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HomeMy WebLinkAboutPROSPECT HEIGHTS #4 BLK 2 LT 6 Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP201214 PID Number: 015-132-40 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name GREGORY & LYUBOV BRUNA ABSORPTION FIELD - EXISTING ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 10100 HILLHAVEN CIRCLE, ANCHORAGE ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot Fill added above original grade Ft. Gravel length Ft. PROSPECT HEIGHTS #4 2 6 Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Ft' Ft. Well 100'+ -- 25'+ TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer GREER Capacity 1250 Gal. Surface Water 100'+ -- Material HDPE Number of compartments 2 Lot Line 10'+ -- NA Foundation 101+ __ LIFT STATION Manufacturer Capacity Gal. Remarks Alarm location Electrical installed by PIPE MATERIAL House to tank 3034 drainfield Tank to 3034 Installer PCN Drainfield CO/MT 3034 Inspector FWCS BENCH MARK (Assumed elevation) 100 ft Inspection V1 7/30/20 ed 7/31/2020 Location and description dates:Z 3`d 4'° TOP OF SONO TUBE ON-SITE WATER AND WASTEWATER SECTION APPROVAL l`��, QF tl Conditional Approval: Date ���Q��••'• •�,f-,t� " " " " " " " 1 r� .. Curtis Huffman •`�� Septic System Appro - Date 2 �'F'• CE 128991 Aiw slF,p• • .g/4/2D29 •'�c��r ll,FSSIO�A4..: � PROFE Note: this approval does not include well permit requirements. 1SS\0 (Nev Ub/UZ/18) PERMIT: OSP201214 0 n A—C=18.9' B—C=35,8' A—D=22,8' B—D=39,0' 0 EXISTING FIELD 0 D C STAKED 100' CREEK DCO SETBACK PRIOR TO CONSTRUCTION CO MH DECOMMISSIONED EXISTING S.T. & INSTALLED NEW 1250—GAL HDPE SEPTIC TANK WITH DCOs. Centerline DCO, ^^^ PID: 015-132-40 STAKED WELL RADIUS PRIOR TO CONSTRUCTION l V30 --j SCALEi 1�< SEPTIC SECTION SCALEt NTS PROSPECT HEIGHTS #4 BLOCK 2, LOT 6 SUPPORTS SERVICES: PREPARED FOR: OF`Q� GREG & LYUBOV BRUNA 10100 HILLHAVEN CIR. 9 TH ANCHORAGE, AK 99507 FIRST WATER CONSULTING DATE: 8/5/2020, rtes Huffman 13030 SUES WAY SURVEY: WALATKA �, CE 128991 DRAWN: FWCS `c�;� 8/5/2020 ANCHORAGE, AK 99516 SCALE: 1" = 30'seor sto�Ay 907-350-9566 firstwaterAK©gmail.com 7/10/2020 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 015-132-40 Property owner(s) GREGORY & LYUBOV BRUNA Day phone 9072807552 Mailing address 10100 HILLHAVEN CIRCLE, ANCHORAGE, AK 99507 Site address 10100 HILLHAVEN CIRCLE, ANCHORAGE, AK 99507 Legal description (Sub'd., Block & Lot) PROSPECT HEIGHTS #4 132, L6 Legal description (Township, Range & Section) Lot Size 101,215 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) (w/wo ADU) Septic Tank X❑ Upgrade FX_1 Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 168. 7� Waiver Fees: Date of Payment: 36 .20 0 Date of Payment: Receipt Number: 8_�03.3 Z Receipt Number: Permit No. OS Ip2D I Z 1 y Waiver No. G:\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350 -9566 / firstwaterAK@gmail.com June 30, 2020 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC TANK UPGRADE PERMIT LEGAL: PROSPECT HEIGHTS #4 BLOCK 2, LOT 6 The owner has requested that we obtain a septic permit to upgrade the existing aged steel septic tank on the above referenced lot. We propose to install a 1250-gallon HDPE tank per the attached design to serve the existing 4-bedroom residence. The lot and area are served by private wells. