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HomeMy WebLinkAboutMT MCKINLEY VIEW ESTATES BLK 1 LT 2 Municipality of Anchorage Page DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: .~ ~1{~ otOq PID Number: OZ.O -~ioj Name: ~e~ ~o~ Wastewater System: ~ New ~ Upgrade ~e~,: ~' ~ r~.~ ,~,~BSORPTION FIELD Phone: ~5--~' No. of B~rooms: ~ Deep Trench ~ Shallow Trench ~Bed ~Mound ~Other LEGAL DESCRIPTION SoilRating: (~i¢ E~¢~ Total Depth from original 9rade: Lot: Block: Subdiv~ion: Depth to pipe boEom from original grade: Gravel depth beneath pipe Township: Range: I Section: ~[' Fill add~abov~ original grade: Gravel length: WELL: ~ New ~ Upgrade Gravel width: ~ Number of lines: Distance be~een lines: Ft. i ~ Ft. Classification (Private, A,B,C): Total Depth: Cased To: ~ Total absorption area: Pipe material: Driller: Date Drilled: Static Water Level: Installer: Date installed: Yield: Pump Set at: Casing Height Above Ground: 'Z. ~ GPM '~ Ft. '~ Ft. TANK SEPARATION DISTANCES ~ Septic ~ Holding ~S.T.E.P.~ To Septic~ Absorption Lift Holding ~ublic/PrivateManufacturer: Capacityin gallons: From Tan~ F~eld Station Tank Sawer Lines ~ O ~ ~ ~ ~ ~ ~ ~ Material: Number of Compa~ments: Surface w~t~, ~oo~ i~+ ioo~ -- ,-- LIFT STATION Size in gallons: Manufacturer: Line ~ "Pump on" level at: ] "Pump Off" level at: I High water alarm at: Foundation ~, ~ i ZO t ~ ~ ~-~ ~lI ~O~ 'l~ ' Pump Make & Model Electrical Inspections pe~ormed by: Remarks: ~ '~5 i~ A~ t~aVA,rt~ ~y~r~- BENCH MARK Location and Description: Inspections pedormed by: S & s ENGINEEEING Da ~ 17034 Eagle River Loop Road, No. ~~ "'}'~/ Eagle River, Alaska 99577 ~/[O~P ~ ~ ~~.' Department of Hea~ an¢ ~uman Sonic Reviewed and approved by: . 72-013 (Rev. 9/91) MOA 25 Permit No. SW960109 2 Page 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 LOT 2, BLOCK 1, MOUNT McKINLEY VIEW EST. 020-101-14 Legal Description: PID No.: A B FCO 1 ' 28.0' C1 23 O' 47.5' C2 26'5' 52.0' MI1 10(3.5' 171.0' ~ ~ Wfrt, LL I -£WATER SYS . x, LNEW 'RENCH LALT. SITE 72-013 A (Rev. 9/91) MOA 25 Permit No. SW960109 5 3 Page 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 LegalDescription:LOT 2, BLOCK 1, MOUNT McKINLEY VIEW EST, PIDNo.: 020-101-14 FLUENT LINE TO SORPTION FIELD ~ UNIT ORIGINAL RADE ISU~T[O AROUND TA~ K~ INSU ~[) AROUND TANK //////////// ~//// A' // //// P~TT ~ ~ = 8g.[' /-FiN~ GR~E ROM QUALITY SAIID & GRAVEL) (T2 = 86.3' ~ ~TT J6.8' N.T.S. 72-013 A (Rev. 9/91) MOA 25 Municipality o! Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: I_O7 ~.- G~ I LEGAL DESCRIPTION:~gv'~' ~'l¢. ~',,~.~¥ Y'J'~,-~ ¢ ,~T.'rownship, Range, Section: ~ I~ ,~ ~-- J/~ ~. ~ ~,~ _,~ SLOPE SITE PLAN 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17- 18 19 20 WAS GROUND WATER ~j 0 ENCOUNTERED? S ! L IF YES, AT WHAT ~ O DEPTH? P E Oepthto Water Alter ~"' ;"- ~onilofin§? Date: Gross Net Depth to Net Reading Date Time Time Water Drop 0 ~..i~. ./ PERCOLATION RATE ~ (m~nutes/inch} PERC HOLE DIAMETER TEST RUN BETWEEN -- FT AND FT COMMENTS $ & $ ENGINEERING /~,~.j~ ~'"'~J"~*-,-'-~ CERTIFY THAT THIS TEST WAS PERFORMED IN PERFORMED BY: m~,~,~ c.~l. I~,t .... I ,,'.