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HomeMy WebLinkAboutEAGLE RIVER VALLEY RANCHETTES LT 10A Municipality of Anchorage On-Site Water and Wastewater Program • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP161242 PID Number: 050-222-26 Dwelling: ❑■ Single Family (SF) ❑ Duplex(D) ❑ Multiple (SF and/or D) Project: ❑ New ❑■ Upgrade Name: Bryan Aafedt ABSORPTION FIELD Address rj Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound 8107 Frank St. Anchorage, AK 99518 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 727-0828 5 1.2 GPD/SF 11.6 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot 4.6 Ft. 7.0 Ft. Eagle River Valley Ranchettes 10A Fill added above original grade Gravel length Township Range Section 0.0 Ft. 45 Ft. Gravel width Beds:Number of Lines Distance between lines SEPARATION DISTANCES 3 Ft. Ft. To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist.between trenches From Tank Field Tank Line 630 Ft2 1 Ft. Well N/A N/A N/A N/A >25' TANK I]Septic 0 S.T.E.P. 0 Holding 0 Other Manufacturer Capacity Surface Water >100' >100' N/A N/A Anchorage Tank 1500 Gal. Material Number of compartments Lot Line >5' >10' N/A N/A Steel 2 NA Foundation >10' >10' N/A N/A LIFT STATION Manufacturer Capacity Curtain Drain None j Noted Gal. Remarks Pump on level at Pump off level at High water alarm at in. in. in. Pump make and model Electrical Inspections performed by PIPE MATERIAL House to tank D3034Tank to D3034 Installer drainfield Red Dog Excavating Drainfield D3034 CO/MT D3034 Inspector Wade Roberts BENCH MARK (Assumed elevation) 100 ft Inspeection ction 1st 12/23/16 2 Location and description �a 3n° 4th Bottom of siding at point B COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp �1�.\,`t --�4G�of,4�k\��1 Conditional Approval: Date P'�v• .w� t i*.49TM ft *�y/ Benja, in Schiller . Approved 1 l � Date —16ol ` �3� „•;„.� Inspection Report_9-1-12.doc EAGLE RIVER VALLEY RANCHETTES, LOT 10A PERMIT # OSP161242 PID # 050-222-26 WHIRLAWAY ROAD A B C a FCO 26.2 20.6 SV1 17.8 32.6 SV2 10.0 42.1 I 2C0 8.8 46.5 CO1 72.9 31.9 MT1 65.9 26.3 LOT 10A CO2 24.8 35.1 MT2 30.2 31.5 G CA II 5-BDRM HOME I 108 FCO •�` I I CO2 I Q svi MT2 • �V2 • CO ,f• TWO 1500 GAL SEPTIC TANK MT1 ... 1 l 51'LONG x 3'WIDE,7'EFFECTIVE DEPTH ABSORPTION TRENCH •01 v• ' -- 10'UTILITY EASEMENT I 6"AC Water Main ALTERNATE SITE :T2) 1 ADVANTEX,5GPD/SF I 100 15'x3'x7'EFF riC 1 I NOTE: ....`.���x NO SLOPES>25%WITHIN 50'OR SURFACE WATER WITHIN 100'OF THE LEGEND OF ;kko PROPOSED SEPTIC SYSTEM CO CLEANOUT AP.' 2C0-DOUBLE CLEANOUT j*•49 TM jc *+// ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS FCO-FOUNDATION CLEANOUT •• or •�' I PROPERTY ARE SHOWN.NO CONFLICTS WITH WELLS OR SEPTIC FS FLOW SPLITTER VALVE ••••�� SYSTEMS. MH-MANHOLE / :-nja•� Schiller 0 20 40 MT-MONITORING TUBE l • ���Fcsf,• z1• 2p92 ,,��`��� j� MI FEET SV-SEPTIC VENT 1`ilePROFESSIOtV=20' TH-TEST HOLE EAGLE RIVER VALLEY RANCHETTES LT10A PERMIT # OSP161242 PID # 050-222-26 o > > 0 — 100.3 — — — -- -- i 96.9 v " - 96.0 96.3 VI1500 GAL 96.1 SEPTIC TANK �— 92.0 96.7 FINISH GRADE 0OF- 2 7 /— 96.7 ORIGINAL GRADE 8U ji -- 92.1 - 92.1 DRAINFIELD ROCK hi:'---- 85.1 45, 85.1 --''--,J 78.7 NO GROUNDWATER 8/24/16 I I— NO). �1, ,9-1 I/• . Benjamin Schiller .:,, PROFILE AS-BUILT /i�i. ,�F;�lCE 1.2592 ,.���..•.