HomeMy WebLinkAboutHYLEN CREST #1 BLK 2 LT 4Hylen Crest F AV m'AAff%3j Block 2 Lot 4 #050-472-81 Municipality of Anchorage Page of Z DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 i Anchorage, Alaska 99519-6650 9 Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: 5a �15�1 U C> PID Number: Name: Wastewater System: ❑ New Ca' J6pgrade L I Address: �� dX �Z_�7 LA ABSORPTION FIELD Phone: tog No. of Be rooms: � "D (1 Deep Trench ❑Shallow Trench ❑Bed ❑Mound ❑Other LEGAL DESCRIPTION Soil Rating: O. � Total Depth from original grade: GPD/Sq. Ft. Lot: Block: Subdivis'on: Depth to pipe bottom from original grade: Gravel depth beneath pipe J 1 L Ft. Lr_ Ft. Township: Range: Section: Fill added above original grade:f.. Gravel length: Ft. a Ft. WELL: ❑ New ❑ Upgrade Gravel width: 7 Number of lines: Distance be)w/Eanlines: — Ft. /�Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: J Pipe material: 04,7 FL FL o f SO. Ft. 1' V C- I� 1 1+ 3 1 f Driller: Date Drilled: Static Water Level: Installer: 1 Date installed: Yield: Pump Set at: Casing Height Above Ground: TANK GPM FL Ft. SEPARATION DISTANCES &-sep c ❑ Holding ❑ S.T.E.P. To Septic Absorption Litt Holding Public/Private Manufacturer:/ //// Z- 6 Capacity in galloons: Z,5 U From Tank Field Station Tank Sewer Lines Jam' Well- / Material: STF �L Number of Compartments: 2 Surface Water , oc , 1 D D / LIFT STATION J� Lot t I Size in gallons: Manufacturer: Line U tG Foundation "PUMP on" level at: p off" level at: High water alarm at: Curtain Pump odel Electrical Inspections performed by: Dri O\,l Remarks: BENCH MARK 11 J�1 P Pcg Q rS 17 Location and Description: 1 L W (— • t�OtM&_ Assumed Elevation: o Loa r E kAL of �hal y C2 �1 y TJ n y lib <:• ;� > �a 5 ENGINEERING Inspections performed by:RimoopOUM a 1st; s area to ivuY, Alaska 99577 2nd to 13 5'T� ., ROBERT C. COWAN " ,M `G'j\ CE -8801 a� do Department of Healt d H ervices approval / �dei�Q. / / Reviewed and approved h, Date: •i�,��,o.,�.p.►* 72-013 (Rev. 9/91) MOA 25 Permit No. SW950100 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 Description: LOT 4, BLOCK 2, HYLEN CREST #1 PID No.: 05047281 I SCALP I" = 40' 72-013 A (1193) - S.T C04 ... . .... .... ............ 93.7' ....... ......... • 79..5` .......... - ...................... 'WATER FOUND B A 27' 5' ')T1 28' 7' ST2 31' 15' 01 32"17 302 33' 18' >03 57' 27' 304 89' 79' dT1 58' 27' �T2 90' 80' .......... .............. - . ............................ "(1r. ......... ROBERT C. COWANW Xfvl . 08 .8801 /c;, J 4P -MAY 25 195 10:38 RICK ALLEN/FANTASTIC FINISHES P.2i1 RICHARD M, & ROURTA M, ALLEN 10220 $ILVERTIP CIA EAM RIYER,AK, . • 6�4-4135 :' . MVNCIPALITY OF ANCHORAGE TO,WHOM IT MAY MEM, WE, RICHARD M, A ROBERTA M, ALLEN, AS OWNERS OF 10220 $ILVERTIP CIRCLE, EAGLE RIVER, ALAWKA,ARE OOING TO BE THE INSTALLER5OF THE, NEW SEPTIC 5YSTFM DE TONED BY AS ENGINEERINOON SAID PROPERTY: SINCERELY, 05t, FA M. ALLEN PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW950100 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:ALLEN RICHARD M & ROBERTA M OWNER ADDRESS:P.O. BOX 774547 EAGLE RIVER, AK 99577 PARCEL ID:05047281 LEGAL DESCRIPTION: HYLEN CREST #1 BLK 2 LT 4 LOT SIZE: 20017 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: gaS Lo -1 5 DATE ISSUED: 6/02/95 EXPIRATION DATE: 6/02/96 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 (18AAC80). 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. SPECIAL PROVISIONS: RECEIVEI BY: ISSUED BY: DATE: ff DATE: bj� HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROADDESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSALSYSTEM DESIGN s&S� �-ineey1nG May 26, 1995 MUNICIPALITY OF ANCHORAGE Depa)ttment ob Heatth and Human Services P.O. Box 196650 Anchorage, AK 99519 REFERENCE: Lot 4; Btock 2; Hyten Caest Subdivision ALI ROBERT C. COWAN, P.E. ROBERTA. SHAFER, P.E. CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 Request you .issue a pe+rm.c t to upgrade the septic system serving .the hour bedroom house on the regereneed property. A test Note was excavated and a percotation test penborme.d in the area ob ,the proposed upgrade. The approximate tocation ob the test hate is Located on .the, attached site plan. An adequacy test pe.rbormed on the existing system bon HeaPth Authority Approvat purposes bound the absorption capacity ob the, system to be, inadequate. At the time ob excavation, water was encountered at 13 beet and abten seven day ground waters monitoking the mon-itoicing tube, was bound to be dry. Attached .is the proposed upgrade, daign. We do not anticipate any adverse ebbects on neighboring properties by the .insta tation ob the proposed septic system. This property is seue.d by a Community water System. Ib you nequi.ne, additional .inbacmation, ptease contact us. S,ince.re2y, W W-,117v,?� Robert C. Cowan, P.E. RCC/gk Enctosuhe. 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 -�E-u0n 0 ;v W O Z ��D� Z D O C D r= z 4 M F- X ;u D y .0 < C >r� fn O p z O r m z nz�l + D", D�� Z Mn Mm =�l1nni-gym OSri�G�) zzmzZ InKNmrl Oro m ^NK NI��A N S z .40' SCALE --IN(nw (n -m®LTA r �m� O�mmZ zo��� 1a m 'Y 00 til O r= 0J ONTO r� 00 II K G� II O II Ln 0 (� 0-000 p �a G7 p 0(A Q7 D-I::� DNN O O O Z Z -i r� ND <— DSC �Zm-��(A m n—z I c o �m Im0mo 71 n o�ZN ODmm� 1 -I - Z o m cn N m K: z m v � Z < N < -u(n mm m ( Z - M- -I p O i m 0>>- i 0 0 2 0 i 21UD �kAL1, (10o m C/) -< z DRI VR i -u m n© Nll; O z o 0 y = -r>> O m -AO Z Z z0 ON � � Z i 1-4 1-4 0 n N o� ~' o .0 D 1 t ' -F✓ e Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 �yI SOILS LOG — PERCOLATION TEST (ENGINEER'S SEAL) 40 W. S ......... - ,,// 0-8801 PERFORMED FOR: �-1 LK-- L�7!io1 DATE PERF0 2�rr y S I(6 r C4)..... ,.. LEGAL DESCRIPTION:_ Township,Range, Section: t37�.