HomeMy WebLinkAboutPREUSS #4 BLK 9 LT 24A - q *C)� �S�a-Sg < Municipality of Anchorage Page of of " 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: 5WJ:j0069 PID Number: 060 -51;'6$ Name: 6rd-Ye-01-t.ee-0 Wastewater System: ❑ New Upgrade Address: egsz-f 105 00i P Eac.+•� Rave At ABSORPTION FIELD Phone: 'i No. of Be ooms: Deep Trench El Shallow Trench ❑ Bed ❑ Mound Other LEGAL DESCRIPTION Soil Rating: $ Total Depth from orig� al grade: GPD/Sq. Ft. 10 Lot: Block: (�S}uu.,bdivision: , r Depth to pipe bottom from ordinal grade: Gravel depth beneath pipe r rCt?LttiS SSD f�'Y J Ft. S Ft. Township: Range: Section: Fill added above original grade - 5, Gravel length: t �� Ft. Ft. WELL: L75T�oTTAt� New ElUpgrade Gravel width: e Number of lines: I Distanceb_iweenlines: • J' Ft. Ft. Classification (Private, A,B,C): Total Depth: o: PerOAT0 C Ft. Total absorption area: SSD SQ. Ft. Pipe material: T O /x• // "i10 Driller: ari lied: Staticwater Level: Installer- • � Date installed: S Ft. ! W 13 G r I Yield: Pump Set at: Casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES Xseptic ❑ Holding ❑ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer:,._. Capacity in gallons: From Tank Field Station Tank Sewer Lines vc - I A0K I aso Welh 100'}, lIoOr _ ast} Material: Srrorl— Number of Com artments: Surfac water 100tf- tooli- — — — LIFT STATION LotI �OI } t Size in gallons: Manufacturer: Line C) { Foundation 5 tf. bU "Pump on" level at: "Pum eat: High water alarm at: Curtain L Pump Ma odel Electrical Inspections performed by: Drainiiiiiiiiiiiiiiiiiiiiiii­o Remarks: 15--XIS71, C, BENCH MARK �QMF�C%) C2v5Hi4 �ri.L�iJ fy Location and Description: oTtoM OF DOORJAAA 3) r�Du,' 6 eLo6E To �ox-AM �• it - Assumed Elevation: 160 _ Ft M �N2 / Inspections performed by: sr sr:Q,l.rrrttNG D s: 1st 9•M MM••4•SYF••. "� "' " •� 17034 Eagle River Loop Road, ft S _ • 2nd !ti 5^ Eau River, Alas Si7 `! ~':'^'_'""" W&R`f t. COWAN 3ri 5 • a� _ 5 '•. Department of He th and n ervices approves ++;' � Reviewed and approved 1 °� Date: ,., y ,,.. .``� y: iz-o16 tnev. aiai7 MVA eo t / PERMIT NO. SW970069 PAGE 2 OF 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P,O, Box 196650 ® Anchorage, Alaska 99519-6650 ® Telephone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 2, BLOCK 9, PREUSS SUBDIVISION #4 P.I.D. NO. 050-572-58 PAGE 1 OF, - F , 1 - 0 / v MUNICIPALITY OF ANCHORAGE ��` ' DEPARTMENT OF HEALTH AND HUMAN SERVICES:/�/` P.O. BOX 196650, 825 "L" STREET, ROOM 9 507�i J /J C a -u ANCHORAGE, ALASKA 99519-6650 ���/%�//j' E^� SSL filti r c�//`el / ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT �4� PERMIT NUMBER:SW970069 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:NICOLELLO KELLY T & JENNIFER L OWNER ADDRESS:10225 DONALD PL EAGLE RIVER, AK. 99577 PARCEL ID:05057258 LEGAL DESCRIPTION: PREUSS #4 BLK 9 LT 2 LOT SIZE: 19600 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1 2 3. 4 5 DATE ISSUED: 4/23/97 EXPIRATION DATE: 4/23/98 THE ATTACHED APPROVED DESIGN. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 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) 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 THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED E ISSUED BY: DATE: 3 /9 DATE: % �J S&Sl EnG1nCCRrnGROBERTA. ROBERT C.COWAN,P.E. SHAFER, P.E. CIVIL ENGINEERS (907)694-2979 !HEALTH April 11, 1997FAX (907) 694-1211 RECEIVED AUTHORITY APPROVALS APR 21 1997 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services Municipality of Anchorage P.O. Box 196650 Dept. Health & Human Services SEWER&WATER Anchorage, AK. 99519 MAIN EXTENSIONS _ REFERENCE: Lot 21 Block 9, Preuss Subdivision #Li SEWER&WATER Request you issue a permit to upgrade the septic system INSPECTION serving the four bedroom house on the referenced property. A test hole was excavated and a percolation test performed. The approximate location of the test hole is located on the ENGINEERING STUDIES attached site plan. AND REPORTS The monitoring tube within the test hole has been checked and found to be dry. WELL INSPECTION &FLOW OWTESTEST We do not anticipate adverse effects on neighboring pe any wells, septic systems or drainage patterns by the installation of the proposed septic system. SITE PLANS If you require additional information, please contact us. Sincerely, ROAD DESIGN l /Z Robert C. Cowan, P.E. RCC /mg SOIL TEST Enclosure PERCOLATION " TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 1 1" = 50' 'SCALE a H co DONALD PLACE -- --- -t. '9gA7p n r m z 2 SITE -PLAN m1p] DESIGN 1 Or t" c�n��o ry opt O d O 1-4 u Ztzj MN O 13 CD 0 Moll x 4 13DRM C cn o Z xm m Or Ming anW D '3 -� Zy0� M KZt1l � 0 EXISTING x 4 13DRM H `O d y d OV M m as D G) H o - p / Wo BARN r (n mp M r � 0 _ 10' UTILITY EASMENT N •-7 __> C 0 Z LJ { r*t n n 00 ou)Z z� - �' `- O r •a� E z m n ox H `O d y d OV M m as D G) H r / 0 0 mp H r � 0 AZN�<Nm �v�imD�r�im •-7 om -P C .Zl < A N H `O d y d OV M m as D G) H r yon n mp g OCyM �..�f.'I cl AZN�<Nm �v�imD�r�im p om -P z .Zl < A N m" LJ { r*t n n 00 ou)Z z� - �' `- O r •a� E z m n �� emilom*CumZ � r oC m o C) `- �C x m y X 0 C/I y >00M~ -in NKOUI 00-01 z mczm t4 MZmx p ZA d� C"a ZN O p�mm �H9 03 m -n-1 alm0— N X bli a� r W'd as 0 m " X c) }per yo�� rti oxo y p p� no O0 n�N ZOti C� LTJ u,ny«' ngc C, ,A=o�Z� C/) PREUSS LANE OUl{mCm ---------- oA o?m =1' m ADf= Z vmi O n a?z tn'pI'"Irn=m r n mp CoT OCyM �..