%0:(NO SCALE) Ikx,°`'ROFESS\01\4 ' FIU[,i T C .I~AL Z TY OF R r-i C H'..,3 R R G E ,~ ~,'.,,~', DEPARTMEHT ~HERLTH A[IO EN'¢IRONMENTRL/ ~OTECTIO['~I/ LOCRT%ON ~ ' .... ~ ~ ' ' LEGAL LlOR B2 EAGLE RIVER VALLE~ RAN LOT SIZE 1~55 SQUARE FEET TYPE OF SOIL ABSORBTION SYSTEM MR×IMUM NUMBER OF BEDROOMS TRENCH SOIL RATING (SQ FT?BR>= THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: 150 DEPTH= I 0 LENGTH---- 4.6 GRR~/EL DEPTH= 5 THE LENGTH DIMENSION IS THE L£NGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTR[ICE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE E}{CRVATION (I~ FEET>. THERE IS ~0 SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFRLL PIPE AND THE BOTTOM OF THE ENCAVATION (IN FEET>. REt,IU I RED SEPT I C TRI'~K S I ZE= ~L00['~ GRLLON$ TI-lO ( 2 ) I I'-ISPEm3T ION$ RRE REQ~J I RED BACKFILLIHG OF ANY SYSTEM WITHOUT FINAL INSPECTION Arid APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTIONS. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR 8 PRIVATE WELL OR ~00 FEET FOR A PUBLIC WELL. SPECIFICATIONS 8[tD CONSTRUCTION DIAGRRMS ARE AVAILABLE TO INSURE PROPER I NSTALLAT I ON. PERMIT VRLID FOR. ONE YERR FROtq ISSUE I CERTIFY THAT l: I Ar'l FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEI.ERS AND WELLS RS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL'THE SYSTEM IN ACCORDANCE WITH THE CODES. ~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLRRGEME~T IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS. SI GNED:- _ _~~_,¢~_ _ ~F_ ~ ~__ ~ ............ ~LICRNT JAMES E DRVIS ISSUED I~ SOILS LOG ~UNIClPALIT¥ OP ANCHORAG£ DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION r-i PERCOLATION TEST Pouch 6650, Anc~o~, AJ~e 99602 276-222! SOILS LOG -- PERCOLATION TEST PERFORMED FOR: ~lV"1"~i'~l;~--~l~,~ ~',*OIV~'"l-~f.~C~"lOt~l ~t~"). DATE PERFORMED: M~;~, "~. IC)77 LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13. SLOPE SITE PLAN ~ ,. WAS GROUND WATER U, ENCOUNTERED? came ~,~ IF YES, AT WHAT DEPTH? W HI~/..I=tW ~V ~r"/z~=-z= / ' Gross ': . Net Depth to Net Reading Date Time ,' Time Water Drop 15- 16- 18- 19- 20: PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT 72-00~ (7/76) ~0 o I)c'~tment of tlealth m~d I-:nvironment~l"?rotection 2516E. rude! Road Anchorage, Alaska' 99507 276-2221 ]nis term reports: ~oi~s Io9 ~ Percolation Lest Depth Feet 5- 6- 7- 10- 11 - 13- Was ground ~atcr Reading Gross Time Her Time Not ilrop -P[?osed i,~stallaYl~,i':"~eep,vle Pit ~" Urain Field ~ ' ' ' I~e,?, of Inlet _ ~ ~ ~..Uepti:Co']J~ff~i(Fi,it o~ trench -'~"~ ..... · . . ~~'~ ..................... ,...~_ ~ . ......... ,...~/~s,~ ~s~ wq.~/~s~-~ ...... · ' ' · ~,~. oP ~d~ ~,~/,~ ~. (Ph. ~ :., ', . •, Municipality of Anchor., e' 1.114l0 1 `o On-Site Water and Wastewater Progra •V An (907) 343-7904 9 4 ( Z-�` / �.�SAFETY i Certificate of On-Site Systems Approval Parcel I.D. 050-222-26 Expiration Date: t2^� _ f 1. GENERAL INFORMATION Complete legal description Eagle River Valley Ranchettes Lot 10A Location (site address) 19108 Whirlaway Rd Current Property owner(s) Bryan Aafedt Day phone Mailing address . 8107 Frank St. Anchorage, AK 99518 Real Estate Agent Day phone 727-0828 2. TYPE OF DWELLING: lx I Single Family (w/wo ADU) n Duplex fl Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 5 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual n Individual Water Storage n Holding Tank ❑ Community Class Well n Community ❑ Public Water System Q Public Sewer U WaiverNariance request for: Distance: Received by: (/l .evt'f'�L44/m Date: *E7,(182//COSA to be released to the engineer,unless otherwise requested by the engineer. 