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RIVERVIEW ESTATES BLK 10 LT 1A
Riverview Estates Block 10 Lot 1A #050-791-17 72-013 72-013 (Rev. Wet) MOA 25 Municipality of Anchorage Page of a DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 0 Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: S,Uj �oaa PID Number: 05U'79/l-7 Name: Wastewater System: XNew ❑ Upgrade Address: �o 7a.9 7a FA6,LE qty Av. �7 91167 ABSORPTION FIELD -- Phone: No. of Bedrooms: p Deep Trench fidShallow Trench ❑ Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: O 00 Total Depth from original grades GPD/S . Ft. Lot:�� Block: Subdivision: ID T.IJC2vlfft.+ EST. Depth to pipe bottom from original grade: 15—Ft. Gravel depth beneath pipe 3.51 Ft. Township: Range: Section: Fill added above original grade: Gravel length: WELL: 0New ❑Upgrade Gravel width: Number oflines: Dislancebetweenlines: Ft. Ft. Classification (Private, A,B,C): Total Depth: Casod To: ?P-?P101 FI, I J I F. Total absorption area: SQ. Ft. Pipe material: AS-rw r6/0 ID3054 Driller: Date Drilled: Static Water Level: :Toe (,IELAQ04JSK1 -7-13-91 Ft. Installer: /^ i Date installed: -7- 3U' 9� Yield: Pump Set at:/ Casing Height Above Ground �Dl� TANK GPM I 9FI. � / 't" Ft. -- SEPARATION DISTANCES --- .septic El Holding ❑S.T.E.P. To Septic Absorption Lill Holding Public/Privato Manufacturer: Atv<Ho R'A" Capacity in gallons: lodo From Tank Field Station Tank Sewer Lines — Well 10-7' 7of,r ��i 14 Material: a�'TE6L Number of Compartments: Surface 0 LIFT STATION Water Lot Line r r _ Size in gallons: Manufacturer: — Foundation a�' — 38 I '.Pump on" level at: "Pump oft" at: High water alarm at: Curtain NoN /5N ��� Pump Make Electrical Inspections performed by: Drain Remarks s�co z - -- BENCH MARK --_ At-'19/7/.VG UGIT DGLAf0I -1'14)— Location and Description: _Tap or -6vTi"& 6a NoaTNwe-ST — Assumed Elevation: /U(7.O ---- - ENGISt j§ I pi tj �v S S ENGINEERING Loo Roar�,No,2Mtes: Inspections performed bp7U3& River 1st Engle River, Alaska 99597 2nd Department of Healthnd-Human rvices approval � 9 al` Lj Reviewed and approved by:Date: 72-013 72-013 (Rev. Wet) MOA 25 Permit No. SW940220 Page _ 2 of ` Municipality of Anchorage 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 Legal Description: LOT 1A, BLOCK 10, RIVERVIEW ESTATES PID No.: 05079117 C01 CO2 X101.0' FINAL GRAD); AAT —d8.9 s7.2✓ 1000 GAL scPTlc TANK 3 C = 40' 72-013 A (1193)' TRENCH LOT 1A WELL 79. ♦ 75.2' NATER POUND 6-20-94 1 ST' 22`: 44' —_ ST2 28' 49' — 001 32' 52' -- 0O2 33' 53' -- 0O3 53' -- 77' MT1 461. -- 42' •• ftiJ. 743)-1< _ Y'_R: (p Si% lit �)/,R,'i0¢�l tlRoif ielt+��y OCT -07 -199' - mm he fa < to y I Pd W 0 tz� UZ CU (nmi: 0 > Tri Z 0 441 ti v~. q) u 44! p. LL) W i a1 1 cz tdi C); cn 4j:! LW: 0;. z w z 09M01�01 wWwm O 00000 9 raw < p tti z 10:20 S&S ENGINEERING I 907 694 1211 P.02/02 tz Pd W tz� CU (nmi: 0 0 Tri U; 0 441 ti v~. q) u 44! p. LL) W i a1 1 cz tdi C); cn 4j:! LW: 0;. z z I 907 694 1211 P.02/02 tz Pd W tz� I&, 0 0 0 0 0 0 v~. cd:l 09M01�01 wWwm O 00000 9 raw < p tti 14 0: 0! 0 Q 0 0 pq 14z i 0 0 f-1 cz rz I 907 694 1211 P.02/02 trurzrltrwt tz tz� I&, 0 0 0 0 0 0 v~. cd:l 09M01�01 wWwm O 00000 9 raw 904w p 0 ce trurzrltrwt tz� I&, me ce m C& cd:l cc: co: 0 Q 0 0 14z 0 trurzrltrwt RECEIVED OCT 7 1999 municlpably-t)j j,W.- ;J.ju, age Dept. Flealth & 1-ILlman Services �n TOTAL P.02 tz� I&, me ce m C& RECEIVED OCT 7 1999 municlpably-t)j j,W.