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Home My WebLink AboutMOUNTAIN AIR ESTATES BLK 2 LT 2Mountain Air Estates Block 2 Lot 2 #017�21 1 �22 / _\\ MUNICIPALITY OF ANCHORAGE • \\ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 -- ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE ❑ NEW 1aj%11e . iSenSO}]n j45-1289 OUPGRADE MAILING ADDRESS - SRA Box 451—A Anchorage, Alaska. 99516 LEGAL DESCRIPTION "— J'ec 35 1 hot 2 Blk 2 Mountain-Air Estates LOCATION 14900 Sierra. Ida.y, mile 3 i,a.bbit Creek Rd. NO. OF BEDROOMS Three UY DISTANCE TO: Well 100,E Absorption area 38 ft Dwelling 28 PERMIT NO. SANN.E-9 a 2 N� Manufacturer r I,.omema.de Material Concrete No, of compartments Liq. capacity in gallons Inside length 17 IF HOMEMADE: Width one Liquid depthf al 11 ft. 4 ft. L� e t DOz DISTANCE TO: Well --_^^___— Dwelling 9 PERMIT NO. ^------- O _ a 2 F- _ _------^--- Manufacturer—_ ^—______—__ Material ^_--^ Liquid cWacit�in gallons kul= DISTANCE TO: Well 100+ft e Foundation 65 ft. Nearest lot line 15+e PERMIT 80886 O. 2 W No. of lines Length of each line one 0 ft, Total len th of lines 0 ft. Trench width `6 Distance between lines H __ Top of the to finish grade Material beneath the inches na. Total effective absorption area. t0 ft T)it �Je�s�7� Y. P 2 inches 600 51' w Length Width Depth PERMIT NO. _ _ CL H wa w Type of crib Crib diameter Crib depth Total effective absorption area N DISTANCE TO: ------------ Well Building foundation ------- Nearest lot line f —_______-- Class private Depth 148 riller Fenn Jerse Dista to lot line g�-I PERMIT NO �� w _ft. _ DISTANCE TO: Building foundation Sewer liq 1 rytc Septi UU+ U _ Absorp�ipr}.ia�ea (sl VV fill OTHER PIPE MATERIALS 5034 _ SOIL TEST RATING 191 ';f/ INSTALLER Frank Jones Fool O RF - C ? REMARKS Crib was pumped and filled in - with earth, ell System covered with 3.5 to 4 fl. _ — -- c ma, er• e spoils and by,,n` the lot. 74I TEIT long r P�:gerI I Efd v:. APPROVED DATE LEGAL in m x c: :�ir. :x: r -v,, I E-.: I I I F`- &!::!!jj�� DEPARTMENT L- HEALTH AND ENVIRONM�NTAL F-]T�CTION 825 . STREET, ANCHCIRAGEr 264-4720 Pf]�:RMIT NO: 840886 DATE ISSUED: 10/17/84 APPLICANT: JAYNE ELSENSOHN ADDRESS: SRA BOX 451-A ANCHORAGE, AK 99516 CONTACT PHONE: 345 1289 LEGAL DEK' CRIP: SUBDIVISION: AIRES ESTATES LOT: 2 BLOCK: 2 SECTION: 35 TOWNSHIP: 121\1 RANGE: 3W ' LOT SIZE: 50600 (SQ.FT^ OR ACRES) MAX BEDROOMS: 3 Listed below are the options aYailable to you in designing your septic system" Choose the option that best fits your site" I certi�y that: 1^ I am �amiliarwith the requirements for and wellsas set forth by the Municipality of Anchorage (MOA) and the State o[ Alaska" 2, I will install the system in accordance with all MOA codes and regulations; and in compliance with the design criteria of this permit" I will adhere to all MOA and State of* for the set back disitances from any existing well, wastewater disposal system or public qewerage system on this or any or nearby lot" 4" I understand that this permit is valid for a maximum and any enlargement will require an additional permit" IF A LIFT STATION IS INSTALLED IN AN AREA BY MOA BUILDING CODE�� THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) ASBUILTS #ILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN" SIGNED APPLJCANT ISSUED BY DATE: ~ � �� ~�� -��.... �X.... ..... ~-� I (A-) Y I 11. L f33 1.