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201214, Deb Wockenfuss, 07/09/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201214, Deb Wockenfuss, 07/09/20 ..... · MUNICIPALITY OF ANCHORAGE DE RTMENT QF HEALTH AND HUMAN SER ES ~) / ~" / '~ Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON=SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name · ~/,,.,.,¢.¢~..~¢.~ ~,.:,~¢ ~~/~-~> DISTANCES - ~ SEPTIC ABSORPTION Address . ~ ~/ TANK FIELD WELL Phone{s) ] Permit No. No. ~B~d ...... WELL //~ i /~ ~ ~EO*~ ~SC.,,T.O. LOT LINE ~ ~, Township, Rangel Seclion /~ ' ~0 AS-BUILT DIAGRA~ (Show Iocahon of well, septic syslem, property hnes, founOahon, Manulact .... Capac'W'ngaO°ns ~ ~ I Material No. of Compa~ments j / , TYPE OF SYSTEM~ ~ ~ Depth to pipe bottom from Total depth from odg,nal grade ~ or,ginal grade ~ ¢¢ FT ~ ~ ~ FT ~ Fdl added above original grade Gravel depth beneath pipe ~ Gravel lenglh Gravel width ~ ~¢ ~*¢ ~ ~ Number of ,,.es J Sod rat,no Pipe mate(iai WELLS 2~ ',,~ _ ~ ~ PRIVATE ~ OTHER,Identify) ~"~-- -- Class,hcahon(A.B.C) TotalDe,th F, Cased,o ~ ~ Scale: Inspections Pedormed by:.: " ~.:¢ ~.~;;' I ~¢ ~ ~2~//~&//t/~ ~flily t~ Ihi~ inspec~on was peflormed according to ~1i ' ' ~ ~ .~ Robert D ScH ng Health Depadment Approval: V Date: ~ % Ei'~,:~;2..~:~.~* PA CE ,-R~'RViCE~ P.O. Box 112207 Anchorage, Alaska 99511 October 15~ 1987 MUNICIPALIIY OF ANC:H~ DEPT. OF HEALTH & . ENVIRONMENTAL PROTECTION SUBJECT: RECEIVED On'si te Septic Health Autt/or i ty Approval ~ Prospect Fteights #4 Lot 6 Block 2 T12N R3W Section 13 SM Municipality of Anchorage Depar tmest of Health and Human Services Environmental Health Division 825 L Street Anchorage~ Alaska 99502 Dear Sir: Attached you will find revised documentations not submitted) corrected or clarified n the first submittal of October 45 1987: ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Questions as to rather this s Addition number 4 or not It is Prospect Heights Add t ion #4. Please see attached portion of official plat attached. Attachment Al Questions as to why change from or9 n al design. On about June 1~ 1987 I presented t. his design change to Dan Sol les. Discussing rather we cou d cut back on size, he said everything meets atandard~ with new design, and just to show it in the asbui It. This change was reducing the size of the field from 24 X 50 to 22 X 44 which st i I I gives required square feet per bedroom. ©r inginal ly owner wanted overbuild septic for possible future expansion. However cost starting to rise he decided to go with minimum and expand later if necessary. A 1500 gallon Tank was installed. the separation between I insg is 3.8' and not 5.8. 5.8 feet ia a transposed number please see Attachment Items not entered have been entered. If I can be of further assistance or provide you with more please contact me. Sincerely information R o'~ e r D/Goodman ;::?. 'r ~.