- ;J.ju, age Dept. Flealth & 1-ILlman Services �n TOTAL P.02 MUNICIPALITY OF ANCHORAGE DEPARTMENT.' OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW940220 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:LUPER CHARLES F OWNER ADDRESS:P.O.BOX 772972 EAGLE RIVER, AK 99577 PARCEL ID:05079117 LEGAL DESCRIPTION: RIVERVIEW ESTATES BLK 10 LT IA LOT SIZE: 44388 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 DATE ISSUED: 7/01/94 EXPIRATION DATE: 7/01/95 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 (24 HOURS) . 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PR RECEIVED B ISSUED BY: OVISIONS: Y: � _ DATE:_ DATE: 1-2 0 June 22, 1994 ROBERT SHAFER, P.E. ROGER SHAFER, P.E. CIVIL ENGINEERS (907)694-2979 FAX 594-1211 HEALTHAUTHORITY APPROVALS Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 'L' Street P.O. BOX 196650 SEWER&WATER Anchorage, Alaska 99519-6650 MAIN EXTENSIONS REFERENCE: Riverview Estates Subdivision; Block 10; Lot lA SEWER & WATER INSPECTION Request you issue a permit to drill a well and install a septic system to serve the proposed three bedroom house on the referenced property... ENGINEERING STUDIES AND REPORTS Test holes were excavated and percolation tests performed. The approximate location of the test holes are located on the attached site plan. At the time of excavation water was encountered at 10 feet in WELLINSPECTION test hole #1 and no water was found in test hole 112. After seven day &PLOW TEST ground water monitoring water was found at 8 feet in test hole #1 and no wager was found in test hole #2. This property has enough area for a future septic upgrade which can be SITEPLANS seen on the attached site plan. We do not anticipate any adverse effects on neighboring properties by the installation of the proposed septic system. ROAD DESIGN If you have any questions, or require additional information for your review, please contact us. Si. erely, SOIL TEST PERCOLATION//I rt A. Shafer, P.R. TEST i STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 1" = 50'SITE PLAN SCALEI��� dm W r- m i V � m 9 cap" "o,o� mNK m w u m p O r 6�m nzz, P2wy �ro OZ �'� o ^^ " D m yt" fir, O m `1 AAUIW V D n U) vo r C9 a oz 'V boO II D m II mo 11 Z :0 �I 0 �11a v < ri Tl \ ti�D mN akti '.b NU1� N < o fJ O 1� fTl O-z y p m` ril 16sY' o X N fiC ZOOOH ZOO (/) 1 �, p0 1<(/1 D c p „F� O.\ pv o 0zm -r1 Nzn O �\o 03 M=rCO N \0/ tb 100• �, �mortn=wm D O \� \ \\ row 00 iVRLI R'A3 oN m<jmm 0) mm _ m" -Im p'Fp-z -ted__---_ ,� rcm0z➢A � YW5'1 gDy91V —" .OL MMi L/)m z O --� ' W n n N A x zm O co -00 N➢ r -' z�� �o D 3 / o 0-0 z Immr p';(i z \ / A OO--1j ZZ 7T r —_/ Z A o 0 r a D III— n o z Z -9 Um mop o a I_L o r ��mo f—I II> Z— Z 1-O =1 " EFF. g._ —I x � O 3, c y: r✓. x7 O X r m C) �! W < 1 rC ink >m O ON—SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS REFERENCE: Riverview Estates Subdivision; Block 10; Lot lA GEaIERAL : 1. The scope of this project includes the installation of a 1000 gallon septic tank and five foot wide drainfield to serve the proposed three bedroom residence for the referenced property. 2. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground utility locates. 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. On all leachf.ield mound systems, the property owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded area. 5. Contractors installing wastewater the Municipal Health Department installing their own systems must Municipal Health Department. SEPTIC TANK INSTALLATION: disposal systems must be certified by for system installations. Owners also receive prior approval from the 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Septic tanks installed with less than 4' of cover shall be insulated. Page `'No Riverview Estates Subdivision; Block 10; Lot lA June 22, 1994 5. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfiel.d there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10' from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSOR13TI0N TRENCH/DRAINFIELD INSTALLATION: 1. Excavate the proposed trench to the dimensions shown on the design. The bottom of: the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (roughed -up) before gravel (sewer rock) placement. 2. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 3. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. 4. Monitor tubes shall. be of four (4) inch diameter and installed approximately in the locations shown on the design. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. 5. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. MINIMUM MATERIAL 1. Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. Page Three Riverview Estates Subdivision; Block 10; Lot lA June 2.2, 1994 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM E810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140/N, or equal.) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements. INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: 1. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but nay not be backfilled before this inspection. 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. Page Four Riverview Estates Subdivision; Block 10; Lot lA June 22, 1994 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required, especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre -construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractor's activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractor's activities. Final acceptance of the contractor's work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER - ,, lFlv�nr y o•�rn�i Municipality of Anchorage C*)- DEPARTMENT OF HEALTH &HUMAN SERVICES � 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG —• PERCOLATION TEST k. _ PERFORMED FOR; P– IIn.Cr-- Lup6IL _— —DATE PER RMED;_ LEGAL DESCRIPTION: US, &-Kr RIUERUIFjU (=SZ, Township, Range, Section: SLOPE SITE PLAN DE H 1��'i 11 g/M 0 9 t0 Net SRC -• WAS GROUND WATER 1,Time �'• f /E✓` i —�6 S 11J.IF 1 YES, AT WHAT l� 1 p :3S DEPTH?l( — — < u" - fn E 2 ( SwAp 13 62 S � Date: a^Iy Manitaring9 T ; . 3 ( d r rA Y 1 61 5 y'— 6 •,'-i,e 1��'i 11 g/M 0 9 t0 Net Depth to Water -• WAS GROUND WATER 1,Time �'• f ENCOUNTERED? i —�6 S 11J.IF YES, AT WHAT l� 1 p :3S DEPTH?l( — — 12 E �� �',, ( tri Water After ` DepthMonitoring? a 13 62 S � Date: a^Iy Manitaring9 T 14 15 16- 17 18- 19- 20- COMMENTS 81920COMMENTS --- PERFORMEA. S EN(Lt 17034 Eagle ACCORDANCj�O4+C IZN,Zl� 72-008 (Rev. 4/85) Reading Date Gross Time Net Depth to Water Net Drop 1,Time —�6 I /a - :3S 62 S �4 PERCOLATION RATE --- i Y- IIminutes,mch) PERC HOLE DIAMETER TEST RUN BETWEEN -4a—)T AND FT — CERTIFY THAT THIS TEST WAS PERFORMED IN ON THIS DATE. DATE: -- (ENGINEER'S SEAL) yt� Municipality of Anchorage L C DEPARTMENT OF HEALTH &HUMAN SERVICES 6t 825 '•L" Street, Anchorage, Alaska 99502-0650 ✓,; SOILS LOG - PERCOLATION TEST PERFORMED FOR:-C-�UC{- I DPS DATI FO ED � I LEGAL DESCRIPTION: .LAILI_�&U" / wJ& l'ownship, Range, Section: P'F ,T'N SLOPE SITE PLAN v, 10 WAS GROUND WATER ENCOUNTERED? 11GNIN L I IF YES, AT WHAT //� 12 r 1' ('t" DEPTH? lJ_ O � E Depth to Water After 13 Monitoring? R Dale: b!�� 41516 14- 15- 16 17 18- 19- Reading 819 Reading Date Gross Time T� OIr!