��, ` �—Q� PT,,,,�� 1— SLOPE SITE PLAN ((F;ET) 1 O 2 /3 � 4° 5 a 6 e. 7 / c 8 - G 6 9 � , 10 0 11 12 ? 31415 13- 14- 15 16- 17 81920 18- 19- 20 COMMENTS C.W�P/15m- 1.1,,1A j.0•, f�',C).� WAS GROUND WATER ENCOUNTERED? S S IF YES, AT WHAT ' �� L 0 DEPTH? P E Depth to Water After Monitoring? 9!::�4— Date: PERCOLATION RATE •� (minutes/inch) PERC HOLE DIAMETER C" TEST RUN BETWEEN FT AND Lf FT PERFORMED BY: S & S ENGINEERING I W - a s CERTIFY THAT THIS TEST WAS PERFORMED IN 17034 Loule River loop Road No. 204 ACCORDANCE WITH A]jgt�TftTfphNA[hVMW.4,yGUIDELINES IN EFFECT ON THIS DATE. DATE: '�7 —5S _ 72-008 (Rev. 4/85) s&S� �in�enrnG ROBERTC. COWAN, P.E. ROBERTA. SHAFER, P.E. AML -4A ON-SITE WASTEWATER DISPOSAL SYSTEM CIVIL ENGINEERS CONSTRUCTION PRACTICES (9X694-29 79 FAX (907) 694-4-1211 and MATERIAL SPECIFICATIONS HEALTH AUTHORITY APPROVALS REFERENCE: Lot 4, Block 2, Hylen Crest S/Dd May 26, 1995 SEWER&WATER GENERAL: MAIN EXTENSIONS 1. The scope of this project includes the installation of a leachfield trench to serve the four bedroom residence located on the referenced property and SEWER&WATER excavation of the existing 1250 gal septic tank to INSPECTION verify its integrity. If the integrity of the existing septic tank is poor the existing septic tank is to be excavated, pumped, crushed, and abandoned in place and a new 1250 gal septic tank installed. ENGINEERING STUDIES AND REPORTS 2. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all WELL INSPECTION applicable State and Municipal Wastewater Disposal &FLOW TEST Regulations. 3. The contractor shall be responsible for obtaining any necessary underground utility locates. SITE PLANS 4. Unless specifically agreed otherwise, the property owner 'shall be responsible for final grading areas subsequently depressed from soil settling. ROAD DESIGN 5. Contractors installing wastewater_ disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own SOILTEST systems must also receive prior approval from the Municipal Health Department. PERCOLATION SEPTIC TANK INSTALLATION: TEST 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. STRUCTURAL& MECHANICAL INSPECTIONS 2, The septic tank shall be sufficient) p Y bedded to prevent settling or shifting of the tank. 3. All standpipes on the septic tank shall extend a ONSITE minimum of 12 inches above final grade. WASTEWATER DISPOSAL SYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 Page Two Lot 4, Block 2, Hylen Crest S/D May 26, 1995 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. 5. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: 1. 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. 2. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 3. 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. 4. 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 4, Block 2, May 26, 1995 Hylen Crest S/D 5. 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 MATERIALS SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). 5. 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. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements. Page Four Lot 4, Block 2, Hylen Crest SID May 26, 1995 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: 1. 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. 2. 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. 3. 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 4, Block 2, Hylen Crest SID May 26, 1995 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 & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264.4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME C� (►�J PHONE EW [-� C_ V-C (j� ('�'(Z... ❑UPGRADE MAI LING ADDRESS, // fL L"c� LEGAL DESCRIPTION "r lay K.-i�P�r( LOCATION NO. OF BEDROOMS - Uy DISTANCE TO: Well �=Cl/Ylil1(iJV/�� Absorption area 7 � Dwelling / �� PERMIT NO. C-71 M a Manufacturer MateiI No. of compartments rn Liq capac�—ity in gallons ""� IF HOMEMADE: Inside length Width Liquid depth 6�-' DISTANCE TO: Well /` Dwelling PERMIT NO. J(9Z f 02 �4x„ Manufacturer .� Material Liquid capacity in gallons 2 DISTANCE TO: Vyell ComnI (G'/t/ 17 Foundation G_� Nearest 101 line PERMIT NO.Lu n zNo. of lines / Length of each it) / Total length..g f between lines LU F � .5 / inches F Top of tile to finish grade Material beneath file/ Total effeptw absorpst /rea �N 26 inches , i Length Width Depth PERMIT NO. LU g F- a— Type of crib Crib diameter Crib depth Total effective absorption area wa LM DISTANCE TO: Well Building foundation Nearest lot line J Class Depth - Dri erg ___� Dis ice to lot line PERMIT NO. J w DISTANCE TO: wilding oundation ewer me Septic tank Absorption areals) OTHER PIPE MATERIALS _ SOIL TEST RATIN 7 /-7-1/t `� INSTALLER REMARKS cr �� ..� a 1 'V P F f 4 e Ar Z DATE LEGAL 3APOVE r' i11r 4J I r -, a a l 77-T (Rev. 3/78) MUNICIPALITY OF ANCHORAGE Department f Health and Environmenta- Protection 825 Street, Anchorage, AK. ,9501 264-4720 '� l Permit # # HANDWRITTEN PERMIT ,wFLL RD oR ON-SITE SEWER PERMIT Applicant:LZ12/ 7� EPC% 4X Mailing Address: F o Location: Phone Number: Legal Description: Ao % /� ,� �u� Lot Size: Type of Soil Absorption System Is: Trench: Drainfield: Seepage Bed: Holding Tank: Maximum Number of Bedrooms: Soil Rating(sq.ft/br) The Required Size of the Soil Absorption System Is: DEPTH / LENGTH GRAVEL DEPTH WIDTH �— The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). # # REQUIRED SEPTIC(HG4-_ NG-) TANK SIZE _ ` �' GALLONS # # Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. .