~ :i, i ............... MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG- PERCOLATION TEST [] SOILS LOG [] PERCOLATION TEST 8 9 10 11 12 13 14 :15 16 17- 18- 19 2O SLOPE SITE PLAN If YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop MUNICIP~ LITY OF ANCHO ~AGE ENVIRONMEI ,ffAL SERVICES E IVISION MA t 1 1987 RE 2EIVE[) PERCOLATION RATE (minutes/inch) TEST RU/[~ BETWEEN FT AND FT z 72-008 4 LATERAL LINE- SHALLOW BED-MOUNDED-SPETIC SYSTEM 2% Mound with Native Material inimum of 4' from top of ~-to top of mound Original~ 6"****~ End of Test Hole iBedro k) · Lot 6 BJock 2 Prospect Heights Subdivision Add tion ~4 Form 1-65BI-lA SEPTIC DETAIL ."A" r ock.~ Fi I I 1/2" - I 1/2" Clean Gravel /2',', Above and 6" Below 4 Per forat,ed)Pipe.~ L I ! ~'~ -" Undisturbed Earth Rated at " 150 Square Feet Per Bedroom Fabr i c MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION MAY 1 1987 RECEIVED 4 LATERAL LINE-SHALLOW BED- SEPTIC SYSTEM From Septic Tank 6' Free Standing View Port 3 Clean--out 6' ~/Typ i ca I 5O Number of Bedrooms 4 .. SHORT FORMULAS X Soil Rating X 1.5 X 150 SQ FT X 1.5 MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION NAY 1 ]987 RECEIVED Total Area Required 900 SQ FT Required Length = Width = Total Area Width Length Total Area 900 SQ FT 24' ' 50.0' Designeor' ' Lot 6 Block 2 Prospect Heights Subdivision Addition #4 - Form 1-65B-2 Septic Detail "B" tL 5 S "~EEK MAINTENANCE E rc, er ON HUB 8, TACK (HT) SPIKE or PK ~) FOUND FENCE GLOBAL ENTE PO BOX 112207 ANCHORAGE, ALASKA (907) :549- 5552 MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION UAY 1 1987 FOUND ""S~T IRON PIPE {IP) [OFOUND OSEI BRASS CAP ~OUND ~ _DRAINAGE ~ PAVING--~ ~ ELEVATION · (x- ~)~ ~ ........... A S M D. F)RISF_S DATE SCALE LEGAL DESCRIPTION SURVEY - :TYPE~: GRID ZONING SUBDIVISION '9518 2441 PROSPECT NEIGH'IS NO 4 DRAWN BY CHECK BY R D RS PROdECT .NUMBER/NAME ]'HEREBY CERTIFY THAT THE PROPERTY DESCRIBED HEREON HAS ]~EEN SURVEYED.By HE,,* OR AT HY DIRECTION,, AND'THAT THE ]HPROVEHENTS SITUATED THEREON ARE NITHIN THE PROPERTY LINES AND DO NOT OVER- LAP OR ENCROACH' ON THE PROPERTY LYING ADJACENT THERETO UNLESS OTHERNISE SHOHN, THAT NO IHPROVF..HENTS ON THE PROPERTY LYING ADJACENT THERETO ENCROACH ON THE PREMISES IN GUESTION AND THAT THERE ARE- NO ROADWAYS TRANSHISSION LINES OR OTHER EASEHENTS ON' ...- ~AID PROPERTY EXCEPT AS SHONN, ~ IT IS THE RESPONSIBILITY OF THE ONNER OR BUILDER,, PRIOR TO CONSTRUCTION/ TO VERIFY PROPOSED tUILDING GRADE RELATIVE TO FINISH GRAD AND UTILITY CONNECTIONS AND TO DETERHINE THE EXlS- · TEN~:E OF ANY EASEHENTS', COVENANTS/ OR RESTRICTIONS WHICH DO NOT PPEAR ON THE RECORDED 6I,,fBDi~I'SION PLAT, · ' ISTED DISTANCES PREVAIL OVER SCALING; "REPRODUCTION HAY CAUSE D I STORT I ON. · P O Box 112207 Anchorage; Alaska 99518 (907) 349-5552 May 17~ 1987 SUBJECT: Prospect Heights #4 Lot 6 Block 2 Septic System Project ll-6ES Reserve Area Computation Municipality of Anchorage DEHP 925 L Street Anchorage; Alaska ATTN: Dan Boyles Dear Mr Boyles: As per our telephone conversation in reference to the SUBJECT Project~ I am providing you with the following: You will find attached a computer printout of topo done on the Subject property, The area defined as reserve area seems to meet the MOA requirements. If there should be further questions please contact me at (907) 349-5552 at anytime. Sincer~ely General Manager pROS~EC~HEIGHTS LOT 