#1N1C_S Net Drop 1 �!•riL>E _ to 2 5 �� , • FAIN S�' 2 i ver 3 4 5 6 4 8 y.. v, 10 WAS GROUND WATER ENCOUNTERED? 11GNIN L I IF YES, AT WHAT //� 12 r 1' ('t" DEPTH? lJ_ O � E Depth to Water After 13 Monitoring? R Dale: b!�� 41516 14- 15- 16 17 18- 19- Reading 819 Reading Date Gross Time Net Time Depth to Water Net Drop _ to 2 5 �� FAIN :uti i ver 20 ¢ t/1 'u PERCOLATION RATE � / (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN �✓' FT AND �"� FT COMMENTS -- --7 --- 17034 Cagle River Loop Road No. 2 PERFORMED BY: Ea'JIG C i9rJ%1— I CERTIFY THAT THIS TEST WAS PERFORMED IN k ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDEIN EF ECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) • Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 E r r (Certificate of On -Site Systems Approval t�> / Parcel I.D. �" � � Expiration Date: —L—),-7 r 1. GENERAL INFORMATION Complete legal description RIVERVIEW ESTATES SUBDIVISION f3 [of L t ✓k Locatiori (site address.) 21525 RIVER PARK DRIVE Current Property owner(s). MIKE ADAMS Mailingraddress...- °,' 21525 RIVER PARK DRIVE y Real Estate Agent "SVETA SOLOVYOVY 2. TYPE OF DWELLINQ: -1 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 622-1222 Day phone 360-5778 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual 0 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ waiverNariance request for: NONE Distance: Received b"v: lo��— Date: Z g COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 52-0-00 Waiver Fee $ Date of Payment 23 } Zo l c� Date of Payment Receipt Number D ® Receipt Number COSA # 05C,[ (o I L5 i 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 C&M ENGINEERING Address 30840 PRUDHOE BAY AVE Engineer's Printed Name CHARLES BALZARINI 6. DSD SIGNATURE System 41 Approved for 3 bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, Phone 854-5558 Date 6/20/2016 too ° axles G. Balzarini �® CE•13954 with the following stipul'atioli° By: J =e�GP Original Certificate Date:__62 _ 2-7`/ �7 i 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 Stale of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue Sheet—f : c 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 ®r0-74!- (-t Legal Description: ���t✓ �S�Ct� In LpT 1 R Parcel ID: A. WELL DATA Well type P R=ti!+ �� If A, B, or C provide PWSID # YWA Well Log ®/N) ')F 5 Date completed '711 Va Sanitary seal ®N)Y�E5 Wires property protected (91N) Ya5 Total depth %d 1 ft. Cased to [DI ft. FROM WELL LOG Date of test 71 iii q 14 Static water level O) L FIF F- w0ft. Well production 15 g.p.m. WATER SAMPLE RE=SULTS: Coliform P6T Iq cool nies/100 mL Nitrate mg/L Arsenic N ug/L Date of sample: I;t/ab(b B. SEPTIC/HOLDING TANK DATA Tank Type/Material SaKPTSG/676—El- Tank size iso gal. Number of Compartments Casing height (above ground) 4 j;�% in. AT INSPECTION /T5�o4.0 ft. g.p.m. Collected by: C 4,q 4FV 6.r u O� I7-XA�G Date installed 941 + Cleanouts (DN) XGS Foundation cleanout (®N) YO Depression overt tank (Yffl A�D High water alarm (Y& NU Date of pumping Pumper A vlTA R Y C. ABSORPTION FIELD DATA Q Date installed �qq Soil rating (g.p.d./ft2 m*e79FN) 0.2L_ System type /LIu(119`,1 71 Length bhft. Width .5 ft. Gravel below pipe 3• S ft. Total depth �^.ft. Eff. absorption area p v r ftz Monitoring tube y� Depression over field MO Date oadequacy,tcgt . �l.