# TWO(Z) INSPECTIONS ARE REQUIRED # Backfilling of any system without final inspection and approval by this departmen will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 fee- for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 3 3 I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I qpdybrstand that the on-site sewer system may require enlarg me if ;V7,7, nce is remodeled to include more that edr s. Signed: e +✓c%� Issued by: L Applicant Date: SWP/024(1/81) SOILS LOG MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ❑ PERCOLATION Q � � 825 L. Street, Anchorage, Alaska 99501 264-4720 TEST o - SOILS LOG - PERCOLATION TEST PERFORMED FOR: `� 4'U /' /���J�'/�f DATE PERFORMED4���A�" LEGAL DESCRIPTION: (J �•- /_ DEPT i (F(EE ) SAL TY .7wali L9 l 2 ^ f/ r, 3 U 4 D, /2-J 6 s 7 n 8 f 9- 10— COMMENTS 10 l WAS GROUND WATER �*� fll 11 I /*'�(`L7NCOUNTERED? 12 /0'Z IF YES, AT WHAT 13 DEPTH? COMMENTS a &;aL411Uteh7r PERFORMED BY: �,���,�,j�1VEl�9�^?•0�� 72-008 (6/79) - SITE PLAN Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE TE” RUN BETWE CERTIFIED (minutes/inch) FT AND -e FT DATE: /0 'I I, - T C) VJ CD O7 I-- I,- CC) ` cC) M M M il- rl_ O O O7 07 V c O LLL h= ,1 y = U uJ m Q p 0 U U) rN^ 06 VJ L c � E Q o m U) 00 W, LO N O N t N co N M n C O .Q X W 0 0 O i OD i N ti d' i 0 LO O m U c0 d ti LO d7 Q Nt J ry N N MJ CO W W r ry � U LU {. U LLJ Z LLJ J —I U) 2 N c ON o �— Q U) U N a) a � a) J (n W OfQ Q 06 W Of W C) 0 01-1W Q Q N c 0 a� Q- 0 Q c 7 U N O O 70 a) Wi 0 a) O Q Q. cu a) L cu a) U) A U a) c 0 a) 0 O 0 - CL Q ca co c O c O Al Ln c� 0 cn c m E O A N 0 N LO d' cu O cu U .E Q) U c0 C O I 0 0 0 U) CL 0 to a O 3 •� '= iQ L O N � N t 0 -O ~ ~ a) '0 U L 0 O 0 Na a) y 4� L ''w^ .V, ^L, W O CL O O 0) U cur a) � 0 'U E U) O Q Q U .N Q con O o — a) ca b a) U) 3 Q •N 3: Z Q 0 cn > Q. 'a O OL C a) Q Q. Q O N 0- Q% r L O N E v v X x W % U) 0^, V/ f �_ N D > N E -0 O QL _ 2> O Q N O N _ N . U O Q 4; m 0 W = O U O cu N O N Q a Q i N W O .Q cc �. L = U Q O U O 0 O .F, Q H N d- I` C) Aa) AO) M�MV \'J \'/ C) CD CD CD 1 W a) x c cu Oil U CL CL coCN o noo AELM __ ��, ^�^ l f. O /m U z Q� ) _0 LL ®( �A CE O O) O N c E O U a) 07 0 � U ® Q a) 9 L � c1..1.. > n 0 `-' � U cn i O -+--' U Q Q Q O Q Q- U) N N CO O O N U 4- a) WE Z r-- 0 O 00 P N � 0 O zo T- O J N Y U m L IE r U U > U) O = N N O a � U U a) O M 0) a) a) a) 0 0 a U O U c 0 m C) RIF 1mm 0 0 � LL a k 0 O cu O U 0 U 0 U U (n coCN o __ ��, ^�^ l f. O ti W Q� ) _0 >, N CE O O) O N c E O U a) 07 0 CO L � c1..1.. > n 0 `-' � � a) El O Q) (D m _0 + Q c > c� 0 Q O 0) L Q C/) > N 0 — U 0 a) o � FEW Q Old m 0 Q) El � J a. O a N d ❑ H 3 O ( 0 U) W ~ U W a a 0- —CF- W L- O LL O U cn z O w a w a f�- N M c 0 m C) RIF 1mm 0 0 � LL a k 0 O cu O U 0 U 0 U 4� W CO C `-' a) O CO cu ❑ Q L U U � 0 CO _0 0 E 3� v O u ❑ U ns N L U 0 Y LL V ❑L L f o a) -a a) >, () N _C L3 a) O A N N 2 C cu El U J-- 000 CL10 ❑ ❑ Q 0 0 U O F+ (nCl) n 0 1E m L a_ U N 0 ❑ L ❑ C E 0 d D .c = +, 0 > cn C O J � >� a) W N a) L a) O — L c.) Z 0 Q to 4- M U 0') w c t 1- N O (D a (1) U)L Q �a � U) Q Q > �' cu a w > ui cfl m c 0 m C) RIF 1mm 0 0 � LL a k 0 O cu O U 0 U 0 U COSA Checklist_June 2022 COSA Checklist Legal Description: Parcel ID: If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank Date of pumping Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes go to bottom of effective. If not, state depth into effective Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) If yes, enter date Adequacy test date Results Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) in Effective depth used in Effective depth remaining in Comments/Deficiencies: COSA Checklist_June 2022 E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F.ENGINEER’S COMMENTS G.CERTIFICATION & 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, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Phone Engineer’s Printed Name Date CO O L Q Q Q N E N A un v Y Y 0 0 a C 0 N O M ro 0 cu E N t t 3 0 v Q E co x au C fu N s 0 rn 4J N M M L O (o O O ai LL O4+ cv (3) U LU ff 99 N a N U O (n cu v > O 4' v U � 4J 4-0 b cuLn E Eai 0 o C � ULn CL I�N N N ai 0; — CL U �..� j N O — Co V OL N N 4A co ^� Q Y N O Q�CQ H O L -v _0 W N m Q >.L 5; GJ Ev 4J c -I O O N N 4-J jo 4.1 �. N N , fB C= W o Nc:L _lie� Ln v aJ v m W 0i +' c bD (IJa WO V) 0b\A 4- 2 N blo i O .. 00 ate+ O W +�+ aJ U (1)_0 fo N Q N > O a1 E N ca aj j N 3 � O 4-J N O) O: 0 0 3 �— U to I— CO O L Q Q Q N E N A un v Y Y 0 0 a C 0 N O M ro 0 cu E N t t 3 0 v Q E co x au C fu N s • Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 Certificate of On -Site Systems Approval t Parcel I.D. 050-472-81 Expiration Date: _ -Z % f lif' 1. GENERAL INFORMATION Complete legal description Hylen Crest #1, Block 2, Lot 4 Location (site address) 10220 Silvertip Cir. Current Property owner(s) William & Zoa Loper Day phone Mailing address PO Box 4381 Houston, TX 77210 Real Estate Agent Day phone 2. TYPE OF DWELLING: F71 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: Individual Well ❑ Individual 7 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ll Public Sewer ❑ WaiverNariance request for: Received by: Date: -i COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Waiver Fee $ Date of Payment Date of Payment Receipt Number ©i/o f I? Receipt Number COSA#— 65C 1 q( a( Waiver # 6. 