6 BLOCK 2 RESERVE AREA COMPUTATIONS SEPTIC SYSTEM COORDINATES IN FEET SCALE 1"= 50 i: 600 ROTATION 60 AT POINT 5 RIGHT .5 DOWN 1.2 POINT t7 18 26 28 OFF SCALE 4 .21 29 3 ~9 +7o \ \ \ \ 774 772 -84 80 -82 +83 +73 PROphECY REIGHTS LOT 6 BLOCK 2 RESERVE AREA COMPUTATIONS SEPTIC SYSTEM AND WELL SETBACK FROM RESERVE AREA POINT 90 IS WELL 101.42 FROM NEAREST PO COORDINATES IN FEET SCALE 1"= 50 1~ 600 ROTATION 60 AT POINT RIGHT DOWN 1.2 POINT 17 18 26 12 1 +74 28 OFF SCALE I MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION 14 _2,~ i JUN 8 1987 ' RECEIVED -22 +72 -84 ,80 ,81 282 -2 -83 NT +73 LOCATION OF WELL (Ple;=se complete either la, lb or lc.) WATER WELL RECORD STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES Division of Geologicol a GeophysicoI Surveys ; ~' _ ' ~ Molerlel ~ype ... : ; Top 8ottom 0g I 5 1987 ..... ' ..... · ' ' .' ~~ - ' " Set between ' ' ft. ond ft. · . ' ' . ' , , , ..,Beckfllling Grovel pock - ft.' a(fer ' ' 'hrs. pumping ' g.~.m. 15. PUMP: (if ~v~ilobie} HP ~ . '. ' L~ngth of. Drop Pipe ' ft. oapacity , g.p,m. . . ' O Subm. O Jet ~ Centrifice[ O Other · , " 14. REMARKS: 16, WATER WELL CONTRACTOE~$ ~TIFICATIO~: 15, We/er Tempereture o ~ F ~ C ~ ~ ~ . ~ ~ . ~ ~ / onlroc, License Number Name .~. MUNICIPALITY OF ANCHORAGE ~. D ',RTMENT OF HEALTH AND HUMAN SEI '~ES Environmental Health Division 825 "L" Street. Anchorage. Alaska 99502. Telephone 264-4720 0 I -.~ I ~ ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Address Phone(s) Township, Range, Section Permit No N'o of Bedrooms LEGAL DESCRIPTION LOT LINE DISTANCES SEPTIC ABS§RPTION TANK FIELD /:...2¢, WELL - 22 J AS-BUILT DIAGRAM (Show Iocahon of well, septic system, p operty hnes, foundahon, ~ ~ [ driveway, water bodies, etc.) TANKS z~'~EPTIC [] HOLDING TYPE OF SYSTEM [] TRENCH ~'~D [] W. DRAIN [] OTI. Depth to p~pe boaom from original grade ,~ ¢" FT FHI added above orig~ grade .~/i FT Total depth Item original grade /~/ F Gravel depth beneath p~pe Gravel w~dth Gravel length [~PRIVATE WELLS [] OTHER fldentifv) FT Cased to (A,B,C) Total Depth Date Installed: Inspections Performed I~lunioip,I ,,d State guidelines ,. ,lice! on this date: /4'~<?'~ _~ Health Department Approval: Date: L.,.EI.'F ~B ]:-ZE c ;q., :!,(q f~l;~ ,,' F'"[ , Ell:;,'. (~ff::i:dZS) t (~CePt. i.l'.'v 'Ll"l~l.: [~il".'~l'i by Lhe IYh..u'~.LC~,p~.j. L5' ~'~ '~r'ichc:~-~.g~ss, (l~fO/~) ~:xnd t.h~.) St.~t:'~,~ c~[ ~:]. ,] u~J. 1 J ':i.r'i[~;t.~] ]. 't'.l"l~:s, fi~W~B'~:.~h'li r-~ ~:~C;C:C)J'C]~:':iliC::(.:¢~ ~.LJ,.[.,H ~:1].:[ f~l:J~ c:;(:~d~::H~ air:ici '~1': ~ L.]:I.::'I" ~N[:YI'.I{.)I'.I ]8 ZNSI'/.~L..L.E:D IN (.~l~.d F~F~:IZ~:~ CI.:)V[;:I:~I~:U [~Y qE)(.~ ~:~U.I:..I)~N6~ CODES, N]:~L. :NOT DE /.~F:'F'T:tOVED N~'[I-K)I..I"[ (.~1',1 EL.E:CTI:R.[CGL ]:NDI::'E.