�f.'I cl AZN�<Nm �v�imD�r�im p om -P td .Zl < A N m" LJ { r*t n n 00 ou)Z z� oom nmA �' `- O r •a� E z m n �� emilom*CumZ a l Vl C) mw OZJ 0 O ro O OD N n �C x m y X 0 C/I >00M~ -in NKOUI 00-01 z mczm t4 MZmx p ZA C"a ZN O p�mm �H9 03 m -n-1 alm0— O :E�00 MO r n > OCyM �..�f.'I p < FA py ' m" ,.: co oom nmA �' `- O r •a� d a l 3 Cy °• ,�. Municipality of Anchorage ?� DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TESTl} ROBERT C. COWAN f �e� •. CE - 8801 PERFORMED FOR: L(-oLA_�,� DATE PERFORMED::,'�`;'^',:;{t'\,�;:`� LEGAL DESCRIPTION: Z ��� �{L.F-JSSS1Jownship, Range, Section: ,...lL PTS SLOPE SITE PLAN (FEET) �j �_ ITT-T� 1 I I I I I 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19. 20. ? I SOVME S I L -'r d COMMENTS Toa N WAS GROUND WATER SO ENCOUNTERED? S IF YES, AT WHAT L O DEPTH? P E Depth to Water After Monitoring? � Date: PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT S & S ENGINEERING PERFORMED BY:1M34 Eagle I i / - CERTIFY THAT THIS TEST WAS PERFORMED IN River oop Road No. -204 � / �. o /q 7 ACCORDANCE WITFFAdeY0M'�AAI®9110tS11�' 74L GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) SO PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT S & S ENGINEERING PERFORMED BY:1M34 Eagle I i / - CERTIFY THAT THIS TEST WAS PERFORMED IN River oop Road No. -204 � / �. o /q 7 ACCORDANCE WITFFAdeY0M'�AAI®9110tS11�' 74L GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) MUNIU1PAL1TY OP' ANCHORAGE He' ih and Environmental Prote ion Fourth Floor West I'}'' 825 L Street Anchorage, Alaska 99501 2644720 INSPECTION REPORT ON-SITE SEWAGE DISP(DISAL SYSTEPA -- -- _ _Ls-�G.....�,MAILING - -- - P..-----a��/ - C, - --- -- -- ---- -_ MAILING ADDRESS ®� � NAMEe pVJOL,F�_�-�c��y LOC.ATION`PoPA.ld- _P �_ �_- LEGAL DISCRIPTION c. a%__ SEPTIC TANK: DISTANCE Py`" 1 NUMBER OF FROM WELL_«�� MANUFACTURER.����'i1,ATL,,AL INSIDE LCNGFf-f_ .___ ___ INSIDE V•lIOTF-i-- --_ LIQUID DEPTI _ .. ______ LIQUID CAPACITY !`GALLONS. -TOTAL LENGTH DISTANCE 1`ROM WELL /I>U� _FOUNDATION__/Dc0 -NEAREST LOT LINE _ OF LINE ____J1_)--- -__ # of Lines-__�—Jn//—�__— DISTANCE BETWEEN LINES /�.`jy7!ZFNCH VJ!L'TVI IN. TOTAL EFFECTIVE A13SORPTION AREA _—L.'/VSQ. F -T. LONG -FH Of EACH LINE — � f 2? e'/ DEPTH OF FILTER DEPTH: TOP Of -TILE l -O FINISH GRADE _ �-_ I:?ATERIAI_ BENEATH TILE 7—--M-AROVE TIT ,_yam v IN, SEEPAGE PIT; DIAME-FER OR WIDTH __., LENGTH_, DEPTH Log Crib _Rings-- Crib Size: Dl,\ME.TER-__-_DEPTH_—DISTANCE FROM: WELL TOTAL EFFECTIVE BUILDING FOUNDATION ___ , NEAREST LOT LINE_____ . ABSORPTION AREA (WALL AREA) SCS. FT Well rw Class: Depth Well Distance To: Lot Line _ Bldg: Sewer Line: Pipe Materials: # of Bedrooms- Installer: Remarks: I i I i I I r--1 I I I Dn T E I___- APPROVED - -- 1 Talifirb DrUt 00foxg., by A & L DRILLING COMPANY BOX 97, EAGLE RIVER, ALASKA 99577 • TELEPHONE 694-2588 _ � 1 OWNER OF LAND fy / tJ % " ` d I-�1/_y t �/� ` ` t f t.�, L DEPTH OF WELL r ` ADDRESS i'' i5< .,Y t f.. i STATIC LEVEL OF WATER FT. =' r LEGAL DESCRIPTION � j e�.Q1.=�J i.5 � �1 /,�A DRAW DOWN FT. `> DATE - Started t � / Ended GALS. PER HR PERMIT NUMBER `7�; i ` j KIND OF CASING KIND OF FORMATION: From <) Ft. to i �Ft. From Ft. to / r) Ft. lq)c From % i; Ft. to Ft. 1 L fiCGn From r J Ft. to—L(' Ft. 6,eiYU,64 From j _Ft. to IV%C) Ft. dl—"L 6<>6=!0rre._ From i . ' Ft. to >%W Ft. From_i.>)%i' Ft. to S/ Ft. From l.` - ft Ft. toFt. From I `� J Ft. to C Ft. 001'(' From (,.5 Ft. tor -J,,... Ft. 54,-040 f,1Mojfi. 1 -/?,w/ From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft From Ft. to Ft From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From J � �3 Ft. to Z� 0 Ft. � � � e e �r'�J ( From Ft. to Ft. From .� lo Ft. to Ft From Ft. to Ft. From - r K Ft. to _ ` ` 'L Ft. From Ft. to Ft. From Ft. to'(Ft. AZ4-A x°j<• �� �t� / �� From Ft. to Ft. From Ft. to -1-1 `b_ Ft., 56Z/ eJ From Ft. to Ft. From 'I L� Ft. to U Ft. From, Ft. to Ft From r_i Ft. to _06 Ft. 66�W 6C-A� From Ft. to Ft MISCL. INFORMATION: <:�-,�"��/ `�..%%ter-Z� •),_)f':� L>s" 4'.�4: �=5ilJl�l y , DRILLER'S NAME MUNICIPALITY OF A CSE • lil ji 1� Development Services Department �Q ` r Aub /01� Phone: 907-343-7904 On-Site Water & Wastewater Section ��- � ti Fax: 907-343-7997 Certificate of On-Site Syst- o Parcel I.D. 050-572-58 Expiration Date: 12-1 Z H 1. GENERAL INFORMATION Complete legal description Preuss #4 Block 9 Lot 2 Location (site address) 10225 Donald Place Current property owner(s) Preston & Katherin EakeS Day phone Mailing address 10225 Donald Place, Eagle River, AK 99577 Real estate agent Cody Keim Day phone 907-250-9558 2. TYPE OF DWELLING: E Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Q Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: 0-ti,44.4 /4/9(pe_..- Date: ` 021/g COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ 63:4<5Mtg.52J Waiver Fee $ Date of Payment 6Date of Payment _ Receipt Number DJ�JaQ Receipt Number COSA# 35CAt6(59" 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 1399 W. 34th Ave Suite 203, Anchorage AK 99503 Engineer's Printed Name Benjamin Schiller, P.E. Date 8/31/18 .= pF% ).;f--:#0 . r v*49] \ 6. DSD SIGNATUREVI " � '�t-==ter` System #1 Approved for Lr bedrooms r �. Benjami ,Schiller .. System #2 Approved for bedrooms �� Fcs•, CE 12592 ,® pp �IrF� 8/31/18 . �� Disapproved ���\1NO�d`0-�'� Conditional approval for bedrooms, with the following stipulations: ON-S1TF WATER AND r, WASTbVVA I ER c PRnGRAM r.' :•. _i, Original Certificate Date: q---) 2,_--(4p. 