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 Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Alk. 99510 Engineer's Printed Name Steven R Pannone Date 5/2014 6. DSD SIGNATURE System #1 Approved for bedrooms /r : eleven R. Par no e System #2 Approved for _ bedrooms r�4, �•, CE -8149 Disapproved Conditional approval for bedrooms, with the following stipulations: By: Original Certificate Date: — 1 Theicipality of Ancho ge Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blwsheet r ' c If more than 1 septic system is on the lot: COSA Checklist # 1 of Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: Hylen Crest #1, Block 2, Lot 4 A. WELL DATA Well type Public Date completed Total depth ft. Date of test Static water level Well production If A. B, or C provide PWSID # AWWU Sanitary seal (Y/N) Cased to ft. FROM WELL LOG WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate Arsenic ug/L Date of sample: B. SEPTIC/HOLDING TANK DATA Parcel ID: 050-472-81 Well Log (Y/N) Wires properly protected (Y/N) Casing height (above ground) in. AT INSPECTION Collected by: ft. Tank Type/Material Septic/Steel Date installed 6/8/1995 Tank size 1,250 gal. Number of Compartments 2 Cleanouts (YIN) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping 3 Z b/� Pumper J f C PU m c C. ABSORPTION FIELD DATA Date installed 6/8/1995 Soil rating (g.p.d./W or ftZ/bdrm) 0.8 GPD/BR System type Deep Trench Length 79 ft. Width 3 ft. Gravel below pipe 5 ft. Total depth 9 ft. Eff. absorption area 790 ft Monitoring tube Y Depression over field N Date of adequacy test 2/27/2014 Results (Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption field before test 21 in. Water added 632 gal. New depth 41 in. Elapsed Time: 420 min. Final fluid depth 21 in. Absorption rate , 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date D. LIFT STATION Date installed "Pump on" level at Datum Size in gallons in. "Pump off- level at in. Cycles tested E. SEPARATION DISTANCES WELL ON LOT TO: Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer /septic service line Holding tank Animal containment areas Manure/animal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Water main 10+ Water service line 10+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water Service line 10+ Surface water 100+ Curtain drain 50+ Wells on adjacent lots 100+ F. COMMENTS G. ENGINEER'S CERTIFICATION i certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Steven R. Pannone Date 3/ 2014 COSA brown sheet 10-10-12.doc Absorption field 5+ Surfacewater 100+ Water main 10+ Driveway, parking/vehicle storage11 0+ in. Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.d.anchorage.ak.us . (907) 343-7904 0 E•C l`►- Zj- 4i2 49 CERTIFICATE OF HEALTH AUTHORITY APPROVALi� FOR A SINGLE FAMILY DWELLING 41 N Parcel I.D. 050-472-81 1. GENERAL INFORMATION HAA# j->�A/�,�a•�/ Expiration Date: — 7- Da Complete legal description HYLEN CREST SUBDIVISION #1: LOT 4, BLOCK 2 Location (site address or directions) 10220 SILVERTIP CIRCLE • EAGLE RIVER, AK 99577 Current Property owner(s) EDWIN & HOLLY McCLURA Day phone 696-7287 Mailing address 10220 SILVERTIP CIRCLE • EAGLE RIVER, AK 99577 Lending agency Day phone Mailing address Real Estate Agent LES BAILEY w/ PRUDENTIAL VISTA Day phone 689-6451 Mailing address 16635 CENTERFIELD DRIVE • EAGLE RIVER, AK 99577 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site 0 Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ® Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Note: Alaska Water and Wastewater Consultants, Inc. shall be paid S at, or prior to closing for the engineering services provided. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, 1 verify that my investigation, based on procedures outlined in the Health Authority 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. 1 further verify that based on the information obtained from the Municipality of Anchorage riles and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) incompliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Finn ALASKA WATER & WASTEWATER CONSULTANTS, INC. Phone 337-6179 Address 6901 DEBARR ROAD, SUITE 28 • ANCHORAGE, AK 99504 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date '71 'bld; Engineer's Comments: In conducting this evaluation, AKWWC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines 8 Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AKW WC, Inc. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for 4 bedrooms. Disapproved. Conditional approval for Attachments: HAA Checklist f% Septic System Advisory Well Flow Advisory By: a��' (Rau. 17101) '�•' 49I �� �,� P yper fey n. �am`seas. 1 0 7953 �Fv bedrooms, with the fllowing stipulations: `\Ok;M OF ANZE ON-SITE •: �'m �22 .wMER AND , WP TEWATER ` FROGRA�A Manitenance Agreements Supplemental Engineers Reort Other Original Certificate Date: 10 - % —0 Z Municipality of Anchorage • Development Services Department Building Safety Division OnSfts Water & Wastewater Program 4700 South Bregaw St. P.O. Box 196650 Anchorage, AK 985196850 www.d.anchorege akus (907).343-7W4 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A. WELL DATA Well type PUBM Date completed Total dna+ h. 0 HYLEN CREST S/D #1; LAT 4, BLOCK 2 Parcel ID: 050-472-81 If A. B, or C provide PWSID# _ Well Log (YM) Sanitary seal (YM). VA Lab pr6perly protected (YM) Cased