�a �tResults Fail) ?5 For bedrooms JAI Fluid depth, in. absorption Feld before test � in. Water added1450 gal. New depth C40 in. Elapsed Time: ruNO min. Final fluid depth 0 in. Absorption rate >= u 50 g.p.d. Any rejuvAt;afloji treatment (,PAst 12 mo.) (Y/N & type) "01 -le KI�VWi✓ If yes, give date N4-/4 D. LIFT STATION IVO 1-1 T -T Date installed r Size in gallons "Pump off' level at Cycles tested _ "Pump on" level at in. Datum E. SEPARATION DISTANCES WELL ON LOT TO: Manhole/Access (Y/N) in. High water alarm level Meets alarm & circuit requirements? i Septic tank/lift station on lot Leo On adjacent lots (o t Absorption field on lot Lco On adjacent lots f 140 Public sewer main 100Publicsewer manhole/cleanout % l� "E CC Sewer /septic service line ¢ ay Holding tank f (09� Animal containment areas 4 (00 < Manure/animal excrete storage areas V00 SEPTIC/HOLDING TANK ON LOT TO: Building foundation + s Property line + rJ Absorption field +*6ko -f i Water main 4 t0 Water service line 4 Surface water 4 t(" � Wells on adjacent lots +100/ ABSORPTION FIELD ON LOT TO: Property line t CJS Building foundation "f' 10 ! Water main 4 ( � � s Water Service line 410 Surface water i ( 00 Driveway, parking/vehicle storage Curtain drain 't 50, Wells on adjacent lots 41oo� F. COMMENTS f © 9:17& r,11AL 'Tta-✓ K TT'S A&F, %'G.EAcH G. ENGINEER'S CERTIFICATION Al tow D Rs6vn AP - in. M ThtG T t Al K 5 y f�cv r^ Td 4,19 MIR Pc I^t AF7S12 QDDTs✓� TEST t vRSErZ / 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 Printed Name GEtAP L E5 tlkG� 4?J FnrZ Date b/ae)/ (1v COSA canary sheet_2-6-15.doc -- a MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services _ On -Site Services Section LLILW P.O. Box 196650 Anchorage, Alaska 99519-6650 (907) 3434744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILLY DWELLING Parcel I.D. # 050-791-17 HAA # O f O O O Cl 1. GENERAL INFORMATION ••- owner :• •: ..•. Dag • • ••694-6045 Mailing .•• RROQKF STILTNFR WITH REMAX OF RIVFR Lending agency Mailing address Day F-061-111 :••. A lill 9. . •21DAM :11 : t. • • •• •• 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 XXX NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site xxx Holding Tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC Ing to the legality and status of system. 72-025 (Rev.1191) Front MOA #21 Computer Version Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $1,110.00 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 inspgction, the on-site water supply and/or wastewater disposal system is in compliance mpliance with all Mu'ic17l and State codes, ordinances, and regulations in effect on the date of this Inspection. ���� Name of Firm Phone (907) 337-6179 In conducting conducting this evaluation, AWWC, I c tt pptoorluprovide a thorough, conscientious engineering analysis of the system In accordance with ADEC and A DRHS Guldelines & 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 fdenf fiiable 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. Satislactmy test results do not guarantee future performance c of the system, nor do theyguarantee that there are no hidden defects or encroachments. Q AMVC, inc. can therefore not provide any warranty for future estimate of how long the p �; system will continue to meet the operational requirements of the ADEC or MOA DHHS. 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, nor will it confer arrylegal right whatsoever. f 6. DHHS SIGNATURE _—Z Approved for 3 bedrooms Disapproved Conditional approval for Additional Comments 0 -7953 bedrooms, with the following stipulations: Date (- S'- 0 / The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an Independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct Inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. 