORAGE Dept. Health & Human Services Department of Health and Human Services P.O. Box 196650 Anchorage, AK 99519 SEWER&WATER MAIN EXTENSIONS '41 REFERENCE: Lot 7; Block 3; Eklutna Heights Subdivision SEWER&WATER Request you issue a Health Authority Approval on the referenced INSPECTION property and grant a waiver for the horizontal separation distance between the leachfield and the property line at one foot. we do not anticipate any adverse effects on the neightboring properties. ENGINEERING STUDIES Attached is a copy of a letter of non objection from the owners of Lot ANDREPORTS 6; Block 3; Eklutna Heights Subdivision . If you require additional information, please contact us. WELL INSPECTION Sincerely, & PLOW TEST / V � ✓g7 SITE PLANS Robert C. Cowan, P.E. RCC/gk ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date __57 / 4t (a) Legal/ Descri tion (in 1l de to , block, .vision, section, township, range) L �j CCz G�GCj�GJ — Location (address or directions) (b) Applicants Name l/L 12 'Telephone Applicants Address (c) Applicant is (check one) Lending Institution Owner/builder Buyer r__1 ; Other/J (explain);; ff (d) Lending Institution Telephone Address (e) Real Estate Co. & Agent Address Telephone 2. Tyne of Residence Single -Family [:::I Multi -Family r:::j Other (describe) Number of Bedrooms 3. Water Supply Individual Fb11 Camiunity _ Public Note: If community well system, must have written �coon'ffiirmation from, the State Department of Environmental Conservation attesting to the legality and status. ^ S Is the well adequate for the number of bedrooms specified in this 4. Sewage Disposal Onsite Public Community Holding Tank Is the wastewater disposal system adequate for the number of bedr (Y [Page 1 of 21 2-15-84 5. Engineering Firm Providing Inspections, Tbsts, Data and Information I certify that`I h effect on;t^ date xr�',�Az Signed CL - Name irm Address_AM 1 Signed by Date 6.DHEP Approval 0 7. to - checked, verified, or conformed to all MOA HAA Guidelines in (ENGINEER SEAL) Approved for bedrooms By Approved 1 Disapproved Terms of Conditional Approval Conditional Date 5 CJ '2J .3 Date The Municipality of Anchorage Department of Health and Environmental Protection does not guarantee the continued satisfactory performance of the water supply anal/or the wastewater disposal system. This approval indicates that, as of the validation date shown above, based on the data and information furnished by an engineer registered in the State of Alaska, the water supply and wastewater disposal system is safe and func- tional for the number of bedrooms and type of structure indicated. (DHEP SEAL) KB2/d5/s [Page 2 of 21 2-15-84 MUNICIPALITY OF A DEPT. OF HEAL MUNICIPALITY OF ANCHORAGE (MOA) ENVIRONMENTAL PROTECn HEALTH AUTHORITY APPROVAL (HAA) MAR 2 81984 CHECKLIST - FEBRUARY 1984 A. WELL DATA Well Classification ICA) B. or C, D.E.C. Appro d( Well Log Present (YM) Date Completed Yield Total Depth Cased to. Depth of Grouting Static Water Level Pump Set At Casing Height Above Ground Sanitary Seal on Casing (YM) Electrical Wiring in Conduit (Y ) j Depression Around Wellhead (Y/N) Separation Distances from We 1� To septic/Holding Tank on On Adjoining Lots To Nearest Edge of Absorpt on Field 9� t ; On Adjoining Lots To Nearest Public Sewer Line To Nearest Public Sewer Cleancut/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected By ; Date Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA �7 Date Installed / Size No. of Compartments f 17 Standpipes (Y Air -tight Caps (Y Foundation Cleanou ( Depression over Tank ) Date Last Pumped 2.7 & P ing/� intenanae Contract on File (Y for �P Holding Tank High -Water Alarm (Y Temporary Holding Tank Permit Separation Distances fran Septic/Holding Tank: To Water -Supply Vb11�- 414eAJ6—/ To Building Foundation (- To Property Lim To Disposal Field To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course Comments Za �Ptlec If � 5,4 _ [Page 1 of 21 Ld�7 13)r-3 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata /� ` gS Type of System Design Date Installed �f Z 3 7 G Length of Field%% ( _ Width of Field 3 Depth of Field _ Gravel Bed Thickness Square Feet of Absorption Area �CJ Standpipes