to ft. Casing height (above ground) In. FROM WELL LOG AT INSPECTION Date of test Statk: water level jpLW uetion g.p.m. ! g.p.m. WATER SAMPLE RESULTS: Coliform cotonles11 OD ml. Nitrate mgJL. Other bacteria *ft. dos/ IOU ml. Arsenic yJL. Date of sample: Collected by: B. SEPTICfHOLDING TANK 04TA Tank Type/Material STEEL Date installed 6/8/1995 Tank size 1250 gal. Number of Compartments 2 Cleanouts (YM) YES Foundation cleanout (YM) YES Depression over tank (YM) NO High water alarm (YIN) N/A Date of pumping 7/1/2002 Pumper JR'S PUMPING C. ABSORPTION FIELD DATA rBa-Ow oosnNc cwDO Date installed 6/8/1995 Soll rating jt.p.d ftlbdnn) 0_8 System type DEEP TRENCH Length 79 ft. Wklth 3 ft. Gravel below pipe 5 ft. Total depth 08 ft. Eft. absorption area790 ft' Monitoring tube YES Depression over field NO Date of adequacy test 9/11/2002 Results (Pass/Fall) PASS For 4 bedrooms Fluid depth in absorption field before test 25_25 in. Water added 705 gal, New depth 38.5 in. Elapsed Time: 135 min. Final fluid depth 31 In. Absorption rate >- 6001 g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date - D. LIFT STATION Date installed Size in gallons _ Manhoie/Acm to (YIN) "Pump on" level at _in. "Pump ofP In -91 at in. High water alarm level at Datum 1Cycles tested Meets alarm & circuit requirements?_ E. SEPARATION DISTANCES ' D P O R L' I C WAT E R SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer /Qap!is sorvice line Holding tank SEPARATION DISTANCES FROM SEPTIC(HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 59+ Water main 10'+ Water service line 10'+ Surface water too'+ Wells on adjacent lots 200'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ in. Water service line 10'+ Surface water 100'+ Driveway. parkingIvehicle storage 10'+ Curtain drain ' NONE KNOWN Wells on adjacent lots 200'+ F. COMMENTS G. ENGINEER'S CERTIFICATION' 1 certify that I have determined through field inspections and review of Municipal records that the above systems are M conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Na��a Date 9'I'e./ra' JEFFREY A. GARNESS HAA Fee $ 375 f/5D= 525 v! Waiver Fee E Date of Payment 1017/0;2 Date of Payment Receipt Number �'� gX Receipt Number (Her. 12MI) I ANCHORAGE WATER & WASTEWATER UTILITY George P. Merch. Mayor Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Road, Suite 2-13 Anchorage, AK 99504 Engineering Division 3000 Arctic Boulevard Anchorage, Alaska 99503-3898 http://www.awwu.ci.anchorage.ak.us September 23, 2002 Re: Hylen Crest #1, Block 2, Lot 4 (Grid NW57) Request for Letter of Non -objection to Encroachment Dear Property Owners: Owned by the Municipality ojAnchorage The Anchorage Water & Wastewater Utility received a written request on September 20, 2002, from Jody Maus, for a letter of non -objection for existing septic system pipes located within the electric and telephone easement located on the southeast 15' of the referenced lot. The as -built survey identifies the easement and encroachments. AWWU has no right to the use of and no interest in T&E easements. AWWU water mains are located within the Stewart Drive and Silvertip Circle rights-of-way. AWWU sanitary sewer is not available to the referenced lot. It is not necessary to request letters of non -objection for encroachments from AWWU for encroachments into easements that AWWU does not have the rights to use. AWWU has an interest in water, sanitary sewer, and utility easements only. Please check the easements when requesting letters of non -objection and do not send request to AWWU for easements that AWWU has no interest in. Should you have any questions, you can reach me at 343-8009. Sincerely, LL Hallie Stewart Engineering Technician G:1Engineedng\Planning\PlanningW MSlencroachmenlsleasemenl-not AWNU easement-Hylen Crest.doc 10-02-2002 3:29PM FROM �EA-ROw 9077619322 tt P.2 • !I iI :r i? STATEMENT OF NON -OBJECTION FOR ENCROACHMENT WITHIN UTILITY EASEMENT ! Matanuska Electric Association, Inc. (MEA) has no objection with the location of a 39TtIG system as shown on the attached as -built drawinq within the utility easement along the southeasterly boundary of the following property; Lot 4, Block 2, Hylen Creat 01 Subdivision, according to Plat No. 83-90, Anchorage Recording District, Alaska. i1 Situated in Section 8, Township 14 North, Range 1 West, Seward Meridian t� .i 11 This nonobjection is granted with the full understanding and agreement by all parties having an interest in the above property that this septic system encroachment will in no way restrict or limit the current or future ability of MEA to fully enjoy the benefits of the; easement for any and all utility purposes that it presently enjoys under the easement; This nonobjection is further conditioned by the stipulation that MEA will be held harmless from liability for any and all damages to the encroachment that may result from tho existing and future use of said easement by MF -A, its contractors, successors, agents, licensees, or assigns. if ii II Matanuska Electric Association, Inc. i By: oat Ca General Manager or his Represe ative' „ at. 2 ) 2407— i s Date ) MEA ACKNOWLEDGMENT ,.:Y1 ? j STATE OF ALASKA SS.�•',QF THIRD JUDICIAL DISTRICT ) n8l��vT''`�py The foregoing agreement was ack owledcled before me this 2ax day of ()e-1o6er .20_gft4?,.by yne P. ;;fr.-.e�.