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 Tan]c 1-,1Vlr\/ (Ale) • COSA Checklist blue sheet 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: Preuss #4 Block 9 Lot 2 Parcel ID: 050-572-58 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well Log (Y/N) Y Date completed 8/5/77 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 500 ft. Cased to 346.5 ft. Casing height (above ground) 24 in. FROM WELL LOG AT INSPECTION Date of test 8/5/77 8/21/18 Static water level 340 ft 306 ft. Well production 2 0 g.p.m. 1 .03 g.p.m. WATER SAMPLE RESULTS: Coliform ND colonies/100 mL Nitrate ND mg/L Arsenic Neg ug/L Date of sample: 8/31/18 Collected by: Forge Engineering B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 5/1 4/97 Tank size 1250 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 8/26/18 Pumper Sanitary Pumpers C. ABSORPTION FIELD DATA Date installed 5/14/97 Soil rating (g.p.d./ft2 or ft2/bdrm) 0.8 System type Deep Trench Length 75 ft. Width 2.5 ft. Gravel below pipe 5 ft. Total depth 12.5 ft. Eff. absorption area 750 ft2 Monitoring tube Y Depression over field N Date of adequacy test 8/21/18 Results (Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption field before test 13 in. Water added 712 gal. New depth 10.5* in. Elapsed Time: 1 167 min. Final fluid depth 7 in. Absorption rate >= 600 g p d Any rejuvenation treatment (past 12 mo.) (Y/N & type) None If yes, give date *Flow rate reduced after pre-soak completed (2000 gallons), and fluid dropped during subsequent test. 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 >100' On adjacent lots >100' Absorption field on lot >100' On adjacent lots >100' Public sewer main >75' Public sewer manhole/cleanout >100' Sewer/septic service line >25 Holding tank 100 Animal containment areas >50' Manure/animal excrete storage areas >100' SEPTIC/HOLDING TANK ON LOT TO: Building foundation Property line >5 Absorption field >5 Water main >10Water service line �10 Surface water Wells on adjacent lots 100' ABSORPTION FIELD ON LOT TO: Property line *71 Building foundation >10� Water main >10' Water Service line >10Surface water >100 Driveway, parking/vehicle storage Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS Home vacant for more than 30 days. Tank liquid level is at 50" indicating no leaks. *Existing trench from 1978 includes waiver #WR940010 to lot line G. ENGINEER'S CERTIFICATION 4���NN\\\ oF'�q�il I certify that I have determined through field inspections and P"�`••• ,�1 review of Municipal records that the above systems are in k conformance with MOA COSA guidelines in effect on this date. * TM ,\ •d Engineer's Printed Name Benjamin Schiller, PE �' ••• �� •• • • ' • g 9/11/18 " " " ' � Date r Benja' chiller V."',•. CE 12592 •�`���..• 9/11/18 •.•.•'k PROFESS10Na4.� COSA brown sheet 10-10-12.doc l`,' UNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT r '� 907-343-7904 On-Site Water and Wastewater Section Fax: 343-7997 www.muni.org/onsite �� Septic Tank Advisory Certificate of On-Site Systems Approval # 0SP181457 Subdivision: Preuss #4 Block:9, Lot: 2 The septic tank for this property is 21 years old. The average life for a steel septic tank is 20 years. Typical replacement costs range from $6,000 to $9,000. This advisory must be attached to all copies of the subject Certificate of On-Site Systems Approval. This is an example of what the metal of a 30 year old steel tank MAY look like. xY c - 4** re '.�� t.t Yofhr'ri114.4'iu . 1,3;94t.,,, .'fi 1•'t''',....11.).'"-. r• j c t•' r•.A -. •.1 ( i • • • • ' "a. w t.+, .fix. S 4,1 s# ry r ,..?..-...,:i...,,, ... ''' ,,1. •••,t.' �'•��, ilc Y r o ` t• 2 �y+•'E`'�wX'V r ,��g.tf�tr .84^tT '.'.4.,.),.."1' "tet .Vk+r• ^Z YAN r ,. r vti x. 1 +. x zl . -:,,7 wk -W1',,,, A,g10 - • V. ``K • ,`` 4 • " • 'G - Rc +` ,4 .'" . ' "r's -1' h3 r c.Tf "'6‘,..' .•x ♦ ; 1 .v .-'z .•i:t-* "/ ,r • fry •`C•r- •3' ` z r'f7t"%, P--,ty ? y •- 4, f i ` 8 40 is O ,,}S �n .'l .t '--ai ' tns, ivij t ,:* Zw• X ,''rr1L'%'fi -Yt •_a S c.o.,. ex . i .4.',......,,,•,f, ,t',,, 0. ' N .it • ,4 , 4 w5y"• z • ,,,.:',1',1'.;.•• • t k� " � �. '`r i t r+n ."T: v . ;, , , 1 iv 7s�.. . : ms ,' },it J, ,h .,_.`: �z . ; `'a4ef, .t ._ i-''',. '":" A N ii "t-.---,'444,,:-‹la �`r i w', i °''" -7�.f 'F 7 ..1,•"-r'..2.•:.0.}} 9j't'ow: '.5 t, ,, ' V'', ";xn..._,..„--N..,...%,,<-.l ...rte. € t .] /� 74 , �•�Ft r, �.tt -, Y^i ..MAi 7. .1 EJdyf4 ,V f _1 rfl f li. ,a I ;,�1 .., ? 'fl ,m Ct 3 i •t•, r.. ',l+ • tr' n., 4 \ 'ry+-_,,,C.?. .. f i. s yt• ,•; f.,,,,,,m.•144--te,,,: , ••, ,T.,,!':'•' 4,..:, -,,,s Mx4fs, s- •• .. '-'s'44-'4''';.= .".7t . .:c4 s-4-•,2,,V•it•:/;4,•.L.- z „•7, 7,^'!"hrcclt; ,..+70.7T T�.MT,. ,c,„'-r7 .-177"-i77-'"?'''''' ,-rr r... -n•, •. '•`7 Mailing Address P.0.Box 196650*Anchorage,Alaska 99519-6650*www.muni.org PROPOSED MINED RAM EM(ASSUMED) Par BuILEIX(ASshED)°COINER l 1 MIME dSTAICT / SIDE IMMO SMACK RDA MEMO SMACK 163.33' S89° 59' 00"E • • o t. i11II7 o Co• UJ WELL I0' , O Q s el 8 H cD o 2 z Z • r� EXISTING E LU a a HOUSE ti J Juo ib D • C.O.s I- cD �� .._ c) c,o N o N A V...a 51. 26.0' . m I 25' N 163.33' S89° 59' 00"E 3 UNDER NO CIRCUMSTANCES SHOULD AN AS-BUILT BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE UNES. THE SURVEYOR TAKES RESPONSIBIUTY FOR THE INITIAL TRANSACTION ONLY AND ASSUMES FINANCIAL UABILITY ONLY FOR THE COST OF THE SURVEY. USTED DISTANCES PREVAIL OVER SCAUNG. REPRODUCTION MAY CAUSE ERRORS IN SCALE. ❑ LOT Burst SURVEY TYPE SYMBOLS ❑ rCUNDATON AS-BUILT • SET REBAR W DRAINAGE I.:.