12-11 ASIA COSA Fee $ z(od 6a + 1(P I I° Waiver Fee $ ''Dafe of Payment 3J2 �i B Date of Payment Receipt Number oat cam I� Receipt Number COSA# CDC- 1 V (1 C 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 Forge Engineering Phone (907) 522-7773 Address PO Box 240773 Anchorage, AK 99524 Engineer's Printed Name Benjamin Schiller, PE Date 3/21/18 u`3 Ce • 6. DSD SIGNATURE mo • . ��' ; gr. .. .o... _.• !' System #1 Approved for 5 bedrooms . -•• :•, i Pert ja-r� 1 Schiller o e System #2 Approved for bedrooms 0.;S:. C 25 2 ,�„ Disapproved ® �° / ����'°�! ESSi c ' Conditional approval for bedrooms, with the following stipulaaibiit.e. _ G\C�ALIl'y�Q/, 14, `�'�9S TSR PA /4k,:14/0 Gy�NO ' I l/,Cr-Q C1��1�' Original Certificate Date:3- — 1 r The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer,registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory. • Well Flow Advisory Other COSA blue sheet_E 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 Legal Description: Eagle River Valley Ranchettes Lot 10A Parcel ID: 050-222-26 A. WELL DATA/ ON PUBLIC WATER SYSTEM Well type NA If A, B, or C provide PWSID# Well Log (Y/N) Date completed Sanitary seal (Y/N) Wires properly protected (Y/N) Total depth ft. Cased to ft. Casing height(above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level ft. ft. Well production g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate mg/L Arsenic ug/L Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 12/23/16 Tank size 1500 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping Pumper New Construction C. ABSORPTION FIELD DATA Date installed 12/23/16 Soil rating (g.p.d./ft2 or ft2/bdrm) 1.2 GPD/SF System type Deep trench Length 45 ft. Width 3.0 ft. Gravel below pipe 7.0 ft. Total depth 1 1 .6 ft. Eff. absorption area 630 ft2 Monitoring tube Y Depression over field N Qate'of adequacy test N2W Constr Results (Pass/Fail) For bedrooms Fluid depth in absorption field before test in. Water added gal. New depth in. Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot N/A On adjacent lots N/A Absorption field on lot N/A On adjacent lots N/A Public sewer main N/A Public sewer manhole/cleanout N/A Sewer/septic service line N/A Holding tank N/A Animal containment areas N/A Manure/animal excrete storage areas N/A SEPTIC/HOLDING TANK ON LOT TO: Building foundation 1 0' Property line �5� Absorption field >5' Water main 10' Water service line >10' Surface water >100' Wells on adjacent lots >100 ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >10 Water main >10' Water Service line 10� Surface water 100 Driveway, parking/vehicle storage 10' Curtain drain None Noted Wells on adjacent lots X100' F. COMMENTS G. ENGINEER'S CERTIFICATION grINa p�E'•O� �aCJ�;� I certify that I have determined through field inspections and 0 ac TH iti, •• . review of Municipal records that the above systems are in °"• •••i' •' conformance with MOA COSA guidelines in effect on this date. 6 .a>t, - .• ••..0• C'0 �I ."IIVI ! Schilder; S Engineer's Printed Name Benjamin Schiller, PE p .,�� c Date 3/21 /18 m©Q� � • �� COSA brown sheet 10-10-12.doc ------------------ WHIRLAWAY ---ROAD ---------------------- 4 I • N N 89 59' 15" W 133.00 • • 0• 9 �9A • ,'L • ‘ 1 *Ail* ' i ot• OOD� tri 1 E FP :40st- o aie in I SL FFLPM� N , T o N 94? O kg / b c, --?o, e o z `� ai 0 V� e e 0 o e e 00000Op�� e QoP,� ,�s�0o ,�:•'49 TH* 7 O g ./!