[./I:].DN RE{:POR"I~G &~ND (:5) 'T'HFZ 50'C.EEK MA,NTE.A.C L7 :SEPTIC SYSTEM CL. EANOUT-- L 5 S 14' 35.8' MULTI-LEVEL HOME '-~[ OETAIL IIA' I"= $0' GLOBAL ENTERPRISES PO BOX .112207 ANCHORAGE~ ALASKA 99518 (907) 549- 5552 FOUND MSL DATE I' SCALE { ! LEGAL DESCRIPTION 20AUG87 I"= I00' ILOT 6 BLOCK ~ GRID ZONING ~ SUBDIVISION 2441 IPROSPECT HEIGHqS NO 4 DRAWN BY CHECK BY RD I RS ISUR~EY TYPE ~PROgECT.NU~/N ~ ~ II 6ES ]'HEREBY CERTIFY THAT THE PROPERTY DESCRIBED HEREON HAS BEEN SURVEYED'BY ME~ OR AT MY DIRECTION~ AND THAT THE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND DO NOT OVER- LAP OR ENCROACH ON THE PROPERTY LYING ADJACENT THERETO UNLESS OTHERWISE SHOWN, THAT NO IMPROVEMENTS ON THE PROPERTY LYING ADJACENT THERETO ENCROACH ON THE PREMISES IN OUESTION AND THAT THERE ARE NO ROADWAYS TRANSMISSION LINES OR OTHER EASEMENTS ON IAID PROPERTY EXCEPT AS SHOWN, T IS THE RESPONSIBILITY OF THE OWNER OR BUILDER~ PRIOR TO CONSTRUCTION~ TO VERIFY PROPOSED BUILDING GRADE RELATIVE TO FINISH GRAD AND UTILITY CONNECTIONS AND TO DETERMINE THE EXIS- TENCE OF ANY EASEMENTS~ COVENANTS~ OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT, ' LISTED DISTANCES PREVAIL OVER SCALING, REPRODUCTION MAY. CAUSE DISTORTION, 7'H15 pLAT CO/VT/I/NS: LO ~-$ I' B ~LO~H I 1-I5' ,~I-OGA' ~ LOT$ ~ 8 UB~I~I~IO~ ~0. ~U~OIVIS/O~ OF ~ U~SU~DIVI~-O 7'~Ac~ OF LOCATED AS ~SC~I~-D I~ ~OT~~ ~' .... , .... cONTAININg ~0,08 ACME8 HOH~ OR L~SS ~NB BEVELOPMENT ~VIOEB, IN 98 -15:' 4 LATERAL LINE-SHALLOW BED- SEPTIC SYSTEM Free Standing View Pot [ 3 3' .Cl een--ou t 6 ' / '=~'~ i'~'~) Typ i ca I 3' From Septic Tank Number of Bedrooms 4 SHORT FORMULAS X "S~il Rating X 1.6 X 150 SQ FT X 1.5 = Total Area = 900 SQ FT Required Required Length Width Total Area Width Length Total Area 900 SQ FT 24' 3'7,~' Requl-red .50.0' Designed IR LO LO O J c ->S %8 S \ 1 O L o, 8 Zl C 6 �A, 9L V/-/ > �PLLs T�� V 1 / / / 4 pr, \ 6Z16 M.K.00.00N a \ T \ O \ J O d C J O -j U N C O m F'- I- Lo 0O Z D. a Q 0 N O O Co F- O.S �c�c�cfl n 155 omc E d= U) cal u) 'O O > Y 3 •.� a) N ig N a) a) Q c Jco ca EaE� 0 JO w E�m= Q m0>acaa)) Q a) zt2'r6 U) Cc: =5 o p oa 0 '? a0i O QU) - a)oaoya cu w U a�cnl-fn ��0;�a-o N� � c NZ sd-OS 0 oa=iCp3� Q LL m U, C7 rn c o -Q c o m 0 co C6 �ot`S o �caaEy @ OF- +L-�' N O o o = J. 3 a a) N j N C 0 L to L� �O2� ��>0 2E o to ►_� maw (Da)¢� o -2 aa) @ = m co U Q 2 0;2 0 0 0'00 U c) N U U 'C a �0 N 93 L a `O., h f ` m low 0 .0 00 00 .00 c) 0-) so 00 O ••en O Cl) a) CL N T '0 Q. m U- C? N 0 m(D � /Z•yz Tap cn l v �/ ryM�. ot. CN F- LLI > 00�� Www / CL O X: ui N II LLOco� z w �o°-r J WCOwO U2w<cco Q��z i1•CCC�`111,VVV•••} wt -a::) Oo V' \\\ /ca O O / m N 4 pr, \ 6Z16 M.K.00.00N a \ T \ O \ J O d C J O -j U N C O m F'- I- Lo 0O Z D. a Q 0 N O O Co F- O.S �c�c�cfl n 155 omc E d= U) cal u) 'O O > Y 3 •.� a) N ig N a) a) Q c Jco ca EaE� 0 JO w E�m= Q m0>acaa)) Q a) zt2'r6 U) Cc: =5 o p oa 0 '? a0i O QU) - a)oaoya cu w U a�cnl-fn ��0;�a-o N� � c NZ sd-OS 0 oa=iCp3� Q LL m U, C7 rn c o -Q c o m 0 co C6 �ot`S o �caaEy @ OF- +L-�' N O o o = J. 3 a a) N j N C 0 L to L� �O2� ��>0 2E o to ►_� maw (Da)¢� o -2 aa) @ = m co U Q 2 0;2 0 0 0'00 U c) N U U 'C a �0 N 93 L a `O., h f ` m low 0 .0 00 00 .00 c) 0-) so 00 O ••en O Cl) a) CL N T '0 Q. m U- C? N 0 m(D co N LN N a) N UQ .0 V m U C N � T � N co c o 0 O rn (a N L m Q) m N a m c m (p N L � a �o zOE2 CO > a) O r- 2 (D o aLL E o 4.0c o � o N O C O 'j 0 U� c2� 0)EnM c ( a m (DJ O E } a L)c U L D m N v - y •- o LIJ O Oa w O N Q N a a�mc co � U Z � •3 N y m w 0) m o 0 m N U �LCo oN = O C .O Q o 0 E E0 o m • C C a) Q1 .L.. L� 'Eu U O Z5 a o'�•E c c •- _ 0 () N N d a) O O 0)(Q,- -6 )(Q, - U o m 3 a U 