� Notary Public for the State of Ata ka My commission expires: r i� t OCT- 2-02 TNU 2:55 P11 October 2, 2002 GCI CABLE Edwin & Holly McClura 10220 Silvcrtip Circle Eagle River, Alaska 99577 Dear Mr. &/or Mrs. McClura, FAX NO. 9078688580 P. 2 Subject to your agreement to indemnify the company as set forth below, GCI Cable Inc. of Alaska has no objection to the septic stand pipes encroaching into the 15' T & E casement on the southeast property line of Lot 4, Block 2, Hylcn Crest Subdivision #I. Known as 10220 Silvertip Circle, in city grid NW57. 'Phis letter of non -objection in no way precludes GCI Cable from full use and enjoyment of any rights it may have within any portion of the utility easement and or the right-of- way, including unlimited access for servicing its facilities. Also any additional and extraordinary costs incurred during any future required construction, repair or reconstruction of GCI's facilities to accommodate any or all of the encroachments shall be paid by the property owner. By signing below, you agree to indemnify and hold GCI Cable harmless, now and forever, for any damage, costs, expense (including reasonable attor ey's fees), liabilities and injury to any person or property occurring as a result of th roachment. I Please indicate your acceptance by signing an -urnig _ tt to myself at the address below. Sincerely, Ac p e ebeccaCtt F OSP Design Engineer Date 5151 Fairbanks Street • Anchorage, Alaska 99503 • 907 / 868-5600 OCT 07 2002 10:57RM ENSTRR NRTURRL GRS 907 562 0053 P.2 ENSTAR Natural Gas Company 6orv�aiow ngsElacoe�aa� 4401 E. Internadwal Airport Road P. O. Bolt 190288 Anchorage. Maks 995194288 (907) 2843740 FAX (907) $834085 10/7/2002 Jeffrey A. Gamess, P.E.,M.s Alaska Water & Wastewater consultants Inc. 6901 Debarr Road Suite 2-B Anchorage, AK 99504 To whom it may concern: ENSTAR Natural Gas Company has no objection to the encroachment of the septic system pipes in the 15 -foot utility easement on the south east side of Lot 4 Block 2 Hylen Crest #1 Subdivision. See attached as -built survey. Acceptance and use of this letter of non -objection by yourself, your heirs, your assigns, or your successors, will constitute agreement to the following stipulations: ENSTAR will be held harmless, now and forever for any damages or Injury to any person or property as a result of this encroachment. Any ENSTAR facility damaged or destroyed, as a result of this encroachment will be repaired at no cost to ENSTAR. Any costs Incurred by ENSTAR for special construction necessitated by this encroachment will be borne by the property owner. All applicable safety code regulations will be observed and maintained. This letter of non -objection will in no way preclude ENSTAR from full use and enjoyment of its rights within any portion of its right-of-way. Sincerely, ENSTAR Natural Gas Company e Cooper cc: File m CL THE Wwoft"TMM KEW 6 POM TMS IMS Or LUMM MSTITVI s sftw ar m Smw AMT COWIXTS METWEN OOSIMO STEIMNOQ AND PLATTED LOT TIES 00 UUMEMIS H 6 MOT TO BE USO FOB MSOIOMMO AMMAL STRUMttt Ot EL1R10KL a .�F..Ot•s.Ai., /}- ...... m ............................. ' SHANE A LT •. lS- I< t �1 •s -mat stem NO OOfAgn SR THOS SAX NJLLI' f0' I MSEIM RJTUY THMT I %%VE PEWWEt A HIMTOATLE•S IHIPECTEm Or THE ralmm DEsanED PROPUM. LUT 4 X.= IL MTLCM GEST WL. UMT MD I AMGIOUAC MECOMMOIG OISTRMT, ALASKA NO TENT TIE VISULE OWWVE)OMTS SITUMED THIOEVE AW n I" M wr w I NCL ANIS Irl V va r tYfMNE'Y " Mt? MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services it On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # HAA # 1. GENERAL INFORMATION Complete legal description Loi .4; Btock 2; Hyten Cn.u.t #1 Location (site address or directions) 10220 sitvek Tip CiZLcte Eagte Riven AK Property owner Rick 9 Robby. Atten Day phone 694-4135 Mailing address. P.O. Bax 774547 Late. Riven AK 99577 Lending agency. Day phone ,Mailing add Agent Ka.thi O2m6.tead/ REMAX OF EAGLE RIVER Day phone 694-4200 Address -- 16600 Ce.ntenfii. ,2d DiLive. Eagle Riven AK Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water 4 `/ XXX NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XXX 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(R".1/91) Front MOAM21 5. 6. 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 S & S ENGINEERING Phone � y - } l 1,1934 e River Loop Road No. 204 Address EagleRiver, Alaska.995Z2-/ Engineer's signature DHH SIGNATURE Approved for Disapproved. Conditional approval for Additional Comments bedrooms. Date /� ° / er 1' � A .� ROBERT C. COWAN i ,C CE - 8801 - .•..��,C: i bedrooms, with the following stipulations: 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 x21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST /' � Legal Description: c- 137 S - ��I�( .S -f�-t� Parcel I.D. OS I�� -7 Zy A. Well Data , �1 Well type t ` Ln A Log present(Y/N) Total depth Sanitary seal (Y/N) Date of test Static water level Well flow Pump levell A, B, or C, attach ADEC letter. ADEC water system number completed Cased to FROM WELL LOG SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line WATER SAMPIX RESULTS: Coliform Nitrate Date of sample: B. SEPTIC/H61=0M1Q TANK DATA Driller Casing height Ptl _Wires properly protected (Y/N) _ x c o z AT INSPECTIO F)c_ M y r 8'7' 0 v O mo ®A n z g.p.m. g.p.m. M c`�s, n i o 10 < N rn O Z On adjacent lots On adjacent lots Public sewer manhole/cleanout Petroleum tank Other bacteria _Collected by: Date installed -S-`15" Tank size 1257a Compartments �— Cleanouts(N) Foundation cleanoutd�%) Depress� N lion (Y High water alarm (Y� rS ` Alarm tested (Y/N) ` Date of pumping '� k N Pumper _4A SEPARATION