-:: 1 S 0 1 - I I I DATE: ~~~----^--- -'-��----�r-~-'-�-- AN,J 11 1 Ei:: ]C11 DEPTH T{] PIPE BOTTOM (FT") 2"0 ** 5"5 4"0, �RAVEL DEPTH (FT") 6"0 0"5 3"0 TOTAL D�PTH (FT") 8.0 6"0 7"0 GRAwaL WIDTH (FT.) 2"5 198 5"0 GRAVEL LENGTH (FT.) 48"0 36"0 75"0 GRAVEL VOLUME (CU. YDS. 28.9 25"4 48,7 TANK SIZE (GALS) 1,000.0 ** 1,000^0 ** 1 000"0 ** SQIL` RATING (SQ"FT./BR) 192 150 212 ** DEPTH TO PIPE BOTTOM < 3"5 FT" REQUIIRES INSULATION ** DI". TO PIPE BOTTOM < 4"0 FT, MAY REQUIRE A LIFT STATION ** TANK MUST HAVE AT LEAST TWO COMPA�TMENTS �� ..... ... ..... ..... .....�� I certi�y that: 1^ I am �amiliarwith the requirements for and wellsas set forth by the Municipality of Anchorage (MOA) and the State o[ Alaska" 2, I will install the system in accordance with all MOA codes and regulations; and in compliance with the design criteria of this permit" I will adhere to all MOA and State of* for the set back disitances from any existing well, wastewater disposal system or public qewerage system on this or any or nearby lot" 4" I understand that this permit is valid for a maximum and any enlargement will require an additional permit" IF A LIFT STATION IS INSTALLED IN AN AREA BY MOA BUILDING CODE�� THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) ASBUILTS #ILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN" SIGNED APPLJCANT ISSUED BY DATE: ~ � �� ~�� -��.... �X.... ..... ~-� I (A-) Y I 11. L f33 1.-:: 1 S 0 1 - I I I DATE: ~~~----^--- -'-��----�r-~-'-�-- ❑ SOILS LOG ;= MUNICIPALITY OF ANCHORAGE •� DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION 825 L. Street, Anchorage, Alaska 99501 264-4720 TEST SOILS LOG — PERCOLATION TEST PERFORMED FOR: a.to.U/ja 6&AISOL DATE PERFORMED: /0 LEGAL DESCRIPTION:L A& 2 8se.,_ cm TlaAl W ruygm SLOPE SITE PI AN I- 2- 3- 4 5 6- 7- a- 9- 10- 11 — 12- 13 14 15 16 17 18 19- 20 COMMENTS PERFORMED 72-008 (6/79) Gn I - Sr /� (?'muds SP- .64pias se»�e Gr�aua/ &PcU J ,,S WAS GROUND WATER - // S ENCOUNTERED? /ALO L 1S, O fi,f. P • ��at�IF YES, AT WHAT E %E2TH? Trill!, D. g.-;, t0'r •'• ON 5130 ,F hr: i K a, Reading Date Gross Net Depth to Net Time Time Water Drop 6 /0 /O MIA/ /o nose/ 23 8/ / IN /o MiAI /r. O.Q 6 / 6 Y MW /o all (o e5 50 i f1 MIAJ PERCOLATION RATE ///)CL (minutes/inch) TEST RUN BETWEEN FT AND\- FT CERTIFIED BY: DATE: /I')- G; ATER ANCHORAGE AREA E MGH Department of Environmental Quality 3500 Tudor Road Anchorage, Alaska 99507 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME G�4�-'r;'l/ `s %�"r MAILING ADDRESS LOCATION SEPTIC TANK: PHONE LEGAL DESCRIPTION �•'.•'.' p's /%I f :•. DISTANCE NUMBER / l t NUMBER OF FROM WELL MANUFACTURER ✓ MATERIAL �� COMPARTMENTS INSIDE LENGTH �� INSIDE WIDTH _ LIQUIQ DEPTH LIQUID CAPACITY 9�' GALLONS. SEEPAGE PIT: 4 /21 NUMBER OF PITS DIAMETER __OR WIDTH LENGTH-&, DEPTH LINING MATERIAL k-�" / =r�61B SIZE: DIAMETER _DEPTH / �' DISTANCE FROM: WELL / r TOTAL EFFECTIVE '"� BUILDING FOUNDATION NEAREST LOT LINE'''D"�. ABSORPTION AREA (WALL AREA) SQ. FT. ADDITIONAL ABSORPTION WELL: ,vnj' ii✓-�j,i/_. TYPE"CONSTRUCTION BUILDING NEAREST NEAREST FOUNDATION—,LOT LINE.---, SEWER LINE CESSPOOL OTHER SOURCES APPROVED. DISAPPROVED INSTALLED BY:ef%�14�'L1_3_ /_ ia/ / PIPE MATERIAL: %f!