~,,,? I~,,,,~,,,,I ~, ~1'14 / ....... - .......................... ACCORDANCE wi~lLt~i~/~E/~j~I:31~u~N~PTAL GUIDELINES iN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG m PERCOLATION TEST DATE LEGAL DESCRIPTION:tV)~ ~"~/Y"' 5 6 7 8 9 10 11 12 13- 14- 15- 16- 17 18 19 2O 5T~Township, Range, Section: SLOPE I P~ PERFORM WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? SITE PLAN Depthto WaterAfter ~o ~- /~i./,~o,9~-) Monitoring? Dole: Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE __ TEST RUN BETWEEN (minutes/inch) PERC HOLE DIAMETER __ FT AND FT COMMENTS PERFORMED BY: ~-xn,~z ~~f^ ~ .... i ~ ~n~ ~ ~1 ~ ACCORDANCE Wl~[t ~E~{~AL GUIDELINES IN EFFECT ON THIS DATE. 72-008 (Rev. 4/85) CERT,.V TH^T TH,S TES~ WAS .ERFORMED ,N DATE: From : ALPINE DRILL 90? 345 0202 Now. 19.1996 12:22 AM PO1 STATE OF ALASKA DEPARTMENT OF NATURAL RESOURCES DIVISION OF MINING & WATER MGMT WATER WELl. RECORD LOCATION OF WELL BOrOUgH eUI~DIVIeIOI~ /'./~ LOT BLOGK LOCATIONISKECH; WELL OWNER: DEPTHS M~SUREO FROM:~casin0 top ~ground Surface WELL DEPTH: ~t-- DATE OF COMPL~ION 60"~.OC[ DATA: ~pth Depth 0f caaing: J/ -ft ~/~ / ~ateriBI Type end Color From TO ' ' ~~. /~ ~ ~~ ft bslow ~top of c~sing ~ ground  ~ETHOB OF DRILLING: ~air t~ol USE OF WELL:~flom~stic g Irrigation g monitor ~ public supply ~ other Casing ty~e: ~ ,, ~. tO ;/ ft  .WELL INTAK~ OPENING TYPE g open ~nd g screened ~ J~ /~-_ Operforated ~pen hole DepLhs of openings: to .... ft SCREEN TYPE: Diem: in. ,.~ Slot/Mesh Si~e: ~ Length:. ft GRAVEL PACK TYPE: Volume used:...,.". Depth to top: ' '.~,~. gROUT TYPE Volume: ,. Depth: from ft to ft PUMPINg L~EL AND YIELD: PUMP INTAKE DEPTH: ~ ft Horsepower: .... ~ WELL DISINFECTED UPON COMPLETION? ~ YES ~ NO CONTRACTOR INFORMATION: REMARKS: negislEred Business Nar~e .. /' ~.- - PLEASE MAIL WHITE COPY OF LOG TO: DNR/DIVISION OF MINING & WATER MQMT 3601 C St, Suite 800 ANCHORAGE AK 99503-5935 Phone (9071269-8639, Fex {$071662.1384 DEC-- 4--96 WED 1 ? = 04 CARCEL ELECTRIC .? 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:SW960109 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:BELL HOMES OWNER ADDRESS:lB622 GUILLEMAT CIRCLE ANCHORAGE, ALASKA 99516 PARCEL ID:02010114 DATE ISSUED: 6/10/96 EXPIRATION DATE: 6/10/97 LEGAL DESCRIPTION: MOUNT MCKINLEY VIEW ESTATES BLK 1 LT 2 LOT SIZE: 217800 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (iSAACS0) . 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 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. l ~PEcIAL PROVISIONS: PRIOR TO TRENCH INSTALLATION, EXCAVATE A TEST HOLE NEAR EACH END OF THE PROPOSED TRENCH TO CONFIRM 2 FT. OF RECEIVING SOILS AND TO ENSURE A 6 FT. VERTICAL SEPARATION TO BEDROCK. (AMC15~,65.060.2.C) R c iv D BY: ISSUED BY: DATE ROBERT C. COWAN, RE. ROBERT A. SHAFER, RE. May 21, 1996 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 HEALTH AUTHORITY APPROVALS SEWER&WATER MAIN EXTENSIONS SEWER&WATER INSPECT[ON ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE ' WASTEWATER DISPOSAL SYSTEM DESIGN MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 2, Block 1, Mt. McKinley View Estates S/D Request you issue a pez~nit to drill a well and install a "innovative" Biocycle Wastewater Treatment System with a pressurized distribution trench to serve the proposed four bedroom house on the referenced property. Two 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 no water was encountered in the test holes and after seven day ground water monitoring, the monitoring tubes were found to This property has enough area for a future septic upgrade which can be seen on the attached site plan. We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic system. Robert Co Cowan, PoE. RCC/g . If you require additional information, please contact us. Sincerely, ~,,~ Enclosure 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 " ! ,1" '- 60' SITE PLAN DESIGN o . -~m;0 _z~ ~ mcn-o;:oeo 0 _t_.l- ~uO 0;:~ 68 FqO z z~ ~ o~ z ~oCO:~ z o r-_m ~ ='T-T~.