`,.'1 ASPHALT ❑ num.STRuctune AS-GILT O FOUND REBAR •A1 CONCRETE 0—o- a •WOOD FENCE l• 0 PLOT PLAN. . .AS-BUILT.. . LOT SURVEY. .. TOPOGRAP'NY 00 ASSUMED ELEV. j(--N—N METAL FENCE PAWL! WOOD DECK .n AS-ECOLT. . .NO CORNERS SET® RECERRACATON AS-WEI'. . NO CORNERS SET PLOT PLANS & LOT SURVEYS NOTE: IT IS THE RESPONSIBIUTY OF THE BUILDER OR OWNER. PRIOR TO ONLY THOSE IMPROVEMENTS ABOVE GROUND AND NSIBLE WILL BE CONSTRUCTION. TO VERIFY PROPOSED BUILDING GRADE RELATIVE SHOWN. FENCES. WELLS. SEPTIC CLEANOUTS. SIDEWALKS. DRIVEWAYS, TO FINISHED GRADE AND UTIUTY CONNECTIONS AND TO DETERMINE ETC.. ARE SHOWN IN THEIR APPROXIMATE LOCATION. ONLY. SNOW THE EXISTENCE OF ANY EASEMENTS. COVENANTS OR RESTRICTIONS MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATED. WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. ALL DISTANCES ARE RECORD UNLESS OTHERWISE NOTED. SURVEY CERTIFICATION Prepared by ..•t OF �(•�� + Robert E. Johns, Jr. & Assoc. Iawrye.wElaalImo MS+e+yy� �r•,�` ""''.••: (1 Professional Land Surveyors PLOT PLAN P,.• ) Or lot d.....•.a eae.ew h......aid Pet I J•. .••4 4. 1700 Brink Drive. h...found or..t.Maw a of IN in gamin ` J + ... "}i . ANCHORAGE, ALASKA 99504 foe....foe. .r to VsebW ly S �— . IY..OI.dE.ona mYaR a a.w b..0 a �, : j�'..` e1"""d(nes end omen, 0 -49th•. ! Scale: 111 30' Rec. Lot S.F. Rec. Plot File No. c `} FOUNDATICH AS-BUILT i•.% I. 'P•r•E wa %.wi.eet yy mel N that I il; ,fit.---3 : Date Surveyed: Drawn by Checked by: A K hand ... .t ow Rat al PW. 05/11/15 " RE IVI Mwrwr..a Nf.ngtbn as t+..-"'K.,' 1f ROBERT E.JOHNS.JR rid: W.O. .M ...,........n air w... >/, p L a/ Date Drown: G rwww ♦. •,, ..4121—S ::• e� 05/12/15 NW056 15-152 FINAL STRUCTURE AS-BUILT ..;pe ••••• '.. o4. r Legal Description: I.Road E.John%twee perionnen do�.-&el e of 'I �� •••............• ca�.a Lot 2 BLOCK 9 *whom on dmonekno no mid and nin end eneeeedlde„*nen horsed'tho ++�'�Pe9sionol��.•ale unload PREUSS #4 I Municipality of Anchorage j' On -Site Water and Wastewater Program (907)343-7904( Certificate of On -Site Systems Approval I Parcel I.D. 050-572-58 Expiration Date: 1. GENERAL INFORMATION Complete legal description Preuss #4; Block 9, Lot 2 Location (site address) 10225 Donald Place, Eagle River AK Current Property owner(s) Kelly Nicolello Day phone 244-3125 Mailing address 10225 Donald Place, Eagle River AK, 99577 - Real Estate Agent Bob Lynn 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY Individual Well Individual Water Storage ❑ Community Class _ Well ❑ Public Water System ❑ Day phone 529-4635 TYPE OF WASTEWATER DISPOSAL: Individual Holding Tank ❑ Community ❑ Public Sewer ❑ WaiverNariance request for: N/A Distance: N/A Received by: COSA to be relea. unless otherwise requested by the engineer. COSA Fee $ 62_<0 �/ Date of Payment hL2%g17 - Receipt Number 09 Ll ( W COSA# oSC %Slag9 Date: Waiver Fee $ Date of Payment Receipt Number 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 Garness Engineering Group, Ltd. (GEG) Phone (907) 337-6179 Address 3701 E. Tudor Road Suite 101, Anchorage AK, 99507-1259 Engineer's Printed Name Jeffrey A. Garness Date S I2�hr In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the systems on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all welts and septic systems depend on a variety of variables including, but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the systems. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the systems; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail. The content of this report is for the sole benefit of the person/party who retained GEG. Reliance upon the information provided in this report by any other person or party, including but not limited to subsequent property purchasers, is not authorized. In short, GEG disavows any legal duty to anyone other than the person/party who paid for this report. 6. DSD SIG ATURE DSD #1 Approved for 3 bedrooms System #2 Approved for Disapproved Conditional approval for In bedrooms bedrooms, with the following Original Certificate tlilitit(1 0 AN�y �= ON-SITE MATER AND �o WASTEWATER oz; PROGRAM The Nffinip6alitf of Ago6rage 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 Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSAbluee eet 8-1-12.dm 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: PREUSS #4; BLOCK 9, LOT 2 Parcel ID: 050-572-58 *DUE TO THE YIELD OF THE WELL, AND LOW STORAGE CAPACITY IN THE CASING. WE A. WELL DATA RECOMMEND THAT A PUMP PROTECTOR AND WATER STORAGE TANKS BE INSTALLED IN THE HOUSE. Well type PRIVATE If A, B, or C provide PWSID# N/A Date completed 8/5/77 Sanitary seal (Y/N) YES Total depth 500 ft. Cased to 346.5 ft. FROM WELL LOG Date of test 8/5/77 Static water level 340 ft. Well production 2 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Arsenic: , ND ug./L. B. SEPTIC/HOLDING TANK DATA Nitrate 0.17 mg./L. Date of sample: 5/13/15 Well Log (Y/N) YES Wires properly protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION 5/11/15 354 ft. *1.2 g.p.m. Collected by: GEG. Ltd. Tank Type/Material SEPTIC/STEEL Date installed 5/20/97 Tank size 1250 gal. Number of Compartments E Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping 11/12/14 Pumper SANITARY PUMPERS INFORMATION ON 1997 TRENCH IS NOTED