_ �/ /"4 �.4•e 10' UTILITY EASEMENT �a0O' '• SHANE A.HOLT m On N 89 59' 15" W 133.00 • • O AS=BUILT SURVEY 17' - 213' Vo, LS-6914 . • o O Gj CORNERS SET THIS DATE ��pp prO f s si0(1°L \*bo I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY Q�4p.QDod OF THE FOLLOWING DESCRIBED PROPERTY LOT 1BA, EAGLE RIVER VALLEY RANCHETTES THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS;AND IS VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES,IMPROVEMENTS,OR FENCELINES. THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EASEMENTS OF RECORD OR OTHER RIGHTS OF WAY,OR ANY ENTITY NOT ON THE RECORD PLAT EXIST OTHER THAN NOTED. ARE NOT SHOWN HEREON.UNLESS NOTED. DATED AT ANCHORAGE,ALASKA THIS_8 TH DAY OF NOTE. FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE _MARCH , 2018 PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. HOLT LAND SURVEYING 9309 GROVER DRIVE 13258, FB 176-27,187-29, SCAN ANCHORAGE,AK 99507 Parcel I.D. # 1. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Se~'ices Section P.O. Box 196650 Anchorage. Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING n~'fl-222-~ HAA# GENERAL INFORMATION Complete legal description Eacjle P, iver Valley Ranchet:t:es Lot: [0,% Location (site address or directions) [9].08 Whirlawe¥, Eagle River Property owner Mailing address Lending agency Mailing address Agent Address Gary & Suzanne McWillia~ lqlnR Wh~r]nwav. Ea~le River, AK Not. est Mcr~.gage/Don Presser Day phone 99577 Day phone 16635 Cente~ield, Eagle River, Ak 99577 ~./Mnw / Joe Perro~i Day phone 16600 Cent:erfield Drive, Eagle River 99577 694-4987 694-1144 694-4200 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Unless otherwise requested, HAA will be held for pickup. 3 NOTE: Individual well Community well Public water X If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. ,~. 4. TYPE OFWASTEWATER DISPOSAL: NOTE: Individual on-site x Holding tank ' ' Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 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 Eaqle River Engineerin.q Services · Address . p_n P, nw 77t2q4. F'.~gl~, R~ver. Ak Engineer's signature .... - Phone _694-5195 99577 Date ' - ' '. DHHS SIGNATURE ~,~' Approved for 3 Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments 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 order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICI~I' ~. r' I V £ L/ . Envimnmenta! Sendces Division · 825"L Street, Room 502 · Anchorage, Alaska 095010 (907) 3431~'~ 29 1ss6 Munimpality ot ~nonorage Dept. Health & H~man 6ewlces Health ^ut~ority Approval Checklist ~ Dcs:flption: A. WRI.L DATA Log pre,mt (Y~I) I.D.: If A, B, or C, alla~ ADEC lmm'. ADEC wat~ system number .