'o m a) O >,-O L oEsa 0 m y N m aZ'= a o :C3, N o NAs rn� C 30)�m Cr> m � CL O O t- a ` Lo In o z a w 0 F- LLI 00�� Www _O O X: ui Wz00 II LLOco� z w �o°-r J WCOwO U2w<cco Q��z Cl) wt -a::) co N LN N a) N UQ .0 V m U C N � T � N co c o 0 O rn (a N L m Q) m N a m c m (p N L � a �o zOE2 CO > a) O r- 2 (D o aLL E o 4.0c o � o N O C O 'j 0 U� c2� 0)EnM c ( a m (DJ O E } a L)c U L D m N v - y •- o LIJ O Oa w O N Q N a a�mc co � U Z � •3 N y m w 0) m o 0 m N U �LCo oN = O C .O Q o 0 E E0 o m • C C a) Q1 .L.. L� 'Eu U O Z5 a o'�•E c c •- _ 0 () N N d a) O O 0)(Q,- -6 )(Q, - U o m 3 a U 'o m a) O >,-O L oEsa 0 m y N m aZ'= a o :C3, N o NAs rn� C 30)�m Cr> m � CL O O t- a ` Lo In o M J MC !1 t:AA Y OF ANCHORAGE Development Services Department '+ Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 015-132-40 Certificate of On -Site Systems Approval Expiration Date: / l—a -ZOZD 1. GENERAL INFORMATION Complete legal description PROSPECT HEIGHTS #4 BLOCK 2, LOT 6 Location (site address) 10100 HILLHAVEN CIRCLE, ANCHORAGE, AK 99507 Current property owner(s) GREGORY & LYUBOV BRUNA Day phone Mailing address 10100 HILLHAVEN CIRCLE, ANCHORAGE, AK 99507 Real estate agent 2. TYPE OF DWELLING: Z Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: Private Well Water Storage Community Well Public Water System Waiver request for: 4 Day phone TYPE OF WASTEWATER DISPOSAL: ® Private Septic ❑ Holding Tank ❑ ❑ Community ❑ ❑ Public Sewer ❑ Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ q1 E 0 CoV 1 p' Date of Payment I o2 /'�w Z) Receipt Number g I12� c) COSA# oscab 137 Y Waiver Fee $ Date of Payment Receipt Number Waiver # 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY, ANCHORAGE, AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 7/25/2020 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems'are subject toOF A these various and dynamic characteristics and are outside the control of the evaluator of the Pi • • •�!`i�1� well and septic system. Therefore, any estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or JJ 49 discrepancies exist can be given by First Water Consulting & FWl.S ' % *' ili •'* 1I 6. DSD SIGNATURECurtis Huffman System #1 Approved for bedrooms ��F9�sT...CE 128991 �i FIF.7,125/ O P Oi. System #2 Approved for bedrooms % ROFEW Disapproved Conditional approval for bedrooms, with the following stipulati\l`\QP"TYfOF(r/� O E 'vQm V�.. Original Certificate Date: g- ' Z 02-0 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 Legal Description: PROSPECT HEIGHTS #4 BLOCK 2 LOT 6 Parcel ID: 015-132-40 If more than 1 septic system on lot: COSA Checklist # _of _ Structure served by this system _ A. WELL DATA ® Well log is filed with Onsite (or attached) Date drilled 4/15/1987 Total depth 328 ft Cased to 195 ft ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 6/23/2020 Static water level at beginning of test 16 ft. Comments B. TANK DATA Age of tank(s) 0 years Tank type/material SEPTIC / HDPE Measured operating fluid level in septic tank NEW ® Standpipes/foundation cleanout per record drawing Date of pumping NA - NEW D. ABSORPTION FIELD DATA Which system tested (date installed) 8/1987 ® ALL standpipes present per record drawing Total measured