~,'-O ~ ~o~© Zz ~ O0 '-' Zo o~ o .> ,..0 ,.,., ~ > ,-.---, o_S ~ ~- o c/)m 0 0o~ ~ > I -.,. ? ~ ,'..-./ o ~: 4.."w47; % ,v,~J ,:',.,,.,... z '~ ~ .¢ .,~.,-',t..?~, ::t ~ ,:,,; .~ Iq ,.t'. S. SCALE DETAIL PROFILE 0 -< C5 .~© --I 71t ~> o~ lo ', N.T.S. X-SECTION DETAIL SCALE 6.06' (1850mm) 2.6' (800mm) PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LOT LEGAL DESCRIPTION: DATE PERFORMED:'i ~ ~'/[~ Township, Range, Section: 1 ? ~ "" 7 8 10 12 14 17 18 20 COMMENTS WAS GROUND WATER /V'0 ENCOUNTERED? S L IF YES, AT WHAT ~ O DEPTH? p E SLOPE SITE PLAN Depth Io Waler Alter Monitoring? Dale: Gross Net Depth to Net Reading Date Time Time Water Drop p(.,q c_ -Tee FA-~'y 'TO /' 6.4 J o,'~ £ - PERCOLATION RATE__ ~ I (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ~ FT AND ~ FT Eagle River Loop Road !~o. 204 i . . . CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE 72-008 (Rev. 4/~) PERFORMED FOR: LEGAL DESCRIPTION: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST N -'' I DATE PERFORMED: :~ Township, Range, Section: 1 2 3- 4 5 6 7 8 9 SLOPE SITE PLAN 10 11 12 13 14 15 16 17 18, 19- 20- WAS GROUND WATER ENCOUNTERED? S L IF YES, AT WHAT ~ O DEPTH? p E Depth to Water After MonilorJng? Date: Gross Net Depth to Net Reading Date Time Time Water Drop ~'.~3 ~z~', ~ ~ '. OV ~ 7/~" PERCOLATION RATE TEST RUN BETWEEN (minutes/inch) PERC HOLE DIAMETER FTAND /"/ FT COMMENTS PERFORMED BY: J~'O~4 F..a~ie River L~,~p ~,oaiJ ~4o. 2.~,~.4 .... J~"'"""~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITI~i~..~,Jxq~.J~]~J~J~J~J~[ZL GUIDELINES In EFFECT ON THIS DA'TE. DATE: 72-008 (Rev. 4/85) ROBERT C. COWAN, P.E. ROBERT A. SHAFER, P.E. HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL iNSPECTION & FLOW TEST SITE pLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL & MECHANICAL iNSPECTIONS ONSITE WASTEWATER DISPOSAL SYSTEM DESIGN 'ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 REFERENCE: Lot 2, Block 1, Mt. McKinley View Estates S/D May 21, 1996 GENERAL: 1. e The scope of this project includes the installation of an "innovatil~ Biocycle Wastewater Treatment System and a five foot wide pressurized leachfield trench to serve the proposed four bedroom residence located on the referenced property. 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. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. TANK INSTALLATION~~ ~,~,¢,+d~-~.): A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. The ccp%i~ tank shall be sufficiently bedded to prevent settling or shifting of the tank. Ail standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 17034 NORTH EAGLE RIVER LOOP ' SUITE 204 ° EAGLE RIVER, ALASKA 99577 Page Two Lot 2, Block 1, Mt. McKinley View Estates S/D May 21, 1996 e De 6e Septic tanks installed with less than 4 ft. of cover shall be insulated. A foundation cleanout shall be installed one to four feet from the building foundation. Final grading ~ the ~ tank shall be such that a positive slope exists away from the ~ tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: t 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 (ruffed-up) before gravel (sewer rock) placement. Once the gravel is installed, the distribution pipe is to be installed level with the holes faced downward. The distribution piping is to be of PVC (ASTM D3034 or equal). All joints are to be solvent cemented. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 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. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design~ and extend a minimum of 12 inches above final grade. 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. Page Three Lot 2, Block 1, Mt. McKinley View Estates S/D May 21, 1996 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 SPECIFICATIONS: Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron ASTM D3034 (PVC) ASTM F810 (HDPE) ASTM D2662 (ABS) Yes Yes Yes Yes Yes No Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. m Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). De A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. e All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. e When sand is being used as a filter material, its gradation specifications must conform to current M.0.A. or D.E.C. requirements. Page Four Lot 2, Block 1, Mt. McKinley View Estates S/D May 21, 1996 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: 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 may not be backfilled before this inspection. 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. e 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 contractors 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 contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. Page Five Lot 2, Block 1, Mt. McKinley View Estates S/D May 21, 1996 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 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 020-101-14 \: NAA# 1~1 ~ ~1 1. GENERAL INFORMATION Complete legal description cot 2, Block 1, Mount McKinle~¥iew Estates Location (site address or directions) 16971 Mount McKinley View Drive Property owner Rohhy ~ Oar]a ,7on~_.~ Day phone 348-0540 Mailing address 16971 Mount McKinley View Drive, Anchorage, AK 99516 Lending agency Mailing address Day phone Agent Tom Alexander/Prudential Vista AddresS241 B Street, Anchorage, AK 99503 Day phone 273-7277 Unless otherwise requested, HAA will be held for pickup. 4 NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water XXX NOTE: If community well system, provide written confirmation from State ADEC attest- lng to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site 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 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. S & S ENGINEERING Name of Firm 17034 Ea¢¢e River Loop ~oad Ne_ ~o4 Phone ~ Eagle River, Alaskn 99577 Address ¢ , ~ ~/7"~'-~-- - Engineer's signature '? ../~/~,~/.;/~ . - Date D.~/S SIGNATURE Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments By: 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. 72-025 (Rev. 1/91) Back MOA~I Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES ~1~ Environmental Services Division '~zJN~o~,~~' '~-'~ 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907)~~,As~l¢~ Health Authority Approval Checklist Legal Description: /_07' 3- I~L~c~ J Parcel I.D.: A. WELL DATA Well type ~ I'~'T~L Log present (~N) ¥~ $ Total depth ~ ~ (~ Sanitary seal (~N) If A, B, or C, attach ADEC letter. ADEC water system number Date completed ~ / ) 5 ~ ~/ /~ Cased to i I ' To ~- '~' Casing height (above ground) Wires properly protected (~N) FROM WELL LOG Date of test '-///3'/ ~ L. '' Static water level '~ I · Well production g.p.m. AT INSPECTION g.p.m. WATER SAMPLE RESULTS: Coliform Date of sample: B. ~ TANK DATA Date installed I ~/~ / ~ Tank size Foundation cleanout ~/N) Date of Pumping C. ABSORPTION FIELD DATA Date installed Length ~ 0 Width Nitrate ). O I Collected by: Other bacteria S & S ENGINEERING ~7G54 Eagle F,;ver Lump Roa~ Eagle River, Alaska 99577 /~ :~ ~ Number of Compartments /'7/ Cleanouts (Y/N). ce~.,~ Depression (Y/~. /,/O High water alarm (~/N) ~'~: J~ Pumper '- Soil rating (g.p.d./ft2 or ft2/bdrm) ! Gravel thickness below pipe Effective absorption area %00 ~- r 7_ Monitoring Tube present (~)/N). ¥~- .r Depression over field (Y/~ Date of adequacy test ~ /~'/~/ Results ~Fail) /~- S ~' For Fluid depth in absorption field before test (in.); ~ Ay' Immediately afterZ/5-7 gal. water added (in.): Fluid depth D ,~-¥ (ins) Minutes later: I O Absorption rate = ~ c) ~ -/- g.p.d. Peroxide treatment (past 12 months) (Y/N) ~'~*v'~- ~,0 ~,~' If yes, give date bedrooms. 72-026 (Rev, 3/96)* D. LIFT STATION Date installed Manhole/Access(~/N) "/~ 5 High water alarm level at* ~ ~ //~-' Cycles tested E. SEPARATION DISTANCES Size in gallons "Pump on" level at*. ~' ~' "Pump off" level at* SEPARATION DISTANCES FROM WELL ON LOT TO: ,.,,.e,,.,ho~ tank on lot Absorption field on lot / o o Public sewer main Sewer/septic service line ~-5~ -/- Lift station On adjacent lots On adjacent lots /o 0 Public sewer manhole/cleanout ,,¢,},4 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation /o .-)- Property line /0 -)- Absorption field Water main/service line /0 ¢-- Sudace water/drainage /0 o ~ /o --¢ Wells on adjacent lots /0 o /-)- SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line )o ~ Building foundation /o --/- Water main/service line ~ / O .-,L Surface water /o o -'r- Driveway, parking/vehicle storage area Curtain drain ,,~ o ,,~ ~..,'c ,~ O ~' ~ Wells on adjacent lots ) o 6 ENGINEER'S CERTIFICATION I cedify that I have determined thru field inspections and review of Municipal reco~.}~'~O~e.~s=~_ ,, ....- ,, are Engineer's Name ~'~¢,¢~ Date ~ f ~ ~ / HAA Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number APR-Z~-~S 1~:5) FRO~I-CTE EJWIRO/~M~I~TAL ~. CT&E Envi,onmental Services Inc.~ --~~~.. -. T-~40 P.O~/O5 F-055 CT&E Ref.# 991617001 Client Name S & S Engineering Project Name/~ N/A Client Sample ID L 2 1~1 M; Mcl~ialey View Matrix Drinking Water Ocaeeed By PWSID 0 Sample Remarks: Client PO# Printed Date/Time 04/22/99 14:00 Collerled Date/Time 04/t$/99 17:~ R~ei~ DazelTime 04/19D9 13.25 Technical Dir~tor: geJe~ Parameter Re$u[;6 PQL units He~ho~ ALLowODLe Prep Anoty$i$ ~j~lts O~e Dale 0.500 mg/g EpA 300.0 0~/19/99 RMV max 0~/19/99 0~/19/99 SCL Robert E. & Darla K. Jones 16971 Mount McKinley View Drive Anchorage, Alaska 99516 (907) 348-0540 May 13, 1999 Jim Cross On-Site Manager City of Anchorage · ' a~it o'~ Dept. Healt~ Re: Robert E. Jones 16971 Mt. McKinley View Drive Dear Mr. Cross: As per our conversation of May 13, 1999, you indicated that a septic sample from my Biocycle System would not be necessary if I could submit documentation regarding regular service by Biocycle Alaska. Gus Andress of Biocycle Alaska has forwarded the complete two-and-a-half year maintenance log of my system. The Biocycle has never malfunctioned, and Mr. Andress has been prompt in both answering any questions that I had regarding the Biocycle's operation and cleaning and servicing the unit quarterly. I and scheduled to close the sale of my Mt. McKinley View properly on the morning of Tuesday, May 18. All additional paperwork was submitted to your office several weeks ago by Bob Cowan of S and S Engineering. It is my hope that this final hurtle will not necessitate a delay in my closing, and that my permit will be issued before 5/18. Thank you for both your understanding and assistance in this matter. Sincerely,~.