�/ n LOT SLOPE: &t (; REMARKS:�✓�'f/ REMARKS DEPTH DISTANCE FROM: SEPTIC SEEPAGE TANK—,SYSTEM DIAGRAM OF SYSTEM DATE 4 -//` 7-3 APPROVLV _lL G.A.A.B. GRE. rER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 �� TUDOR ROAD POUCH 6.650 � - , ANCHORAGE. ALASKA 99502 \ (' TELEPHONE 279-8686 SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT NAME OF APPLICANT _64AY/ICS INSTALLATION LOCATION LEGAL DESCRIPTION Geor ` 1&& MAILING ADDRESS 1'7y2- w 1,2 T4 PERMIT NO. -- PHONE174- 33r'l INSTALLATION OF: SEPTIC TANK A SEEPA EPPII- WTT- „ { DRAIN/ FIELD .. OTHER _ TYPE AND SIZE OF FACILITY A TO BE SERVED FINANCED THROUGH — �"j4i TO BE INSTALLED BY V SOIL TEST RESULTSC �Iwll�t NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION. FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE SEPTIC TANK SIZE TYPE MINIMUM DISTANCES, REQUIREMENTSFOUNDATION TO SEPTIC TANK -15-' FOUNDATION TO SEEPAGE PIT-- DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK SEEPAGE PIT o(,V DRAIN FIELD TO NEAREST LOT LINE. SEEPAGE AREA SIZE WELL TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK DRAIN FIELD SEEPAGE PIT SEPTIC TANK, ._-�GrDr „ SEEPAGE PIT DRAIN FIELD TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT qF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS, GRAVEL BACKFILL CONFORM TO BOROU REGULATIONS REGARDING INSTALLATION. z . \. y—rc HEALTH AUTHORITY OR LICENSED DESIGNER DIAGRAM OF SYSTEM I CERTIF THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA DESCR E S TEM IS IN ACCORDANCE WITH SAID CODE, DATE L� • APPLICANT'S SIGNATURE - G H ORDINANCE NO, 28.68 AND THAT THE ABOVE, EATE 11 ANCHORAf,F ARF"`' BOR0h-,I DEPARTMErdr OF ENVIR0NrlEN�IA.L OUALI!Y C A S L 3500 TUDOR ROAD ANCHORAGE, ALASKA 99502 Performed ForCharjPS pai4j,, Date Performed Leaal Oescri nti on : Lot 2 B1 ock. 2 Subdivision Mountain Air Sub•____. __ This Form Renorts Soils Loq x Percolation Test Denth Feet Soil Characteristics I A — Slid well graded sand & 5 _ gravel (125) Was Ground Water Encountered? no_ If Yes, At what Depth? o/1 Reading Date Gross Time Net Tim Depth to H2O Net Dropl i rercoiation mate flinute Proposed Installation: SeeDa(IP- Pit _X —_Drain Field Death of Inlet Denth To Bottom Of Pit Or Trench CnMrIENTS -7�� - - �y� y ._ t.PRt ,Ole �� - no--knowi1-�]roblem-NA-t--grcnindlOater--__ t4pographX--stinh------ Test Performed By_ Data CertifiP P P.v 0 V 43: R. 14 Z w 1 20 E4 I; 0 E-4 cc i 4D: rO: co: -Zf.. HI j: 'j:: E-4 E-4 �0: H. lz z 1 20 E4 I; 0 E-4 (D Z .fl 4> E-4 j O:rj: Ni Lil E4 C= rf N:• 0 C\I: i cv; 0 C 0 C) 0 zz E-4 Eo E-4 --'En g 0 ko E-; rA E; LC E-4 , v a -n E4 E4 m C= 0 0 C 0 C) 0 zz E-4 Eo E-4 --'En g 0 ko E-; E+ E; E-4 , v a -n E4 E4 m err. O 4� 0 O 0C 0 (D 0 0 0 0 0 0 0 rx w 44 ww w Pi 0 pi (D rz . co U]ito: CO: Q 0 E.; E4 E4 E4 E4 E-( 1-; E 4 E-4* Ww w 44 w W4 w w w 44 w w 4-� O w EQ 0 C) (D C 0 C C 0 0 0 0 0 CO H E* H E-4 H E-4 &4 E-4 E* E-4 E-4 E+ E4 E4 E4 E-4* E -4O , E-4 1p: C rA IG Municipality Cb o M1 U P.O. BOX 196650 ANCHORAGE, ALASKA 99519-6650 (907)264-4111 TONY KNOWLES, MAYOR DEPARTMENT OF HEALTH 6 HUMAN SERVICES November 21,1986 Robert A. Hunt 14900 Sierra Way Anchorage, Alaska 99516 Subject: Grandfather Rights for Well -to -Septic Tank Separation Dear Mr. Hunt: The existing 98.5 foot separation between the septic tank and well on Lot 2 Block 2 Mountain Air Estates Subdivision is in full conformance with the 