DISTANCES FROM SEPTIC/HG6D*4G-TANK TO: Well{s) on lot r1 On adjacent lots SIA Foundation t t To property line Lio Absorption field 23 Water main/service line Surface water/drainage t k::> C ---p � G_I 0�k 72-026(3/93)' Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) "Pump on" level at High water alarm level Meets MOA electrical codes (Y/N) SEPARATION DISTANCE -F -R LIFT STATION TO: On adjacent lots D. ABSORPTION FIELD DATA Manufacturer Manhole/Access (Y/N) Cycles "Pump off" Level Surface water Date installed Lam' `3 --r-1 s Soil rating (GPD/Ft2) 0.8 System type Length Width Gravel thickness S Total depth t o' Total absorption area i qv, Cleanout present (PN) TJJ Depression over field (Y4�i Date of adequacy test �5 Results (pass/fail) /� for "k Id Bedrooms Water level in absorption field before test AA__ After test ' AI Peroxide treatment (past 12 months) (Y& N d If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot IA On adjacent lots �Ib Property line 1 dt To building foundation' To existing or abandoned system on lot On adjacent lots k Cutbank '� �- Water main/service line loth k Surface waterI C-1 U,> k Driveway, parking/vehicle storage area (- Curtain drain r Ic. E. ENGINEER'S CERTIFICATION I certify that l have checked, verified, or conformed to all MOA and HAA guidelines iri effect on the t of this inspection. Signature /°l"/� Z!:L_- Engineer's Name i C Date / q �^ HAA Fee$ Date of Payment�/% S 7 Receipt Number %7� Czlo'/ 72-026 (3/93)` Back Waiver Fee $ Date of Payment Receipt Number or CIO *Y . K....... N ................... ........ a ROBERT C. COWAN `mac, ce-aevl��", �4fe,a.-%.. rev MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 1. GENERAL INFORMATION (a) Legal Description (include lot, Location (address or directions) Application Date subdivision, section, township, range) vl C-eJ 7- / (b) Applicant Name ^ /Telephone: Home Uf?3 Business Applicant Address T - ��/�� al/ (c) Applicant is (check one): Lending Institution ®; Owner/builder ® ; Buyer El ; Other (explain); ®` (e) Telephone (f) Mail the HAA to the following address: a 2. TYPE OF RESIDENCE Single -Family Multi -Family ❑ Other Number of Bedrooms 3 3. WATER SUPPLY Individual Well ❑ Community ❑ PublicX 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 OnsitejlSl Public ❑ Community ❑ Holding Tank E 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 (17/86) 5. ENGINEERING FIRM PROVIDING ..+SPECTIONS, TESTS, FILE SEARCH, DA1. AND INFORMATION e a As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigatiornaf this Mealth 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 Address 1 �— Date Telephone O„ l Ena Sea `^bars A. 6h,w fi No. 1457•E r` d 6. DHEP APPROVAL �U(�(�� Approved for bedrooms by l�dS ate _ Approved K Disapproved Conditional Terms of Conditional Approval 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 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 72-025 (1 W64) MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION MUNICIPALITY OF ANCHORAGE (MOA) NOV T n 1*HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 RECEIVED Legal Description: Z- Com✓ A. WELL DATA Well Classification 416 ff 4- If A, B, C, D.E.C. Approved (Y N) Well Log Present (Y/N) Date Completed Total Depth Static Water Level Cased to Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: Depth of Grouting — Pump Set At Yield Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) To Septic/Holding Tank on Lot '7' ; On Adjoining Lots 2c'' ( r To Nearest Edge of Absorption Field on Lot 2490 f- ; On Adjoining Lots 2150 _ To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date Date Installed 7 �'-3 Size �2 Sc7 No. of Compartments L Standpipes ON) Air -tight Caps(Y N) Foundation Cleanout/N) Depression over Tank (Y/6 Date Last Pumped 1161g S Pumping/Maintenance Contract on File (Y/N) - ; for Holding Tank High -Water Alarm (Y/N) N A- Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Kofdirng Tank: To Water -Supply Well --2- C212 t4- To Building Foundation' s` To Property Line . f To Disposal Field S To Water Main/Service Line / t To Stream, Pond, Lake, or Major Drainage Course A-1-0 0` r Comments .&A4 6 A0 j/— Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Type of System Design ,�P J4 C_ �J Date Installed 9 /7 /g3 Length of Field 3 - Width of Field Depth of Field /2-/ Gravel Bed Thickness G of Square Feet of Absorption Area 6717-2, Standpipes Presentt)N) or Depression over Field (Y N) Date of Last Adequacy Test N�GrJ - 3 Results of Last Adequacy Test A/ 4 7zszz e-7ple7 Separation Distance from Absorption Field: r /t To Water -Supply Well To Property Line r , To Building Foundation L� Lot To Water'1¢faia/Service Line To Stream/Pond/Lake/or Major Drainage Course To Existing or Abandoned System on On Adjoining Lots 30 f l — To Cutbank (if present) To Driveway, Parking Area, or Vehicle Storage Area .440 r4 Comments 14 /-F o Q�I C sG�,f fEyrr h �ee L� fn ` e /rr G� A," h�r2 ccffl- Hi'1, Gv eCS D. LIFT STATION A t Date Installei ' �' � ��^`�"! _ .