BELOW. C. ABSORPTION FIELD DATA *BELOW EXISTING GRAD INFORMATION ON 1978 TRENCH IS ON FILE WITH THE MOA. Date installed 5/20/97 Soil rating (g.p.d./ftlor /bdrm 0_8 System type TRENCH Length 75 ft. Width 2.5 ft. Gravel below pipe 5 ft. Total depth *12.08ft. Eff. absorption area 750 ft2 Monitoring tube YES Depression over field NO * Date of adequacy test 5/11/15 Results (Pass/Fail) **PASS For E bedrooms Fluid depth in absorption field before test 25 in. Water added 1070 gal. New depth 45 in. Elapsed Time: 120 min. Final fluid depth 25 in. Absorption rate >=- 450+ g.p,d, Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date — **TESTED THE 1997 TRENCH. SUMP IN 1978 TRENCH EXTENDS 11.5 FEET BELOW GRADE AND WAS DRY ON THE DAY OF OUR TEST. D. LIFT STATION Date Installed Size in gallons "Pump on" level at in. "Pump oir E. SEPARATION DISTANCES Manhole/Access water alarm level at Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tanknift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main 75'+ Public sewer manhole/cleanout 100'+ Sewer /septic service line 25'+ Holding tank 75'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Properly line *7' Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, paddng/vehicie storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS *FROM 1978 TRENCH TO LOT LINE #WR940010 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 data. Engineers Printed Name JEFFREY A. GARNESS Date ,5%25.& (Rev. 11/05) RttPY3D Marto rtOa1 1 1 { i RNaasr euax¢ caarx I OAv. (ASAILo) I :nuN asnazT � i .' � �Nr exDNa ra oe xe IIUDMT sTeea: 163.33' S890 59'00"E o NISJ o 0 Q ' EO W 0 WELL 26.0' 2,61V O 0 O s12 J Z a a s LIJz W EXISTING y: HOUSE I J 1 O z O I `_ O O o .... ..,.... n. O CV n. I N I r - 51. 26.0' 251 163.33' S890 59'00"E 3 � � UNDER NC CIRCUMSTANCES ^l. 0 'AN, AS_B r T BE LSEO FOR CONS�UCTOON f R FOR ESTABLISHING BOUNDARY OR FENCE UNES. THE SURVEYOR TAKES RESPONSIRIIJ TY FOR ME INITIAL TRANSACTION ONLY AND ASSUMES FINANCIAL LIABILITY ONLY FOR THE COST OF ME SURVEY. LISTED DISTANCES PREVAIL OVER SCAUNG. REPRODUCTION MAY CAUSE ERRORS IN SCALE. LOT sXtl4r SURVEY TYPE '_:N iI(M A' wLT SYMBOLS SET REBAR DRAINAGE ASPHALT ❑ RNAL 8IRUCIURE A5-BUCT o FOUND REBAR - - - .WOOD FENCE CONCRETE 0 PLOT PIAN ... As-91p.T .. LOi suRVEr ... TOPOGRAPNv DOff ASSUMED ELEV. .X ---X X METAL FENCE ® WOOD DECK Fj T.., NO SETEM11POA71011 AS-11ULT .. NO CORNIms SET PLOT PLANS & LOT SURVEYS NOTE: ITIS THE RESPONSIBIUTY OF THE BUILDER OR OWNER. PRIOR TO ONLY THOSE IMPROVEMENTS ABOVE GROUND AND VISIBLE WILL BE CONSTRUCTION, TO VERIFY PROPOSED BUILDING GRADE RELATIVE SHOWN. FENCES: WELLS. SEPTIC CLEANOUTS, SIDEWALKS, DRIVEWAYS, TO FINISHED GRADE AND UTILITY CONNECTIONS AND TO DETERMINE ETC., ARE SHOWN IN THEIR APPROXIMATE LOCATION, ONLY. SNOW THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATED, WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. ALL DISTANCES ARE RECORD UNLESS 07HERWNSE NOTED. SURVEY CERTIFICATION+'+rgilllfA' CF a�+� Prepared by A Robert E. Johns, Jr. & »ssoc. PLOT PUVR °" 1rtMY MNY NR 1 LW MYIdY we'eY� e.. NI we.. ..a e.mier •..®, ad ua1 ��.•�� �j� Professional Land Surveyors 1700 Blink Drive. e..N ama s .wmxx.e a s a.. u m,raJ 5, ANCHORAGE, ALASKA 44303 wrwwy-a.s_ e.. a amnNsr nma ew „w•a a.. ati smxc - - L / 49tIT --. ♦S $COIe: 111 _ 301 _ 3 Sec. Lo! S.F. Ric. PIaL elle N9 - FOUNDATION AS -BUILT.. pmNaenreswYwr, rwfY t.rm ' .tF Date Surteyed: 05/11/15 DawbyPCJ Checked bJy( baxdn•. a=wawrrw ..................................................` °°••••°° ...., , ' Oota Drawn: Grid: ���05fWA.0511115 15-152 stlw eAmtrswrm5wYnnlowsae� rnrNNr,eewro •nmn nwx:+.a..m ', T♦ROBERLE.JQHNS.FR. ' s FINAL STRUCTURE AS-BUILTsl -, •., s i41 L 1— J . ,°•' i ; Legal Description: i t Ae.wt F. +N.ra r.. Mims aalr owl a„ .. yp ♦ �t eap •°•,••••••• ` �� r+ls Lot L BLOCK 9 VA o>`� PREUSS #4 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate forthe 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 —Dayid R. Dayton P r, Phone Address 20210 Donalar St. ugia I, Engineer's signature 4 Date Z 6. DHHS SIGNATURE Approved for �� bedrooms. Disapproved. Con 'nal approval for -L 1C 4n, SLA /..r✓, 4,1 13.E /A, / /Cl-/. By: .or OF A 4 2t r F A DOYid R. Dayton, J ���r bedrooms, with the following stipulations: u // 691— 7 11ITIC 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. IM) Back MOA #21 Municipality of Anchorage Department of Health and Human Services 44 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LOT- 2- a A2&'!;5 56Parcel I.D. A. Well Data Well type PIZ' cA��, If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Y Date completed 8077 Driller A � L Dx[,1Jn1 .7 Total depth Cased to 3E �� t - Casing height Sanitary seal (Y/N) 1/ Wires properly protected (Y/N) c FROM WELL LOG AT INSPECTION o Z Date of test ��ry7 AM ?Z /A/Aw r" v W Static water level 367 3� / � CD a � o Well flow `Z ! g.p.m. /, z_ g.p.m. � < v n � Pump levell m N G) SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot r0o ; On adjacent lots l o� Absorption field on lot Ito ; On adjacent lots /Fro ^1 Public sewer main/Cf Public sewer manhole/clean119 jjout Sewer service line 2- -4-- Petroleum tank AE„z7- /1�6 a,U J ' WATER SAMPLE RESULTS: 0 yg � � Coliform NitrateOther bacteria Date of sample: — V20315W Collected by: D4_>_� B. SEPTIC/HOLDING TANK DATA Date installed Tank size I L S 0 Compartments Cleanouts (Y/N) Foundation