50 foot separation distance required at the time of installation. Our records indicate that the septic tank was installed in June of 1973. State law changed to require a 100 foot separation in October of 1973. Please consider this letter as confirmation of grandfather rights for the existing septic system. No waiver of the current 100 foot separation requirement is necessary. This letter will be permanently property. If you have questions contact me at 264-4744. Sincerely, Stephen S. Morris Civil Engineer On-site Services included in our files for your regarding this matter, please Municipality of Anchorage Dept. of Health and Human Services Att: Mr" Steve Morris P^O. Box 166650 Anchorage, AK" 99516 Anchorage, AK. November 199 1986 Subj: Well�Septic Tank Separation Lot 2, Block 11, Mountain -Air Estate S/D, Anchorage, AK. Dear Mr. Morris: After purchasing the above described property, it has come to my attention that the well and septic system may be in violation of present separation requirements. It is my under� standing that the minimum distance between the well and septic tank is 100 ft. I have measured the distance (with a hand�held 50 ft cloth tape) and found it to be 913°5 ft" from the well casing to the septic tank vent pipe" Having previously discussed my concerns with you, it is also My understanding that the 100 foot separation requirement became effective in October 1973" As evidenced by the Well Log on file With your office, the well was completed February 22, 1973" I have photographs, showing the well being drilled, with a development date of Feb" 1973, and also of the installation of the septic tank, with a development date of Nov. 1972" (Of course these photos are available upon your request.) It is therefore that I request a letter granting nGrand~ father Rights» for the well ..... septic tank separation distance for my property located on Lot 2.1 Block 2, Mountain -Air Estates SubdivisionAnchorage, Ak" You may contact me at 271- 4176 if necessary^ Thanking you in advance for your reply, I remain; Attachments: Sincerely, Robert A. Hunt 14900 Sierra Way Anchorage, AK. 99516 NVm|C|p^uTY0F ^wC*cwME ocr/pr .*^J`/ u L|v/|�Oumim;��p��r�now �� NOVo:�O nuv ~ -~- �S, L\��v�L/ Z 29. 00 ger' W-4- I z-,+ µ, z- 3 N F„d, R.ti�r AS -BUILT 1 hereby certify that I have surveyed the following deicrIbed Mpe 1-07` �� to -k Z—, fou ' g_,. °� s �r_�t �•,1sE ��- R , n:norage ct-°c r:lirtt Frecirut, Alaska, and d"t the k,,,..;rmv,- menta situated thereon are within the Property lines and ,'Io not overlap or encroach on the property lying adjacent thereto, that no improvements on property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. DAted at Eagle River, Alaska this j day of CPC- Y • ROBERT C. JOHNSON .� «• SCALE: Registered Land Surveyor No. AB LS Box 77-0456, Eagle River, Alaska 9957/ Phone (907) 6942543 f .1 p — G•Mt/.[.J r ) , ti i 1A ` l i f. ey�'j .•" — . q 2. 4 z-,+ µ, z- 3 N F„d, R.ti�r AS -BUILT 1 hereby certify that I have surveyed the following deicrIbed Mpe 1-07` �� to -k Z—, fou ' g_,. °� s �r_�t �•,1sE ��- R , n:norage ct-°c r:lirtt Frecirut, Alaska, and d"t the k,,,..;rmv,- menta situated thereon are within the Property lines and ,'Io not overlap or encroach on the property lying adjacent thereto, that no improvements on property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. DAted at Eagle River, Alaska this j day of CPC- Y • ROBERT C. JOHNSON .