~j ~ Robert E. Jones,,/ ' ~: 'OVERALL ~-'YKI~EM ".':'PE~'ORMANC£ mm $1udgaD~ptflAi~,~ptab]e?- ~ mm Sq~r~Jfi~c~oasinPla~-Clu. n? . Are the Chlofin~ Cannls~ers Clean and Int~at? A~ th~ Chlorine C~nJst~r Lid~ On? . IRRIGATION TAN.,,K :'"" ' . '. '~,,,o~s~' ' '.' "'.' "'" '-' '.. OVERALL SYSTEM PERgoRMANcE $~um D~ A~ib~abl~? ~ - , · All'Diffuse~s Operating? ~ Su~.~i~t Air ~upph~? _ Airpump Filter Cleaned: ~. AEI~,,,TION .CHAMp, ER .Pinwork ~taet? Liquid C?our Ace~l~ble? (Dark Brown); · 'CHLORINATOR''. /I,/~ ~".. ~ ~; Chlogno Canaia~ CI~ and ~ct? - ~. A~ ~ Chlo~e C~st~ ~da On? ~ ' .. ' ' 'lsth~TSrikCl~m;~ .~ . .~thoLiquigCotourCl~-: .~T'~ Comm~ng: ,: ..... . :,.OV%IIALL S'Y~gM :.PERFORMANCE' - w~y Oood Municipality: l:)at~ of This ~iervicc: mm Sludg¢'Dep{hAJ~'~tmblm? ~ Airpump FilI~ CJmtn~d: ~ . · CLARIFIC. AT, lO, .N TANK '" SludseRctum Ol~retit~'; '.J~-l" $oum Return Ol~ralJn[?. '[~r'~ Liquid ColourAeexpt~bic'! ..' . . . pirmworkinl,~ot? __ . ':?:J '".' .: ~GtTION T~ "' ' :' ' ".: '." :"~"~'~' :': :.'"~ "'-.~.. -.' . ~~c~'~% :"".:.-" ".:.. "...:..'..:.:- ..f? . ~GATION SYSTEM .: -, :: . ....... ~mm~int~r 8~ WOr~*"~" , , :' · ..: ... ~AL~S~8. '~~ -. .... .,: ,' · '.:5 ~iu~ ~ OVERALL ~'Kf EM PERFORMANCE OVERALL PERFORMANCE' I~O~Y~£ PTY L'~. OVERALL ~'YSTE M PEP~ORMA N,I2I~ Chk)vinator I;~ 'riom.Fomi$" Mailer?... N~m~r ffChlo~e Tab~ Ad~; · . thin,or ~:~'mfing ~''  ~ ~e Chlofine~ CI~a~. ~ ~ t~e Chl~ C~i~ds ~? . .. ~.. .il ,.~.~. ~L~C~ SYSTEMS... ' · ' "." .':'..: ::.... '" ""~ ' · ' :~ : :::.~ ~,~,v,~ ..:.'~.:.'... .., ..:. ___....,.::..::., ~ · . ' . ' ~.~:':-"".',,' , . ".?.1 ..... ~.. .. ~...., . _..~,,: . .' ..i,~ .~_ , .... ' .' '.' ' ' ' 'F. :. ' t) o~.~ ~ ,~=~.~::. ' .~, . .. ........-~--~:, - .-: ....... ~FOR~NCE V.~ ~ ' ~ . . . . '.. . ' S~= ....... ~'".'~ ...... "~"~ ............ HOME' (YES "." . ' '~ ': "?"'"',"'"'"~"-'"',~.~,~,~,c~,/..~.....~,.~,,c,,d 'L~ ".'. '-'- ..... :'"-':""""Z~'~ON c~=~'~-~Xi~B'~"~7~--.- ....... :<..-.-~ ...... :.,.. PRE~SURE ~s>~'c~ ......... :-'"':~~ .............. ...._. .......... ::...~.:.. ....... ;'" COM~N)S . .. ',' '." CLARIFICA~ON. CHAMBER' - ........... 7-4'+ .... ' : - COM~NTS- ' · ' · ' ~ ~M.. .... · . . ~,~.~ . ~T ~ ' , .~_ · . . . ' :.... .:. ~'....' '.. . 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. # 1. GENERAL INFORMATION Complete legal description CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Lot 2; Block 1';: Mt'. McKinley View Estates Location (site address or directions) Mt. McKinley View Drive Property owner Mailing address Bell Homes Day phone 18622 Guillemot Circle Anchorage, AK 99516 Lending agency Mailing address Day phone. Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 4 TYPE OF WATER SUPPLY: individual well Community well NOTE: XXX Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality'and status of system. : ~ ., ,r , 4. TYPE OF WASTEWATER DISPOSAL: NOTE: individual on-site 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. 