cleanout (Y/N) Depression (Y/N) High water alarm (Y/N) AI/A Alarm tested (Y/N) Date of pumping /O fi//--I 3 Pumper Oaw H -u -- SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot 1 &0 On adjacent lots /06) Foundation To property line /0 y' Absorption field /01 Water main/service linep Surface water/drainage 72-026(3/93)=Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed _ /V1 1A Manufacturer Size in gallons Manhole/Access (Y/N) Vent (Y/N) "Pump on" level at "Pump off" Level at High water alarm level Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot_ On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed //181 Soil rating (GPD/Ft2) 1/Z9 ��� System type P7-eP Length "a Width 3 Gravel thickness 71 Total depth Total absorption area 490 0 Cleanout present (Y/N) YI Depression over field (Y/N) A✓ Date of adequacy test Results (pass/fail) l% for —Bedrooms Water level in absorption field before test I�a.e�4_ &,de After test A Z - Peroxide treatment (past 12 months) (Y/N) /✓ If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation On adjacent lots > C� • -- On adjacent lots IGJ Property line 7 (PA,0�t- Y6 io °'P"r) To existing or abandoned system on lot All, Cutbank Water main/service line 4 -J -O` Surface water ) 0-c-4- Driveway, parking/vehicle storage area Curtain drain lk,/a"'F g),,)°) E. ENGINEER'S CERTIFICATION L 3 t I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection HAA Fee $ � ( C7 , (f0 Date of Payment o) - Receipt Number 4 72-026 (3193)' Back Waiver Fee $ Date of Payment n) Receipt Number aL".� ,wKry"6�.`4i�P V d v w David R. Dayton P.E. 20210 Donalar St. Signature Chugiak. Alaska 99567 Py�� C Engineer's Name / 2�� bau u a a. a°°.. a a.. e°o s eoo e �>� n�; Dn;ton / /,%G'n De•rd R. Date / y e NO. 2i?0.'i-E � •�� va u° , ggT t3. 1" Glen HAA Fee $ � ( C7 , (f0 Date of Payment o) - Receipt Number 4 72-026 (3193)' Back Waiver Fee $ Date of Payment n) Receipt Number aL".� Municipality of Anchorage K Department of Health and Human Services Tom Fink, 825 "L" Street Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 March 14, 1994 David R. Dayton, P.E. 20210 Donalar Chugiak, Alaska 99567 Subject: Waiver Request for Lot 2 Block 9 Preuss Subdivision #4 Waiver Request #WR940010, PID #050-472-58, HA940057 Dear Mr. Dayton: Your request for waiver of the required 10 foot separation between a septic system and a lot line has been approved. The waived distance is the leachfield to the property line of 7 feet. This approval applies to the existing septic system lot line separation only. Any future upgrade to the septic system will require all separations be met or another approval from this department. Sinc ely, Robert W. �Roobinson Civil Engineer On-site Services RWR/ljm#7 �..,„ MUNICIPALITY OF ANCHORAV�✓ Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR# WR940010 PID# 050-472-58 HA# HA940057 Permit # Date Received: March 11, 1994 Legal Description: Lot 2 Block 9 Preuss Subdivision #4 Engineer: David R Dayton, P.E. 20210 Donalar, Chugiak, Alaska 99567 Applicant: Doug & Marcia Stone Waiver Requested: Lot line waiver of leachfield to property line of 7 feet. Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Waiver is Granted: List Conditions or \ Waiver is NOT Granted: asons for above: Rec #: Amount: $ Date Paid: -c -LA •A • giak, Alaska 99567 (907) 20210 Donalar 696-2417 March 11, 1994 Mr. Robert Robinson Municipality of Anchorage Dept of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Re: Lot 21 Blk 9, Preuss Subdivision 10225 Donald Place Dear Mr. Robinson, MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION a i 1994 RECEIVED In the process of obtaining a Health Authority Approval for the subject lot, it has been found that the end of the septic system trench is 7 ft. from the property line instead of the required 10 ft. As the system meets all other regulations we request you issue a.waiver of the 10 ft. lot line setback for this system. If there are any questions or concerns please contact me at 696-2417. Sin rely David R. Dayton D. R. DAYTON, P.E., R.L.S. Chugiak, Alaska 99567 20210 Donalar 1907) 696-2417 February 1, 1994 WELL & SEPTIC SYSTEM ADEQUACY TEST Legal Description: Lot 2 Blk 9, Preuss Subdivision Date of test: January 31, 1994 Well: Well depth: 500' Casing depth: 346'5" Static water level: 351' MOA Requirements: 3 BR -450 gpd - 0.301gpm Test: The well was tested by pumping the 11 water level to near the pump level and adjusting the flow tomatch the volume entering the well.Testing was continued for 4 hrs. Results: The well produced 1.2 gallons per minute. Septic system: Tank: 1250 gallon steel tank Absorption system: 35' x 7' x 3' trench MOA Requirements: 3 BR 450 gallons per:day Test: The system was tested by pumping water into the trench while monitoring the volume, time and water level:rise. After pumping was stopped, the water level drop was measured at timed intervals. Results: The septic system trench is currently functioning adequately for a 3 BR home.' Note: The trench has water standing to a level 1.2 ft.,below the the leach pipe.. This may indicate the trench is in its waning years. ,�� c�i ' e••a°•p � t� ,? :9 i ••sac sr. ;; '�` David H. p4• r ii3r �-/' MUNICIPALITY OF ANCHORAGE �J Si 7 % DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION © 0 DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVALISS� OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date 