� «• SCALE: Registered Land Surveyor No. AB LS Box 77-0456, Eagle River, Alaska 9957/ Phone (907) 6942543 0 vv� �� k r2� «] m Yj� \I \\ � :� 0 vv� �� k r2� «] m r2� «] m \\ � :� 11p I 'JUL) STATUTORY WARRAPII'Y DEED 11�THE GRPNn�R, SAMUEL R. PIERCE, JR., THE SECRETARY OF HOUSING AND URBAN 29 C() DEVEJAMEPW, HIS SUCCESSORS AND ASSIGNS, of Washington, 1). c., for and Q in consideration of 71+10 THOUSAND DOLLAR' ($2,000.00) in )nzand paid, the (Yi receipt of which is hereby acknowledged, and other good e,.nd valuable i consideration, conveys and warrants to Q2ANTEES, ROBERT A. IRM AND BETTY J. HUNT, husband and wife as tenants by the entirety with rights of survivorship Of �4AQ(1 Si rra L�� v �1ric`hora� Alla•, ..;.. the following described real properly: Lot TWO (2). Block TWO (2). MOUNTAIN -AIR FSTNTES, according to the official plat thereof, filed Lander Plat No. 70-376, records of the Anchorage recording District, Third Judicial District, State of jklaska. MA U 4 S U SbWECT TO all. reservations, easements, restrictions, cc>venants, conditions, exceptions and rights of way of record, if any. Tb have and to hold the premises, all and singular, together with the appurtenances and privileges thereto incident unto said Grantees, and to the heirs, executors, administrators and assigns of the survivor, FOREVER. Dated this day of nc-- a- -el 11986. SECRETt W OF HOUSI14G AND URBAN DEVELOPMENT By: lii ")�retr 4-t � 2 ,� MCs'c i;ackie, Is), Speci.ali.st _ STATE OF ALASKA ss. THIRD JUDICIAL DISTRICT ) , a On this )day of 910 ✓ , 1986, before TCF.', the undersigned Notary Publ c in and for the State of Alaska, personally appeared Marci Mackie, Loan Specialist, known to me to be the indiv.1d :a:l. described in and who executed the within and foregoin deed, and ta)no a0ncAftedged before me that she was duly authorized to and did exegete the sam as her free and Municipality of Anchorage On -Site Water and Wastewater Program K a (907) 343-7904 $ A ET Y CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. tit -7- 2 r 1- 2 Z Expiration Date: J - , L-13 1. GENERAL INFORMATION Complete legal description Lo f 2 61 k 2 jl,-? can )t t6� Location (site address) ! k 9&z9 -C" e r Current Property owner(s) 13 a 4-w s , H t.<,i Day phone Mailing address a L�cRnc�ro�ccaa F} 9951 Real Estate Agent bd« L[Ji r,dSe, " Day phone -7 2,7 - 2, TYPE OF DWELLING: P Its ® Single Family(w&o ADU) at ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System S n�'LGE1e G�^ rne-U, '1tea/Epi-. wtnc�Scrr�.ccic�fx, net �.. 5 Received by � `� �� c�.� c `i�� Date: .COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ `t70 Waiver"Fee Date of Payment 9 l/Mtr�Jl-lp3 Date of Payment Receipt NumberUJ Jot!�r - Receipt Number COSA# Q�C/3/cr/---)S- Waiver# TYPE OF WASTEWATER DISPOSAL: ® Individual ❑ Holding Tank ❑ ❑ Community ❑ ❑ Public Sewer ❑ �.. 5 Received by � `� �� c�.� c `i�� Date: .COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ `t70 Waiver"Fee Date of Payment 9 l/Mtr�Jl-lp3 Date of Payment Receipt NumberUJ Jot!