depth from grade 4_2 ft (max) Measured depth to pipe invert from grade 3.7 ft (min) ❑ N/A — pressurized field ® Monitor tubes go to bottom of effective. If not, state depth into effective Well production at time of test 1_6 gpm Water storage tank volume_ gallons Well disinfected for coliform test? ® Yes ❑ Nc ® Coliform bacteria is Negative Nitrate 3.94 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) Collected by FkS & Sullivan Date of Sample 6/23/20 & 7/2/20 C. LIFT STATION ❑ Required maintenance completed Age of lift station _ years Lift station material Comments: Adequacy test date 6/23/2020 Results 0 Pass . For 4 bedrooms Fluid depth prior to test 0 in Water added 820 gal New depth 0 in Elapsed time <1 min ® Code -required soil cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate 600 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N date of test) If yes, enter date Gallons introduced gallons Comments/Defciencies:. FRES E., SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ® Yes if No ft Wells on Adjacent Lots: Community Sewer Manhole/Cleanout > 100' ® Yes if No ft ® Yes if No Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No Neighboring Absorption Fields > 100' Community Wells > 200' ® Yes if No Surface Water > 100' Animal Containment > 50' ® Yes if No ® Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No ft ® Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water > 100' ft ft ft ft ft ® Yes if No ft Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No _ Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Water Service Line > 10' ® Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ® Yes if No ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No —ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' ® Yes if No _ ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATIONor— I certify that I have determined through field inspections and review ��Q�,: •' • • ���� of Municipal records that the above systems are in conformance •:9' with MOA COSA guidelines in effect on this date. r • Curtis Huffman '��, •. CE 128991 .• c`�i Al AN -7/31/202Q.* - //31/202Q . * R A ft ft MUNICIPALITY OF ANCHORAGE DEPARTMENT dF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORMATI ON (a) Legal Description (include lot, block, subdivision, section, township, range) (b) (c) (d) ~ '-Address Location (address or directions) ~ Applicant Name t~:~/~'/ ~/2~'~'~~''' Telephone: Home Applicant Address ./::~¢) -,,~.y' //~,~-z3 ? ~¢/~//'z¢,,~,¢~;.~--'~/ ,,~'~/,,,¢~',~¢/"~ ~--'~,-~'J,,'" Applicant is (check one): Lending Institution []; Owner/builder []; Buyer []; Other [~"~xplain); Lending Institution Telephone (e) Real Estate Company and Agent ' ' ' ::'~' . : ":i;; ~ ~-,: ~ .,:-Address "' , "'... ~' ¢:; ~"~'i~l'eleph°ne'' ' "'" ' ' J""%':' .- f:~ '";.-: >: . . . _ - . , . ' ;,;:.~ . · ' ' ( ) '~.Mail the HAA to the following address : ' · --',-.-: ~-~; ~ ..'"'':' :: ' - · 2, /TYPE OF RESIDENCE ;':" ; '_ -L.'-:: : - .-': · i :"': ';-' ~';: :;"~ *'.Z./''~' ~':~: '.'.:'~'-;'-~ ¢'.: · . ' -"~":.~:: -' :'Single-Family Iff-Family[] Other" . .. '- ..-. ' Individual Well ~omm unity • Publici-I '"-:.':~:;-,~1:1'_ .... :,,~. ,.:.. . ..-_-..