Present (Y Depression over Field O Date of Last Adequacy Zest Results of Last Adequacy Zest 5;fYT/ yt:;o4c Separation Distance from Absorption Field: To Water -Supply Well Corn er ivr "z7 To Property Line l0 f To Building Fo dation 904 _ To Existing or Abandoned System cn Lot fM On Adjoining Lots -7/- To Water Main/Service Line/ i% To Cutbank(if present) IJ i1 To Stream/Pond/Lake/cr Major Drainage Cause A To Driveway, Parking Area, cr�Vjehicle Storage Area 5C) Comments_ go /45- i,'o , 7 /'I � `s' Cif' e a 0 -re /Uv D. LIFT STATION Date Installed Dimensions Size in Gallons Manhole/Access (YM) "Pump On" Level at "Pump Off" Level at High Water Alarm Leve&/Y. Vent (YM) Tested for Pumping Cycles during Adequacy Zest. Meets MDA Electrical Codes(YM) Comments ** Check Permit Bedroan Rating Against HAA Request ** I certify�'t I h ve checked, verified, or wnformsd to all MOA SH...Guidelines in effect on the`d�t of ction. 14p Signe Y C,,, MOA No. N4N f ' SRS 196X RIVER, ALASKA Lev.77 KBl/d5/sL pli. fi*,?^7 r .r (Page 2 of 21 2-15-84 5. LEGAL DESCRCTIO 'A—� I C �S sob, DATA RECEIVED - INSPECTION APPOINTMENTS TIME NUMBER OF,BEDROOMS TIME TIME DATE L� Two ❑ Five DATE DATE 7. WATER SUPPLY ❑ INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled INSPECTOR since June 1975. For wells drilled prior to that date, give well INSPECTOR INSPECTOF3 8. SEWAGE DISPOSAL STEM MUNICIPALITY INDIVIDUAL/ON-SITE** MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ❑ PUBLIC UTILITY DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTI(]MVIRONMENTAL PROTECTION'. 825 L Street - Anchorage, Alaska 99501 NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. SEP 4 1981 ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 RECEIVED. REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER PHONE L' CA OSS' MAILING ADDRES )SOX P l© S PROPERTY RESIDENT (If different from above) ONE 2. BUYER PHONE MAI LING ADDRESS 3. LENDING INSTITUTION �� /PHnOONE —1 �r�CQ MAILING ADDRESS (( ,� C( l \ Q -C r 4. REALTOR/AGENT L:, �a ch,� �rkc PHONE �-a� MAILING ADDRESS �c��(� IC L-vcas C.y�. ever 5. LEGAL DESCRCTIO 'A—� I C �S sob, STREET LOCATION \-� N - 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS SINGLE FAMILY ❑OO ❑ Four E] Other L� Two ❑ Five ❑ MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SUPPLY ❑ INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled K'-16OMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL STEM INDIVIDUAL/ON-SITE** YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑Septic Tank or ❑ Holding Tank Size: If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL T0: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE 47. " ( BY 11 U 72-010 (Rev. 6/79) Sincerely, ROBERT A. SHAFER, P.E. RAS/'ss cc:- C'entruy 21, Metropolitan ATTENTION:- Charley Hall Alaska Bank of Commerce ATTENTION: Carol Schrode Municipality of Anchorage Department of Health and Environmental Protection SRB 196X EAGLE RIVER, ALASKA til�i EXCAVATION ROBERT A.SHAFER WORK A CIVIL ENGINEER 694-2979 September.3y 1981 Py CSF RIVEN AIASq-P MUNICIPALITY OF ANCHORAGE W DEPT. OF I![;", ENVIRONMENTAL rd;.)TECTION Patty Markle ' c/o H.A. Eddens 3 i<3s,1 P.O.. Box 369 Chugiak, Alaska 99577 RECEIVED Dear Mrs. Markley, Reference: Lot 7; Block 3; Eklutna Heights #1 Subdivision ° A sewer system adequacy test was performed on the system located on the referenced property as you requested. The septic tank was pumped and verified to have a capacity of 1000 gallons. The absorption trench was tested by a continuous flow of 520 gallons of water over a period of 24 hours without any measurable rise in the sump at the end of the trench. It can be concluded from this test that the waste water disposal system serving the two bedroom residence located on this property is currently functioning adequately. However, the system cannot be guaranteed against subsequent failure. If we may be of further service, please do not hesitate to call. Sincerely, ROBERT A. SHAFER, P.E. RAS/'ss cc:- C'entruy 21, Metropolitan ATTENTION:- Charley Hall Alaska Bank of Commerce ATTENTION: Carol Schrode Municipality of Anchorage Department of Health and Environmental Protection SRB 196X EAGLE RIVER, ALASKA