�r - Receipt Number COSA# Q�C/3/cr/---)S- Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal.affaed hereto and as of the validation date shown below, 1 verity that my investigation, -..based onprocedures outlined'lathe. Certificateof Onsite Systems Approval Guidelines for. this application; shows that the onsite water supply and/or wastewater disposal system is (are) safe, functional. and adequate for thenumber 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-sfte 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 Finn F!c<fk��, Zech, Yrs cef f S.e✓vr�%� Phone Address ) HSSe ',Fctio 6Wi Zzv, R!!2! ri h i r_4egL i AL,- 99,f -,o6 Engineer's Printed Name i h2e�--eo,r r• 1't&0r'2 _,,Rate 91/1 f.? 6. DSD"SIGNATURE l.� System #1 Approved for bedrooms. System 92 Approved for bedrooms. Disapproved. =eca eaeeamsoeo�so� Conditional approval for bedrooms, with the following stipulations:. C I Ve ete 4 ter? ye'n.e,-er ;M7unT OriginalCertificate Date: Q 3— Z 3 pall o chorage Development Services Division (DSD) Issues Certificates of On -Site Systems Approvar(COSA) based only upon the representations given in paragraph @ by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage Is not responsible for errors or omissions in the professional engineers vrork. N ATTACHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Other !f. more than 7 septic system Is on the lot: COSA Checklist # of �I Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: _ 1, o }' 2. 13 loc k 2f fK au n *kir) Air ECtParcel ID: D V7 - 2r I 2 Z A. WELL DATA well type jV If A. 13, or C provide PWSID # ^- Well Log (YIN) Dale completed 2 / hrl 73 Sanitary seal (YM) Y Wires properly protected (Y/N) `f . Total depth 1't it Cased ao�i ft.. Casing height (above ground) _ lain. FROM WELL LOG AT INSPECTION Date of test 2! 2 / 7 2 7 / 31 / r3 Static water level 613, it & y it Well production 20 g.p,rn, 6. g.p:m. . WATER SAMPLE RESULTS: Coliform .&1490) cobnies/100 mL Nitrate o. r mg1L Arsenic<:�� ug/L: Date of sample: &%Z6/r3 Collected by: Elisticr Tech Sic D. SEPTIC/HOLDING TANK DATA Tank Type/Material 5eP fi.c /, Con arc hP Date installed 6 / i l % 72 Tank size 13 ZV, gal. Number of Compartments • - Cleanouts (YIN) Y1 L tom_ Foundation cleanout (Y/N)R: Depression over tank (Y/N) . N High water alarm (Y/N) 0. of. Date of pumping 7 Is ! 2a (3 Pumper M c 0sncr A um4 r.r y E erv+r 4 Pee- #6,08/8Y )IA.# F'runaea+.f cn C. ABSORPTION FIELD DATA iS flan eK �� in..rra-fp Date installed -LC-2 L 16 1011 Soil rating (g.p.d ./ft2 or fftdrm) _12L C7r Systemtype T.r�n gA Length SU . it Width __ 3 ft: Gravel below pipe /, _ it .",. Total depth �_ ft Eff: absorption area OG fe . Monftoring tube Y Depression over field hl Date of adequacy test /31 ? l 3 Results (Pass/Fail) Pe -S-11 For 3 - bedrooms Fluid depth in absorption field before test K 6 in. Water added gal. New depth 77. / in.. Elapsed Time: IS 3 mina Final fluid depth 7 S, f in. Absorption rate >= I g.p.d• Any rejuvenation treatment (past 12 mo.) (Y/N & type) -Na of & krw. w.i ►f yes, give date N A D. LIFT STATION N. fi ; Date installed Size in.gallons ManholelAccess (YIN) 'Pump on' level at in. 