// Dale of tm1 Sta~c wamr l(,vr, l J Well pmdu~Jo~ Col~onn ~ NtUm &p.m. g.p.m. Col/~:tcd t~: Plum depth in absorpUon field bcfore test (i~); Fired d~3 (~ (iDs.) l~im~c~ lat~: Pemxid~ t~t (past 12 momh~) (Y/N) ~ o Absoq~o= r~ - ~ ~ ir.p.d. E. ~EPAP~TION DL~TANCF_~ Sl~ARATION DISTANCES FROM W~ ~- ON LOT TO:. Septic/holding ~nk on lot Abso~tion fidd on lot pupilc ~ rrmin L/fl SI~ARATION DISTANCI~ FROM Sl~TI~O TANK ON LOT TO: Building foundation ~ Propew/line ~ ~- ~ Al~oqrdon field Sm"fa~al~ldr. l--~ ~"/~) Wellsonadjncentio~ Fo l~ceipt l~.mher ~ Waiv~ Fee $ P_ _,"ce/__'pt ld!,mH~l' Rev. 8/95 OSS: Ima.wk.doc 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 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 050-222-26 HAA# ~-~r~-~ t~ 1. GENERAL INFORMATION Complete legal description Eagle River Valley Ranchettes, Lot 10A Location (site address or directions) PropeHy ownerGary & Suzanne McWilli~ms Mailing address 19108 Whirlway, Eagle River, AK Lending agencyt'~Ti3A!P,-~n~ ~- Kelly Mailing address P.O. box 770548, Eagle River, AK 19108 Whirlwav. Eagle River ' Day phone 267-1270 (Gary) 99577 Day phone 694-2103 99577 Agent Address Day phone 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Unless otherwise requested, HAA will be held for pickup. 3 (Three] NOTE: Individual well Community well Public water X If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site X NOTE: Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 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. ~/"""";" '~ '"'~" x.~ ,~.;,~.~:,~=_.~...,.~. Name of Firm Eaqle River Enqineerinq Services Phone 694-5195 Address p ~ p~ '77'~9q4: v. a01~ Piv~,~-: A~ qq577 Engineer's signature ~'~_~"- Date 6. /~ SIGNATURE ...<::~ Approved for Disapproved. bedrooms. Conditional approval for bedrooms, with the following stipulations: Additional Comments 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 engineer's work. Louis Bulera, P.E. Registered Civil Engineer June 44, 1993 John Smith, P.E. Municipality of Anchorage Dept. of Health & Human Services 825 L Street Anchorage, AK 999502 I ECEIVED MUnicipali of ....., ~ervices Re: Eagle River Valley Ranchettes, Lot 10A 19108 Whirlaway Dear Mr. Smith: On behalf of our client, Mr. Gary McWilliams, we are requesting a variance for Health Authority Approval 0tAA) on the above referenced property. On June 9, 1993 we conducted a septic adequacy test, and the system did accept a total of 1,300 gallons. Upon review of the asbuilt survey and use ora metal detector it was found that the water service line crosses the septic service line between the house and the tank, and the septic tank is within 10' (see site plan). The system was installed in 1977 and has not been modified. We could not verify vertical separation distance from surface measurement, however, one would assume the water line is under the sewer line. As the line is under constant pressure from the Municipal water lateral, we believe this represents a minimal risk of contamination and therefore request HAA issued. Although the leachfield was issued a four bedroom HAA in 1982, and the leachfield is functions adequately for an eight bedroom home, we are revising our application for HAA to three bedrooms to expedite approval. If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. \I993\93-036B.LTR FO. Box 77~29.1 · Eagle Rker, Alaska 99577 · Telephone (907) 69-1-5195 · Fax (907) 691-3297 · Louis Butera, RE. Registered Civil Engineer June 14, 1993 John Smith, P.E. Municipality of Anchorage Dept. of Health & Human Services 825 L Street Anchorage, AK 999502 Re: Eagle River Valley Ranchettes, Lot 10A 19108 Whirlaway Dear Mr. Smith: On behalf of our client, Mr. Gary MeWilliams, we are requesting a variance for Health Authority Approval on the above referenced property. On June 9, 1993 we conducted a septic adequacy test, and the system