72-025 (Rev. 1191) Back 610A #21 Computer Version Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division ti25 "L" Street, Rm 502 Anchorage, Alaska 99501 (907) 3434744 Health Authority Approval Checklist Legal Description: RIVERVIEW EST. S/D: LOT 1A, BLOCK 10. Parcell.D.: 050-791-17 A. WELL DATA ARTESIAN WELL *FROM ORIGINAL GRADE O LANDSCAPING AROUND PIPE 0 Wen Type PRIVATE R A, B, or C, attach ADEC letter. ADEC water system number N/A Log present (YM) Y Date completed 7/13/94 Total depth 101' Cased to 101' Casing height (above ground) ►12'+ Sanitary seal (Y/N) YES Wlres property protected (Y/N) YES FROM WELL LOG Data of test 7/13/94 Static water level 101' Well production 5 9— p.m- WATER SAMPLE RESULTS: AT INSPECTION 11/29/00 0' 2.9 g.p.m. Coliform 0 Nitrate 0.918 ma/L Other bacteria 0 Date of sample: 12/22/00 Collected by: A.W.W.C.. INC. S. SEPTIC/HOLDING TANK DATA Data krstaned 7/30/94 Tank size 1000 Number of Compartments_2 Clearouts (Y/N) YES Foundation cleanout (Y/N) YES Depression (Y/N) NO High water alarm (YIN) N/A Date of Pumping 1/4/2001 Pumper JR',q PUMPING C. ABSORPTION FIELD DATA Data installed 7/30/94 Son rating 0.p.d orR2/bdrm) 0.8 system type TRENCH Length 66' Width 5' Gravel thickness below pipe 3.5' Total depth 9' Effective absorption area 611 S0. FT. Monitoring Tube present (Y/N) YES Depression over field (YIN) NO Data of adequacy test 9/14/00 Results (Pass/Fan) PASSED For 3 Bedrooms Fluid depth in absorption field before test (In.); 9" Immediately atter 729—gal. water added (In.): 14- Fluid depth 9' (Ins) Minutes later. 656 Absorption rate = 450+ Perwdde treatment (past 12 months) (YIN) N/A If yes, give date — r2_= pc v. yea)' CanWW v mon D. LIFT STATION Date installed Size In Manhole/Access (Y/N) "Pump on" High water alarm level at' *Datum "Pump oft" level at" E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septirfiolding tank on lot 100'+ On adjacent kMs 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main N/A Public sewer manhole/deanout N/A Sewer/septic service One 25'+ Uft motion 100'+ SEPARATION DISTANCES FROM SEPTIGHOLDING TANK ON LOT TO: Foundation 5'+ Property line 5'+ Absorption field 5'+ Water maintseMce line 10'+ Surface water/drainage 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO: Properly fine 10'+ Building foundation 10'+ Water maln/service line 10'+ Surface water 100'+ Driveway, paridng/vehide storage area 50'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. ENGINEER'S I certify that I I ofMun/dpal n wlfh MOA HA Engineer's 1/9-/6/ HAA Fee $ 300 .0 0 Date of Payment / — 5 Receipt Number 66i, y 3 72-M (Rev. Mr Cmp tw Venbn fd inspections and review stems are In conformance this date. Waiver Fee Date of Payment Receipt Number 12-29-00 11:49 FROLKTE ENVIRONtENTAL 5615301 T-761 P.02/03 F-569 ALCUE Environmental Services Inc. CT&E Ret N Cllent Name Project Name/# Client Sample ID Matrix Ordered By PWSID Sample Remarks: 1007879001 AK Water & Wastewater Consultants Inc. Riverview Est Lot I Block 10 Riverview Est Lot IA Block 10 Drinking Water 000000 Client PON Printed Dateffime Collected Date/time Received Date/time Technical Director Released $ O yrz 12/29/2000 9:07 12/222000 8:30 12/22/2000 14:40 Stephen C. Eden Q Allowable Prep Analysis Puameter Results PQL Units Method Limits Date Dam Init Waters Department Nitratc-N microbiology Laboratory Total Coliform F: 0.918 0 0.500 m8/L EPA 300.0 col/IOOmL SM189222B 10 max 12f22/00 SCL 12/12/00 SKW IZ -- = - WATER & WASTEWATE ALASICR CONSULTANTS. INC. i April 