'Pump oft" level at in. High water alarm level at in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tanMtft station on lot 96' 4e- C. o, On adjacent lots :�t tvb Absorption field on lot > 1001 On adjacent lots > 106" Public sewer main N • /b Public sewer manholetdeanout N • 1h. Sewer /septic service line > 2S Holding tank M Animal containment areas Alon[�� > 190 Manurelanimal excrete storage areas T1yn�, SEPTIC/HOLDING TANK ON LOT TO: Building foundation 2 Property line 7 ty r Absorption field �I S" tlUatermain. N. A. Water service fine > co.' Surface water Wells on adjacent lots } I UU ' ABSORPTION FIELD ON LOT TO: . Properly line 7 10 Building foundation 7 & r Water main N• /I Water Service line > 10 Surface water 1 � ' Driveway, parking/vehicle storage Curtain drain Atone SpP^ Wells on adjacent lots < F. COMMENTS jlic Weli SP/rec�c��an �.lu�GncP ui'cEs It4ac/ u/' i'r,nt t>� )n.r/Y+/fa�hiur, 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 'n1 eo 1ja ✓7' Date 9 /1( 10 COSA brown sheet 10-10-12.doc B -.W.a r --R% =•a Ji . 0 PBPJILTSUPVEY 1'=3V SCA L,E aF THIS PRINT Engineer: -egal Description permit: 2eport Type: Municipality of Anchorage P.0 Box 196550 4700 Elmore Road Anchorage, Alaska 99519-6650 (907) 343-7904 Fax (907) 343-7997 http://www.muni.org/onsite Planning and Development Services Department On -Site Water and Wastewater Program On -Site Sewer/Well Submittal Comment Sheet FLATTOP TECHNICAL SERVICES MOUNTAIN AIR ESTATES B2 L2 OSC131475 WellSeptic COSA Completed By: rhe attached paperwork has been reviewed and is being returned for the following reasons: 9/17/2013 J.Poet Per COSA guidelines D. 4. Adequacy tests must be performed with the effluent levels in the absorption field below the top of the distribution pipe. MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date (a) Legal Description (include lot block, subdivision, section, township, range) o Url 8.tn nl r 1�'� i al,c>.:�, :111 114 3 ?1 /4 :: ei' 35 t12Td .i >''11 Location (address or. directions) 14'_)00 >ierra. '; : PYa M i.le � ;{ri,bba t (' .reek: ;toad. (b) Applicants Name Jatiyt"_e J�;1�Se��sol'ix1 _ Telephone - Home>45-12Luiness Applicants Address -�`�A Box: A':)1• -A, atic hol,a; e, l,la.�1-�a 99516 (c) Applicant is (check one) Lending Institution; Owner/builder ; Buyer � ; Other � (explain); _- (d) Lending Institution Aa'Iskn. Cont n��u1;�3.7 ,:�ni� TclephoneR Address Ui;ic ')nd Tudor (e) Real Estate Co. & Agent Address Telephone (f) Mail the HAA to the following address: C��1.1_ to pick up„ 345-1 f39 2. Type of Residence Single -Family aEl Number of Bedrooms 3. Water Supply Multi -Family F—�j Three Other (describe Individual Well Ufl Community E:::1 Public M Note: If community well system, must have written confirmation from the State Department of. Environmental Conservation attesting to the legality and status. 4. Sewage Disposal Onsite .�X. Public E=j Community [::] Holding Tank = Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 2] 5. Engineering Firm Providing Inspections Tests, File Search, Data and Information As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that, based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection. Name of Firm Par uer and. fa ,oc .tE: > Telephone 5031- N 614, Address 6. DHEP Approval 1 `1'ud.or Ton Crc]_e (ENGINEER SEAL) Approved for `-i{rte bedrooms Approved / Disapproved Terms of Condi.ti.onai. Approval B f �(�c�•-ri-ate._. i �:.