-_,.,... : ' Note: If corem Unity w~ll system must have written'confirmation from the State D~padment of Environmental Conse~v&tion' attesting t0 the legality and s~atus. .. ' . - '-. .' ._: ~:. ~: .-.:?..~., ..' .",;: .:{.- ?.~ ... ,.. _' -' . .....:,.:.,:~.--.,~- . _. .. , '':.; ~.-~.' '--... . _ 4.-SEWA~E~SAL '. - :- "'"' ' -. .. ..::.:---~ _: - _:;. . :. _ _ ' -_; ._ - . .' . ~ .' .. ,'; :' . _'.' _ .'. - Onsi~e ~Pu'~lic ~' Comm'uniiy ~ H01~ing Tan~'~ ........ ' ' ' ' ..... ":': ..... '"'""- '' Note: If community well system, must have written confirmation from the State Depadment of Environmental Conse~ation attesting to the legality and status. Page 1 of 2 72-025 (11/84) 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 regulations in effect on the date of this inspection. Name of Firm ,~5z~' '~/~"- ~'~/'~"-~"~"/~ Telephone ~-~'~"~"~:'-:~'~'":~ ~ Address ,'~) ~/~"~" //~72~7' ,~z,/~-'/~,,~'~Z~-.. Date DHEP APPROVAL ' Approved for ~ bedrooms by Approved ~ Disapproved Terms of Conditional Approval ' --" ' Engineer's Seal Conditional CAUTION 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':6ertain 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-o25 (~ 1/84~ WELL DATA MUNICIPALITY OF ANCHORAGE (MO*,,, MUNICIPALITY OF ANCHOP~GE DEPT. OF HEALTH &HEARTH AUTHORITY APPROVAL (HAA) ENVIRONMENTAL PROTEC~IONCHECKLIST - FEBRUARY 1984 264-4720 OCT 1987 RECEIVED Well Classification Well Log Present (Y/N) Total Depth -~,~.¢¢ ' Static Water Level Casing Height Above Ground ~?" Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments Cased to IfA, B, C, D.E.C. Approved (Y/N) Date Completed ~'3~ ~--~'¢ ~ ~ Yield Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) '~::~ <7 Depression Around Wellhead (Y/N) -' / ~ ; On Adjoining Lots ~ .... o,~-~ :~- ,"~'~ f ~--'~"~ / ; On Adjoining Lots ~:~-~ ,~ To Nearest Public Sewer To Nearest Sewer Service Line on Lot ',"~ : :?-?.~';;:~,~<"' ; Date _ B, SEPTIC/HOLDING TANK DATA Date Installed Standpipes (Y/N) ,~/, -/> Air-tight Caps (Y/N) Depression over Tank (Y/N) .:/ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Ho!ding Tank: To Water-Supply Well ', -~" To Property Line / ~ To Water Main/Service Line Size J/~O0~',~/_ No. of Compartments ~:~:-, ~- '-~ Foundation Cleanout (Y/N) Date Last Pumped /V':''-¥/~'¢-'3 ; for Temporary Holding Tank Permit (Y/N) To Building Foundation ~;"~ / To Disposal Field / ~' / To Stream, Pond, Lake, or Major Drainage Comments Page I of 2 72-026(11184) ABSORPTION FIELD DATA Soils Rating in Absorption Strata Type of System Design Date Installed Width of Field Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot ~)¢-~-~,~5' ~--0~ To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Length of Field .52'¢ Depth of Field ~"¢'" Gravel Bed Thickness / '/ Standpipes Present (Y/N) Date of Last Adequacy Test To Property Line -¢¢~'~ ¢ To Existing or Abandoned System on ; On Adjoining Lots ~'~ ~-~'~S'.~" ~ ,~::-~'~)CP ' To Cutbank (if present) Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** 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 Company .,42'~¢~,¢¢ ~¢'~'~'~'~--'"""""""'~-"~ MOA No. Receipt No. ('~('~) /-- 0~ ~ ~ Date of Payment /D ~5 ~ ~ Amount: $ /~C%- C?O Engineer's Seal