72-025 (Rev. 1/91) Front MOA #21 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 170,34 =,_q~ R;,~r Luup ~,Qad No. 204 Phone Eagle River, Alaska ~577 Address Y~2 ~ EngineeCs signature ~ Date I ~ / ~/ _ ~ G DHHS SIGNATURE .X Approved for 4 Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Cei'tificates. based only upon the representations given in paragraph 5 above by an independent profe~ional 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 DH HS 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-o25(Rev. 1/91) Beck MOA~21 J~UNI(;ipALI1'Y gE S WCES Municipality of Anchorage DEC 0 1926 DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division P~ E C E J V E 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Legal Description: LoT A. WELL DATA Well type Log present ~N) Total depth Sanitary seal ([~N) Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform ,~ Date of sample: Health Authority Approval Checklist i~Locv- J't I~'i'~ J~L~.,~.¥ParcelI.D.: Cased to B. ~--OLDING TANK DATA Date installed Foundation cleanout(~N) Date of Pumping .~1~ C. ABSORPTION FIELD DATA Date installed ~ - 'J,- ¢:l ~ Length ~;' -~ Width If A, B, or C, attach ADEC letter. ADEC water system number Date completed "7 - I~ ~'~ (. g.p.m. FROM .WELL LOG '7- Casing height (above ground) Wires properly protected (~N) AT INSPECTION Effective absorption area '~0 ¢ Monitoring Tube presenti~N) ~E._~ Depression over field ~/~ __ Date of adequacy test ~1/~ ~ Results (Pass/Fail) For /'~ Nitrate (~. ~'~/q Other bacteria J 'Z ~ 7-- e,.~,' ' Collected by: S & S ENGINEERING 17034 Eagle Ever Leop Road,~ No. 204 . Eagle River, Alaska 99577 Tank size ~ ~ ~Z Number of Compartments ~ Cleanouts ~N) Depression ~ ~e High water alarm ~N) Pumper ~' i Soil rating ~orfl/bdrm) 2,0 ~ystem~pe ~ ~ Gravel thickness below pipe O, ~ Total depth ~i_~ __ gal. water added (in.): Fluid depth in absorption field before test (in.); Immediately after bedrooms Fluid depth '-"- (ins) Minutes later: '"-' Absorption rate = ~ g.p.d. Peroxide treatment (past 12 months) (Y/N) If yes, give date 72-026 (Rev. 3/96)* D. LIFT STATION Date installed e/Access ~N) High water alarm level at* Cycles tested /'~//~ E. SEPARATION DISTANCES Size in gallons j~'~'Z. "Pump on" level at* ~'Z Ii "Pump off" level at* *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: ~olding tank on lot Absorption field on lot Public sewer main Sewer/septic service line On adjacent lots On adjacent lots Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM~HOLDING TANK ON LOTTO: Absorption field Wells on adjacent lots Water main/service line Foundation ~o~ Property line I I$ Water main/service line io Id- Surface wateddrainage SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line -~- ~ Building foundation Surface water I OC?~' Driveway, parking/vehicle storage area Curtain drain /'~//~ Wells on adjacent lots i ¢...~1~ ENGINEER'S CERTIFICATION / ........ certify that I have determined thru field inspections and review of Municipal record~.~..~..~.~.ti~ ........ ~b~ ~toms;~ are ~n conformance w~th MOA ~A~ ~utdeflnes tn effect on this date. Date / ~ / ~ /~ 0 Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* 1~×05×96 11:48 CT&E ESI ANCHORAGE N0.659 ,d~l~l~ CT&E Environment=l Services I~c. CT&E Ref.# Client Name Project Name/# Client Sample ID Matrix Ordered By PWSID 966249001 S & S Engineering L2 B1 Mt. McFdnley View Est. Drinking Water Ddnkiug Water Client PO// Printed Date/Time 12104/96 17:27 Collated Date/Time 12102196 22:00 R~elved Date/Time 12/03/96 08:00 Teehnlcal Director: Stephen C. Ede Released B~.~. Sample RemaXk~: R@$u[ts P~IL Uni ts ALLowabLe Prep Anetys~s Hethod Limits 0ate 0ore Init Nitrate-H 0.899 0,100 mg/L $N18 4DOO-NO3F 10 max 1Z/03/96 ENB ¥otat CoLiform 0 0 cot/lOOmL SH18 92228 12/0M96 TNW