} // � /6(Ai;risions Size in Gallons Manhole/Access (Y/N) "Pump On" Level at "Pump Off' Level at High Water Alarm Level at A=Vent (Y/N) N 9 i --f �c ern l/U � Juh • �� Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) 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 MOA No. Receipt No. (a41 j 2 Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) .haa�ae rv. % I �''�' I{ i i I j 1 ''% i I '� ',I A BILL SHEFFIELD, GOVERNOR DEPT. OF ENVIRONMENTAL CONSERVATION Telephone: (907) Address: ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 274-2533 ANCHORAGE, ALASKA 99501 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH 8, ENVIRONMENTAL PROTECTION NOV 18 IMi DATE:djjg4,Qt 1q, IqRECEIVED U PWS 1-0.6,2t,5289 To Whom it May Concern: Accordiqg to records on file in this office the kjjkfY(,M, Water System is in compliance with the State Drinking Water Regulations Sincerely, qajWj, Aj&tk, MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEATUI DEPARTMENT OF HEA,'IT-I AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEAVITI AIMIORITY APPROVAL, CERTIFICATE 1. Gemra1Information (a) Legal Loscrip. xon ( inc u 10 lot, blQgkf Location (address or directions) (b) Applicants Naas Applicants Address Application Date 0/// CIelx C/ vision, section, township, range) 110 (c) Applicant is (check ore) Landing Institution Owner/builder ; Buyer ; Other 1= = (explain); (d) Landing institution___ _ _ Telephone Address (e) Ictal Estate Co. & Agent _ `,�/1 C. G� 4"'L. Address Telephone 2 . Typ.. of Pe s ide nc e Single®Family Multi -Family Other (describe) Number of BedroaTo 3. Water 5upPLv ,Individual Fbll C. I Community F-1 Public Note. If carmiani.ty well system, must have written confirmation from the State Dppartmnt of Environwntal Conservation attesting to the legality and status. 'Is the well adequate for the number of tndrocxns specified in this HAA 4. Sewage Disposal OnsiteT --ft Public COMAni.ty T Holding Tank Is the wastewater disposal system adequate for the number of lxadrocros 44— (Page (Page 1 of 21 2--15--84 5. Encinearing Firm Providing Inspections, Sts, Data and Information I certify that I have checked, verified, or conformed to all YOA HAA Guidelines in effect on the d to of this,;ns ction. Signed �1� � Date Name of Firm a' As `It Address Signed by r Date (ENGINEER SEAL) o.DHEP Approval Approved for bedroom By Approved ��1T Disapproved r conditional Terms of Conditional Approval ofa� /t.rf1 ili N/oo»e la. OB69iTi• .I 'N l ir? A, O'Na sr eP � pos MO. 1457.0 4 Date The Municipality of Anchorage Department of Health and Environmental Protection does not guarantee the continued satisfactory performance of the water supply and/or the wastewater disposal system. 'Ehis approval indicates that, as of the, validation date shown above, based on the data and information furnished by an engineer registered in the State of Alaska, the water supply and wastewater disposal system is safe and funs- tional for the number of bedrooms and type of structure indicated. (DHEP SFAL) "i. Mail the HAA to the fol..owi.rg address; KB2/d5/s [Page 2 of 21 2-15-84 MUNICINWTY OF ANCHOP,AG( MUNICIPALITY OF ANCHORAGE (MOA) mP'f. OF HEALTH & HEALTH AUTHORITY APPROVAL (HAA) ENVIRONMENTAL PROTECTION,' CHECKLIST - FEBRUARY 1984 J U [ I '1 -,8 11, A. WELL DATA C I V D, Well Classification L -/C_ If. A, B. or C, D.E.C. Approved y�N) Well Log Present (Y/N) Date Completed Yield Total Depth Cased to Depth of Grouting �® Static Water Level Pump Set At Casing Height Above Ground Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot /' ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot ; On Adjoining Lots To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole Water Sample Collected By Water Sample Test Results Comments B. SEPTIC/ TANK ARTA To Nearest Sewer Service Line on Lot Date Date Installed 7'-CGl - Size /� .� "�� No. of Compartments � r Standpipes'6*) Air -tight Caps <� Foundation Cleanout ff%N) Depression over Tank (Y&I Date Last P d /V(" `I Y= Pumping/Maintenanoe Contract on File (Y ) ; for Holding Tank High -Water Alarm (Y/10 Temporary Holding Tank Permit (YIN) Separation Distances from Septic/He1-dtnq Tank: To Water -Supply Nbll 3L C To Building Foundation r To Property Line � To Disposal Field .5� To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course _A11A Comments P tit '0/11" 1442 c!Si' (Page 1 of 21 2--1584 C. ABSORPTION FIELD DATA .,//, Soils Rating in Absorption Strata ] y /%t Aye; Type of System Design Date Installed �� 7� �> Length of Field 37 / Width of Field 3� �' Depth of Field 12,1 Gravel Bed Thickness q6 Square Feet of Absorption Area '7Z Standpipes Present CV'N) Depression over Field (Y/9 -D Dae of Last Adequacy Test A1C -"-J Results of Last Adequacy 'lest �/'')- Separation Distance from Absorption Field: To Water -Supply Wb11 & /c To Property Line �� l To Building �Fo% dation 'Z� 1 { To Existing or Abandoned System cn "� Lot I , On Adjoining Lots 30 /-/- To Water Main/Service Line 14 To Cutbank(if resent) To Stream/Pond/Lake/or Major Drainage Course IV IA To Driveway, Parking Area, or Vehicle Storage Area Comments /-/-000 -4/y ol'a /yz-)r. s5� D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes Comments Dimensions Manhole/Access (YM) ",Pump Off" Level at —Vent (YM) during Adequacy Test. Meets MOA ** Check Permitted Bedrocm Rating Against HAA Request ** I certify that I ha e checked, verified, or conformed to all MOA HAA Guidelines in effect on the date P thi p n. Signed � ' Date A, v Icor Company ;; 1, 196), MOA No. KB1/d5/s [Page 2 of 21 AV '.. 1437-4 A �Fp �H '• w!�lV��gp: 2-15-84 in SOUTHCENTRAL REGIONAL OFFICE 437 "E" STREET, SUITE 200 ANCHORAGE., ALASKA 99501 PWS I . D. ;# To Whom It May Concorn: BILL SHEFFIELD, GOVERNOR Telephone: (907) Address: 274-2533 According to records on f610 in this office -the �DLP� �ZZIt\)IJ Water System is in compliance. with the State Drinking Water Regulations. Sincerely,