0d- 2 � MR 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) T,OT 2. RT,OCK 9: PREUSS SUBDIVISION ,T14N R1W, SECTION 8 Location (address or directions) 1 10225 DONALD PLACE, EAME RTVFR AK (b) Applicant Name MARK SPARROW Telephone: Home NA Business 694-4200 Applicant Address [--()- mm ((so4y, rHki r n i v n, Mn = )( ( (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder ❑ ; Buyer ❑ ; Other K (explain); REALTOR (d) Lending Institution AK 14011STN(' FTNANCF CORP- Telephone 276-559.9 Address Pn R0X 1n720, ANCHORArF, AK 99.510 (e) Real Estate,Company and Agent REMAX OF EAGLE RIVER ATTN: MARK SPARROW Address P.O. BOX 772849 EAGLE RIVER, AK 99577 Telephone 694-4200 (f) _ Mail the HAA to the following address: HOTD FOR PICKUP BY E R E S 2. .TYPE OF RESIDENCE Single -Family), Multi -Family ❑ Other Number of Bedrooms 3' 3. WATER SUPPLY . Individual Well FLK Community ❑ Public ❑ 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 OnsiteXX Public ❑ 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 72-025(11/84( 5. ENGINEERING FIRM PROVIDING.SPECTIONS; TESTS, FILE SEARCH, DA111.lND 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 regulations in effect on the date of this inspection. Name of Firm FA > ,F RDMR ENTNEERTN , SVC. Telephone 694-5195 Address P.O. BOX 773294, EAGLE RIVER, AK 99577 Date &' 7 eei S, ea /�OOOq Op0a9• ap eGoosc., JO- OOq �i Louis A. Eulara 8 �< J°a CE -6736 Q�,�� ROFESSIONP®��� 6. DHEP APPROVAL Approved for fh' C3 edrooms by ''��� �` '�' �'-� Date Io — -57 Approved L--� Disapproved Conditional Terms of Conditional Approval The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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. Page 2 of 2 72-425 (11/84) A. MUNICIPALITY OF ANCHORAGE (MOA) Gk HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 CZ O' 264-4720 O� �, J�✓' Legal Description L21 E)q Preuss U Mvj.sjcin Ql��`��Pti 01 TI'tN R 1 W Se -C+ Idyl C9 WF,U [ ITA.;`, �� '` Well Classificatin�' .'r/ d� If A, B, C, D.E.C. Approved (Y/N) Well Log PresentY/N) Date Completed Yield Total Depth Cased to 3 y� Depth of Grouting Static Water Level 3 2 ���i o ` Pump Set At y %� Casing Height Above Ground — Electrical Wiring in Conduit (Y/N) Separation Distances from Well: Sanitary Seal on Casing (Y/N) — Depression Around Wellhead (Y/N) To Septic/Holding Tank on Lot foo " ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot 1/11 r —;On Adjoining Lots — r A/ To Nearest Public Sewer Line N14 To Nearest Public Sewer Cleanout/Manhole "A To Nearest Sewer Service Line on Lot Water Sample Collected by %„i5 "✓ear ; Date /z f/S-7 Water Sample Test Results Gam-' ' ' O "2'J'''' ri/.6-7 Comments B. SEPTIC/HOLDING TANK DATA Date Installed / 9 71� Size No. of Compartments Standpipes (Y/N) Air -tight Caps (Y/N) 2" Foundation Cleanout (Y/N) Depression over Tank (Y/N) Al Date Last Pumped f%7 `.c 13%'r �M s V Pumping/Maintenance Contract on File (Y/N) ;for Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply Well Uo r To Property Line tea r To Water Main/Service Line Course NA_ Comments Page 1 of 2 72-026(11184) To Building Foundation To Disposal Field /y r ao i To Stream, Pond, Lake, or Major Drainage C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field 3 I/d 4612 Type of System Design v TreNo� Length of Field 3, `^ •Nsn. re�.w� Depth of Field Gravel Bed Thickness 71 Square Feet of Absorption Area %/�U Standpipes Present (Y/N) % Depression over Field (Y/N1 v Date of Last Adea T t � f 343 i5�7 Results of Last Adequacy Test 77 r17'i•.c/2rr Separation Distance from Absorption Field: To Water -Supply Well // U To Building Foundation Lot ^f1� To Water Main/Service Line -,1-/0 To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) — Comments 11 cy es G.bjo r.�77 CJN /-� SSW S"' 7E'. LC �Pea_Je i/ To Property Line To Existing or Abandoned System on On Adjoining Lots f 30 To Cutbank (if present) Dimensions Manhole/Access (Y/N) "Pump Off" Level at ** Check Permitted Bedroom Rating Against HAA Request ** Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed �-'' ���— Date Companyr�r7= S' MOA No. Sr ' a26S Receipt No. Date of Payment oy� Amount: $ iG U Page 2 of 2 72-026 (11/84) Engineer's Seal r_ c, EAGLE RIVER ENGINEERING'59RVICES Lou Butera, P.E. 4 P.O. Bax 773294 Eagle River, Alaska 99577 4* Telephone (907) 694.5195 October 2, 1987 Mr. Steve Morris Civil Engineer, On-site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 REF: Lot 2, Block 9 Dear Mr. Morris: Preuss Subdivision In the process of completing the Health Authority Approval for the above referenced lot, I could not find a soil log in the records. This would mean that either the soil log was lost from the records or never performed. As there is a specified soil rate, I would assume some type of soil investigation was performed. The total depth of the leachfield was measured thru the monitor tube as 1115" below ground surface. A search of soil log records for adjacent lots shows several soil logs to a depth of 13'-16' with no indicated water table on any soil log. With this evidence, we are requesting a Municipal determination as to the necessity of another test hole on this property. If a test hole is required, please inform us immediately so that it may be excavated as soon as possible. If there at 694-5195. Sincerely, are any concerns or questions, feel free to contact me Louis Butera, P.E. LAB:bls )p /3� �seS94al�tfi'o.