6,2001 qty of Anchorage Muni Services Department �Dgite Services Section ts.O. Box 196650 Anchorage, Alaska 99519-6650 Subject: Riverview Estates, L9, B3. Septic System Evaluation To whom it may concern: Attached is the HAA application for the subject property. During our testing and evaluation of the septic system we noted the following: • The house had been vacant since August of 2000. We "pre-soaked" the drainfield on 3/26/01. Prior to the pre-soak there was 4 inches in one MT and the other was dry. After introducing only 610 gallons it was noted that there was 8.5 inches in the deepest MT. The septic system was tested the following day. • On 3/27/01 there was 8 inches standing in one MT and the other was dry. Over a period of 100 minutes, 527 gallons was introduced into the bed. The liquid level rose to 15 inches in the deeper MT and 8 inches in the other MT. It was noted that there was approximately 4 inches of water in the post tank clean-out. • The bed was exposed at the east MT (which was discovered to be a sump) by Southfork Construction. We then confirmed that the west MT was also a sump. Invert elevations were then shot in the post tank c/o, & the bed sumps. The bottom of the monitoring tubes were shot also. The data confirmed that the bed bottom and drainpipe invert is 6" to 7" inches lower at the east end of the drainfield then at the west end of the drainfield. This explains why there was such difference in the liquid levels in each monitoring tube throughout the test. • It was noted that the drainpipe holes were facing up on the portion of the pipe that was exposed near the east end of the drainfield. • Based upon the aforementioned data, during our test, a portion of the drainfield had to be completely submerged in order to fill the upper portion of the system. When the water was shut off at the end of the filling period, the water level was one (1) inch above the top of the drainpipe in the post tank clean-out and the west sump. 6901 Debarr Road, Suite 2-B * Anchorage, Alaska 99504 Ph: (907) 337-6179 * Fax- (907) 338-3246 * Website: akwwc.com MUNICIPALITY OF ANCHORAGE Y'9� DEPARTMENT OF HEALTH & HUMAN SERVICES OWS 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 DWELLI'N1Gl� Parcel I.D.# 050-70 �._ C1 HAA# LAW8 LA -910 1. GENERAL INFORMATION Complete legal description Lot 1A, Block 10, Riverview Estates Location (site address or directions) NHN Riverpark Drive Chuck Luper 696-5060 Property owner _Day phone —� Mailing address PO—Box 772972, Eagle River, Ak 99577 Lending agency -- Day phone Mailing Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well XXX Community well Public water 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 #21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I furtherverify 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 & C ENGINEERING Phone G 0y " 3ti 17034 Eagle River Loop Road No. 204 Address Eagle River, Alaska 99977 Engineer's signature Date d y F •� ROBERT C. COWAN oz - 6. 6. DHHS SIGNATURE �� CE -8801 J� Approved for I H fi'r F bedrooms. 