�_,tG rt CAUTION Conditional Date THE 14UNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIOWIL ENGINEER. REGISTERED IN THE STATE OF ALASKA. THE DHEP DOES TRIS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE R1QUIRE- MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CER11FICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONSi IN THE PROFESSIONAL, ENGINEER'S WORK. (DHEP SEAL) RR4/ej/D18 [Page 2 of 2] 7-19-84 A. MLL EATA 03AID34 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL ( HAA) CHECKLIST - FEBRUARY 1984 NOIZ340dd IV1N3wN0d1ANq �V N17V3H d0 J.d3a Legal Descriptio J O Mj01W °,u 1NQ, Mountain Air Estates, Sec. 35 T12N R3W Well Classification private If A, B. cr C. D.E.C. Approved(YM) N/A Well Log Present (Y/N) Y Date Completed 2/16/73 Yiel 4.5 m Total Depth 148 ft. Cased to 40 ft. Depth of Grouting na Static Water Level 60 ft. Pump Set At Casing Height Above Ground 12 in. Sanitary Seal on Casing (Y/N) Y Electrical Wiring in Conduit (Y/N) Yes Depression Around Wellhead (Y/N) N Separation Distances from Well: To Septic/Holding Tank on Lot 100+ On Adjoining Lots 100+ To Nearest Edge of Absorption Field on Lot 100+ ; On Adjoining Lots 100+ To Nearest Public Sewer. Line N/A To Nearest Public Sewer Cleanout/Manhole N/A To Nearest Sewer Service Line on Lot Water Sample Collected By T. Barter Date 10/14/84,-`- Water 0/14/8/Water Sample Test Results Satisfactory Comments B. SEPTIC/HOLDING TANK DATA 1320 gallons Date Installed 6/11/73 Size 4X4X11 No. of Compartments 1 Standpipes (Y/N) Y Air -tight Caps (Y/N) y Foundation Cleanout (Y/N) Depression over Tank (Y/N) N Date Last Pumped 10/ 13/84 Pumping/Maintenance Contract on File (Y/N) N ; for ------ Holding - - -Holding Tank High -Water Alarm (Y/N) N Temporary Holding Tank Permit (Y/N) N Separation Distances from Septic/Holding Tank: To Water -Supply Well 100+ To Building Foundation 28 ft. To Property Line 10+ To Disposal Field 45 ft. To Water Main/Service Line 1W A/q To Stream, Pond, Lake, cr Major Drainage Course N/A Comments foundation cleanout was discussed with Robie on 10/15/84 and will not be required as it was a legal installation in 1973 ana -Cne ianx is oversizea. [Page 1 of 21 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 192 SF/BDRM Type of System Design Trench Date Installed 10/18/84 Length of Field 50 ft. Width of Field 36 in. Depth of Field 8 ft. Gravel Bed Thickness 6 ft. Square Feet of Absorption Area 600 SF Standpipes Present (YM) Y Depression over Field (Yn) N Date of Last Adequacy Test 10/18/84 upgrade Results of Last Adequacy Mast upgrade Separation Distance from Absorption Field: To Water -Supply Well 100+ To Property Line 10+ To Building Foundation 72 To Existing or Abandoned System on Lot 30 on Adjoining Lots 30+ To Water Main/Service Line )EK N/A To Cutbank(if present) N/A To Stream/Pond/Lake/or Major Drainage Course N/A To Driveway, Parking Area, or Vehicle Storage Area 30+ and dressing up the lot. D. LIFT STATION Date Installed ----------- Dimensions ---------- Size in Gallons ---------- Manhole/Access (Y/N)----------- "Pump on" Level at --------- "Pump Off" Level at ---------- High Water Alarm Level at ------------ Vent (YM) -------- Tested for ------------ Pumping Cycles during Adequacy Test. Meets MDA Electrical Codes(YM) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA HAA Guidelines in effect on the date of this inspection. ="'' Signed Date Company Bar r and Associates MOA No. �t 8¢-208 EERS 3� CIO °ray A KB1/d5/s [Page 2 of 21 foray D. C� 311 'y 2-15-84