� or gf�,,� ora G2�� Aftew.f .Pis•"�.. nr Z�s+t' 4"".Q L✓ Ua-�%'e.- h -07C �O' e...-.e�G i n n e.A. 46 10.1S. C'i vim... 4AI'S r'n �.� rKa�7'o..� &1;C— wi / s /✓j !o -s - 0. - Sir APPLIC NT FILLS OUT UPPER HAL ;ONLY Property Owner �l� 9-�7.,�-rp--�j{ ��•�ic�r3'7��s`'"t: - Phone Mailing Address ip Code- Buyer �/ �" Address / — Zip Code Lending Institution �j Phone Address - Zip Code Realty Co. & Agent Phone - Address - ! Zip Code Inspector pica Legal Description Street Location Type of Residence Single Family O Multiple Family No. of Bedrooms_— ❑ Other Water Supply h�`llndividual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. ❑ Community - For wells drilled prior to that date, give well depth (attach log if available). ❑ Public Utility Sewer Disposal Windividual Year Individual Installed: O Public Utility When Connected to Public Utility: ❑ Holding Tank - NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date iron Inspector Inspector - Inspector Inspector pica Field Notes: f `, r �, „�„ MUNICIPALITY OF ANCHORAG DFpT C° Ir, X ENVIRJ lt,'.:t .. A.. .. :.TION RECEIVED ( '-) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL - i / S•- r 3 DATE B Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Septic Tank Size ' -- Well to Tank 72023 (3182) ` MUNICIPALITY OF ANCHORAGE n i t±t DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 r STREET LOCATION NHN David Ave. _ /C�•- d- ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 ` ❑ One ❑ Four ❑ Other REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER PHONE Terry A. Treutel 694-9081 MAILING ADDRESS * ATTACH WELL LOG. A well log is required for all wells drilled 5704 David Ave. Eagle River, Ak. 99577 since June 1975. For wells drilled prior to that date, give well PROPERTY RESIDENT (If different from above) - PHONE 2. BUYER - - -- -- - - - - - PHONE Gerald C. Sechrist 243-4456 MAILING ADDRESS If system is over two (2) years old an adequacy test is required 8503 Jade St. Anchorage, Alaska 99502 by this Department. 3. LENDING INSTITUTION PHONE The Lomas & Nettleton Co. 274-7661 MAILING ADDRESS 4449 Business Park Blvd. Anchorage, Ak. 99503 4. REALTOR/AGENT PHONE None MAILING ADDRESS 5. LEGAL DESCRIPTION 2 Preuss s d STREET LOCATION NHN David Ave. _ /C�•- d- 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS �5,�- /'G`5 ❑ One ❑ Four ❑ Other SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILY Ck# Three ❑ Six 7. WATER SUPPLY ® INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTI LITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM Q INDIVIDUAL/ON-SITE** **If individual/on-site, give installation date If system is over two (2) years old an adequacy test is required ❑ PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCO EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONLY INSPECTION APPOINTMENTS DATE RECEIVED TIME TIME TIME - DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS - ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑Septi Tj��nk or ❑ Holding Tank Size: L_)C), I If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS n ❑ APPROVED FOR BEDROOMS .❑ CONDITIONAL APPROVAL (letter must accompany certificate) LW DISAPPROVED DATE 6Y (Title) LEGAL DESCRIPTION 72-010 (Rev. 3/78) 1xtILa,5- MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION SUBDIVISION 825 L Street - Anchorage, Alaska 99501 0 ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 NUMBER OF BEDROOMS REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTYOWNER ❑ Two ❑ Five PHONE SELLENS, Paul A. and Phyllis G. 7. WATER SUPPLY 808-325-7103 MAILING ADDRESS * ATTACH WELL LOG. A well log is required for all wells drilled P.O. Box 413, Kailua Kona, Hawaii 96740 since June 1975. For wells drilled prior to that date, give well PROPERTY RESIDENT (If different from above) depth (attach log if available.) PHONE NHN Donald Street, Anchorage, Alaska ® INDIVIDUAL/ON-SITE** **If individual/on-site, give installation date 1978 2. BUYER If system is over two (2) years old an adequacy test is required PHONE SAPS AS ABOVE NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. MAILING ADDRESS 3. LENDING INSTITUTION PHONE Alaska Bank of Commerce 279-5641 ext 34 MAILING ADDRESS 3230 "C" Street, Anchorage, Alaska 99501 4. REALTOR/AGENT PHONE MAI LI NG ADDR ESS 5. LEGAL DESCRIPTION Lot 2, Block 9, PRUESS SUBDIVISION STREET LOCATION NEIN Donald Street 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS ❑ One ❑ Four ❑ Other IN SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILY ® Three ❑ Six 7. WATER SUPPLY [XI INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM ® INDIVIDUAL/ON-SITE** **If individual/on-site, give installation date 1978 If system is over two (2) years old an adequacy test is required ❑ PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) c� a �`, THIS SIDE_ FOR OFFICIAL USE ONLY INSPECTION APPOINTMENTS DATE RECEIVED - - TIME TIME TIME DATE DATE DALE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED - 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON-SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATEINSTALLED INSTALLER eptic Tank or ❑ Holding Tank Size:, So If -Tank is homemade give dimensions: SOILS RATING to TYPE OF -TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS Ezr APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY (Title) ,---� t� LEGAiDE RIPTION - -- 72-010 (Rev. 3/78) or-,