did accept a total of 1,300 gallons. Upon review of the asbuilt survey and use ora metal detector it was found that the water service line crosses the septic service line between the house and the tank, and the septic lank is within 10' (see site plan). The system was installed in 1977 and has not been modified. We could not verify vertical separation distance from surface measurement, however, one would assume the water line is under the sewer line. As the line is under constant pressure from the Municipal water lateral, we believe this represents a minimal risk of contamination and therefore request Health Authority Approval be issued. '][~[~4eachfield~was i~talled in 19.77 for'th~eebedroom Opacity. In 1982 our client purc~hased I~ liome with full Health Authority Approval for a four bedroom house. We request approval ?of this system for fou~: bedrooms as the septic tank is adequate (1,250 gallons), and the'- ~]eachfield is functioning adequately for an eight bedroom home. If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. \I993\93-036A.LTR RO. Box 77329.1 · Eagle River, Alaska 99577 · Telephone {907) 694-5195 · Fax {907} 69.1-3297 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A. WELL DATA Well type Log present (Y/N) Total depth Sanitary seal (Y/N) Date of test Static water level Well flow ~GLF~ ~'IVE.~ Parcel I.D. Pump level SEPARATION DISTANCES FRO~: Septic/holding tank on lot ; On adjacent lots Absorption field on lot // ; On adjacent lots Public sewer main // Public sewer manhole/cleanout Public sewer se~e WATE~,~PLE RESULTS: If A, 13, or C, attach ADEC letter. ADEC water sysiem number_/ __ Date completed_ ~ Drill~'~ __Cased to Casin~ht_ ~ __ Wires properly prot~/~l~ (Y/~)I- -- . x~P~ ~ g.p~ Nitrate Petroleum tank Collected by: Other bacteria B. SEPTIC/:,'CL~:.~;C TANK DATA Date installed l~?/? '~ Cleanouts (Y/N) )/~;~ High water alarm (Y/N) Date of pumping Tank size /~ Compartments ~" Foundation cleanout (Y/N) y~c ~ Depression (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOb~fHC~TANK TO: Well(s) on lot ,/~/~ On adjacent lots Topropertyline '/~'~ Surface water/drainage Foundation Water main/service line ~=~2~ (R~. ~B~) Fruit MOA 21 CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons vent (Y/N) ' High water alarm level .~ Meets MOA electrical c~~~ ~ ' SEpARATI~T~A/~E FRoM LIFT STATION TO: Well on/.[o~~ * On adjacent lots D. ABSORPTION FIELD DATA Date Installed 0'~/~ ~J~ ' C~n~th ~0' Width Totai absorption area ~0 Depression over field (Y/N) Results (p~ss/f~i) P~ro~ide treatment (past 12 months) (Y/N) ' . *~ : . Manufactu~rer __ ._ Manh "Pump on" level at ./ *' "Pump off" level at Cycles tested Surface water Soil rating /50 z~ System type 4~ G ravel thickness ~ / Total depth /~" Cleanouts present (Y/N) )/~, · Date of adequacy test 0~,/~ If yes, give date for bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Wellon lot TO building foundation On l~djacent lots t~ ~0 / Surface water ~urtain drain /~///~ -' E. ENGINEER'S CERTIFICATION Onadjacentlots''/' /~J~ ' Propertyline To existing or abandoned system on lot Cutbank /~//,~ Watermain/serviceline /t~',,,-',',, ~-' Driveway, parking/vehicle storage area ~ .~ / I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection Signature Engineer's Name Date HAA Fee $ / ~ ~Z~a Date of Payment Receipt Number Waiver Fee: Date of Payment Receipt Number fio.?b.