3+tit°"'AFL- Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments 0 Date Z O The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesyto purchasers of homes and their lending institutions in orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025(Rw."1) Back MOA#21 REC E e Municipality of Anchorage OCT 04 199Ik 9 i DEPARTMENT OF HEALTH & HUMAN SERVICES EeNVIRO.nvironmental Services Division ry RC PALItY OF I CNME:NIAL SERVICESES DDI 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744 Health Authority Approval Checklist Legal Description: l-0 r IA 13L°cK /o Qiv(Avi9w aST._Parcel l.D.: 0S0-- 70 - 11'7 A. WELL DATA Well type P R IV 4 7 C If A, B, or C, attach ADEC letter. ADEC water system number Log present &N) Total depth --- Sanitary seal &N) Date of test Static water level Well production Date completed 7 /13/ `f q Cased to ) u I Casing height (above ground) _ r Y f --- Wires properly protected C/N) _ S' — FROM WELL LOG L:3 / y U I `�t �yH Ou r_scM -- S --- g.p.m. WATER SAMPLE RESULTS: AT INSPECTION q/a'l c9 g.p.m. Coliform __ ',,> /�—,__ Nitrate .ls (� _� Other bacteria 9- 2 _ d Date of sample: _ -1 —__ Collected by: _ S & S ENGINEERING 17034 Eag a River Loop Road No. 204 B. SEPTIC/HOLDING TANK DATA Eagle River, Alaska 99577 Date installed '11101" Tank size )000 Number of Compartments 2. Cleanouts 1&N). Foundation cleanout &N) __'/9 J Depression (Y/@ N _ Date of Pumping. q La-b'� `1 `I_ Pumper _� 'e C. ABSORPTION FIELD DATA Date installed '7/30/ ('1q Soil rating rrg.p.d./ft2 or ft2/bdrm) High water alarm (Y& T/ U S{14�La w 0?f —system type Length —C — Width ALL— Gravel thickness below pipe 3 ), Total depth Effective absorption area Cit _ Monitoring Tube present&N) Y S Depression over field (Y(() -)\" 0 _ Date of adequacy test _ q b- 4 Result (PaO/Fail) _ P/1 sS _ For _3 _ bedrooi Fluid depth in absorption field before test (in.); _ V — Immediately after SSfr'gal. water added (in.): _ g _ Fluid depth _ N by (ins) Minutes later: N4 4 _ Absorption rate = —fi !S 0 14__g.p.d. Peroxide treatment (past 12 months) (Y/N) If yes, give date _ 72••026 (Rev. 3/96)' D. LIFT STATION Date installed Manhole/Access (Y/N) "Pump on" High water alarm level at* *Dat Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: r Septic/holding tank on lot 160 -4- Absorption field on lot /0 0 Size in gallons On adjacent lots On adjacent lots "Pump off" level at* Public sewer main )Y A Public sewer manhole/cleanout Sewer /septic service line a S f Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation Property line a Absorption field Water main/service line /0 Surface water/drainage % 00 Wells on adjacent lot: SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: 00 N Aq N/g 1 � -t- /00 .4 - Property line 41 Building foundation 3 k Water main/service line v 3 Surface water 00 'h Driveway, parking/vehicle storage area `-0 Curtain drain N od k k Now rJ Wells on adjacent lots y 00 4 F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal record 'aday�r in conformance with MOA HAA guide 'nes in effect on this date. C,) J* Signature ���� �✓h—' � t`' ':*"� Engineer's Name /` da 6,t T •l A ` ROBERT C. COWAN f Q Jy /'f / ct Cl CE • 8801 Date Q Fe,, HAA Fee $ 07J Waiver Fee $ _ Date of Payment 1011V ITT Date of Payment Receipt Number �' �G�B l Receipt Number 72-026 (Rev. 3/96)* are OCT -02-99 11:12 FROM -CTE ENVIRONMENTAL 5615301 T-531 P.02/03 F-039 'AL.CUE Environmental Services Inc. �rrrrw�wri�rwwwia�r� CT&E Ref.# 995313001 Client PO# Client Name S & S Engineering Printed Date/Thne 10/01/99 14:35 Project Name/i/ L1A B10 Riverview Est. Collected Date/Time 09/28/99 09:30 Client Sample ID L1A 1310 Riverview Est. Received DateMme 09/29/99 09:25 Matrix Drinking Water Te"cal Director: tephen C. Ede Ordered By PWS1D 0 Released B %) �a vL�Xrl Sample Remarks Parameter Total Coliform NitraTe-N AlLovam a Prep Analysis Results _ POL _ un�irs _- Netpod �- LimiTs _ Date Date _ Init 0 cot/100m4 SR18 92228 09/29/99 KAP 1.65 0.500 mg/L EPA 300.0 10 max 09/29/99 09/29/99 SCL