~ .' t¥- ' .. ;.., ...~. 4. · .~.,"'.. · ..", iu-IT ' : "";" : ~" ' ' :...;.:..,:.. ';.. f..'t.' 19,~,~.~' .~ . ~: : ', "'" . ~ ;,' . .... ... . ~ · -....,. '~g-B · :'e.~ , . .~.,~.,? · . ~ ,...._ . .. , , , rnFtovemenll ittlliled thettoP ire wlthlp IJ es in~ do n~,o~etlk~ Of l~troacl~ on Inf a Jatt~lthereto that no Improvkmifi~.bn~o~* nos et etl~t risible elsement~ off Sa ~ pro us Indlcitea hereon. . ~'r .%: .. ' '~'L' :'. '-. · ~ALK: ' ~: :' lleglst~ed ~nd B~veyOr ! ~ ~.0 ; .Box 45a Ealle Rivet, Alalkl ':,¢ , l'hona ~g4.2513 · · '. · ;" ; · Time " - Time Date Date Dete Inspectur Inspector Inspector Comments Date Sewer Installed- T"'~~,'~ Permit No. Septic Tank SIze ~ "7 --7 '7 Holding Tank SIze Soils Rating Well To Absorption Area Well Log Received Well to Tank APPLICANT FILLS OUT LOWER HALF ONLY Property Owner ~ay B. & Loretta L. Long Phone Mailing Address Sr 2 Box 125 Raven View Loop Chugiak Alaska 688-9480 Buyer Gary & Suzanne McWilliams Addrese166 [~hirlaway Rd Eagle River Alaska 99577 Lending Institution Bank of the North " Address 3301 C Street % ~ 278-4501 Phone Realty Co. & Agent Totem Realty Inc Laurie Long ...... :,_ Address Artillary ~Road Eagle River Ak - : 694-9494 Legal Description LOt 10A Eagle River Valley Ranchettes ~] Single Family n Multiple Family No. of B s Fo%l.r ~ Other Water Supply ~ Individual ATTACH WELL LOG. A well log Is requtred for all wells drilled since June ~2] Community 1975. For wells drilled prior to that date, give well depth (attach log if E] Public Utility available.) Sewage Disposal ~,3 Individual Year Individual Installed: 1977 n Public Utility When Connected to Public Utility: E] Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. June 9, 1932 Ray B. and Loretta L. Long Sr 2 Box 125 Raven View Loop Chugiak, AK 99567 Subject, Lot 10A Eagle River Valley Ranchettes Approval for the individual sewer and water facilities cannot be granted until the following items have been completed~ · The septic tank pumped with a receipt submitted to this department. An adequacy test needs to be performed on the existing leaching area. ~is test will determine if the system is adequate according to National Standards. A listing of private firms performing the test is enclosed. This report needs to be submitted to this office for our revie%;. Please notify this Department for a rcinspection when the noted discrepancies have been corrected. If there are any further questions, please call this office at 264-4720. S!ncere~, Robert C. Pratt Associate Environmental Specialist ~nclosure EXCAVATION WORK June 10, 1982 ROBERT A. SHAFER CIVIL ENGINEER 694-2979 Laurie Long SR 2 Box 125 River View Loop Chugiak, Alaska 99567 Dear Mrs. Long, Reference: Lot 10A: Eagle River Valley Ranchettes 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 1250 gallons. The absorption trench was tested by a continuous flow of water over a period of 48 hours without any adverse effect on the system. It can be concluded from this test that the waste water disposal system serving the four bedroom residence located on this property is currently functioning adequately. However, the system cannot be guaranteed against subsequent failures. If we may be of further assistance, please do not hesitate to call. sit, ely, //~ /J Totem Realty Attention: Bob Dunn National B'~nk of the North SRB 196X EAGLE RIVER, ALASKA