Loading...
HomeMy WebLinkAboutHYLEN CREST #1 BLK 3 LT 6Hylen Crest Block 3 Lot 6 #050-474-02 Municipality of Anchorage Page / Of Z DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 i Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: __ SW 920132 PID Number: 056`111"k-07, Name: 121VCe Wastewater System: New ❑ Upgrade Address: 1P0 fox y/y07 /lniCH 9a/� ABSORPTION FIELD Phone: L -s' /J No. of Booms: O Deep Trench (Shallow Trench EJ Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soll Rating: Total Depth from orig inal grade: • GPD/Sq. Ft. Lot: Block: Subdivision: G /' Depth to pipe bottom from original grade: Gravel depth beneath ipe -3 YYG4W LrdGS% /,S Ft. Ft. Township:/`/ Range: / Section: W Fill added above original grade: Gravel length: F Ft. Fl. WELL: ❑ New , ,❑ Upgrade 7�/STiIl. 1', Gravel depth: yV/P r4Y ` - Number of lines: Distance between lines: �., Ft. / I U FL Classification (Private, A,B,C): 7U Total Depth: Cased To:- Total absorption area: % Pipe material, `, ,f /1,� G J.— Ft. FL .560 SQ. Ft. 'ri J J l /� 57 Driller: !- / Date Drilled: Sialic Water Level: Installer: Date instal ed: - Ft. 6- Yield: Yield: -Pump Set at; Casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCESSeptic 11 Holding ❑ S.T.E.P. To Septic Absorption Lift Holding PubffuWrlvale Manufacturer: Capacity In gallons, From Tank Field Station Tank Sewer Lines fj NChe�et Well t-uo/ 1-doo /V//f 1,11A 4100' Material: ZT�r4 N umer o: b f Compartments Surface Water /� IA �// � /',/ A �//� /'/%.�1 LIFT STATION•-•-®"`� Lotv Line Sri C /D ///A 1111 r / S Size in gallons: Manufacturer: Foundation c� v v r /� �, % / A / f �/ ' ^ °Pump on" level at: mp off' level at: High water alarm at: / ! f4 Curtain 1/// A j'Y/ ,I f ^ /","/11 1%/1 Pump Make 8, el Electrical Inspections performed by: Drain I /i,//I 1"1114 Remarks: BENCH MARK 35P51 3041AI- ro A/ -I ov " "7—(-)12 Location and Description: r,11� i�e�y & rl C4 la 1LlNCS T%l/✓!T Assumed Elevation: !!`` /00' V ENGINEER'S SEAL Inspections performed by: Dates: 1st 06 ; 2nd 0� 0 9 Department of Health nerv' approval r Reviewed and approved by: Date.1�'��l/// •5 tl/U II MVA eO Permit No. __5W 92 0/3 Z Page 0- of -4- Municipality 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: H%i-GN o4c5T w/, GOT &,, OLK 3 PID No.: U50-475 -OZ GX • MONITOR TUBE )/9 o — SEWER CLEANOUT IJ/J Q WELL — — EASEMENT' TOP OF WATER KEY BOX ELEVATIONS V ASSUMED ELEV = 100.00' (NOT TO SCALE) ENGINEER'S SEAL GROUND LEVEL TRENCH 01 @ 98.5' GROUND LEVEL TRENCH 412 @ 98.5' GROUND LEVEL TEST HOLE 2 @ 97.5' / B. 2' 35 PSIr3 INSULATION 1x. TANK TRENCH 41 EAST 96:5' 97.2' 96.9' WEST 96.5' TRENCH k2 EAST 96.4' GWT @ 89.5' ' WEST 96,4' 87.5' FIELD 72-013 A (2/91) MOA 25 SCALE: 1"=40' SWING TIES \� A -F=143' L ❑ T A -G=38.8' A -H=43.2' D10O�� N A -J=56 3' A -K=72.9' 13-F=18.5' B -E=15.9' P B -G=19.6' �(Vy ^, B -H=15.4' B -J 31.6' B -K=40.2' A \ C -F=41.2' - n�OJ C -E=37.9' `` C -G=38.1' C -H=28.6' 1250 GAL F TANK E C -J=37.7' - C -K=21.9' O Ln E 5 \ \� c Xe4'C \�\F 0 H o 10, 5'k40, KEY BOX J \/ N e2027'171 W 72,67 10' \ L❑❑N CIRCLE GX • MONITOR TUBE )/9 o — SEWER CLEANOUT IJ/J Q WELL — — EASEMENT' TOP OF WATER KEY BOX ELEVATIONS V ASSUMED ELEV = 100.00' (NOT TO SCALE) ENGINEER'S SEAL GROUND LEVEL TRENCH 01 @ 98.5' GROUND LEVEL TRENCH 412 @ 98.5' GROUND LEVEL TEST HOLE 2 @ 97.5' / B. 2' 35 PSIr3 INSULATION 1x. TANK TRENCH 41 EAST 96:5' 97.2' 96.9' WEST 96.5' TRENCH k2 EAST 96.4' GWT @ 89.5' ' WEST 96,4' 87.5' FIELD 72-013 A (2/91) MOA 25 PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE 2•mmsf/ ?-Pv`g2 DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW920132 DATE ISSUED: 6/16/92 DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES EXPIRATION DATE: 6/16/93 OWNER NAME:EAGLE RIVER VALLEY DEV OWNER ADDRESS:P.O. BOX 141907 ANCHORAGE AK 99514 PARCEL ID:05047402 LEGAL DESCRIPTION: HYLEN CREST #1 BLK 3 LT 6 LOT SIZE: 20032 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ISSUED BY: 3044\! SI -1 DATE: DATE: //g c] Z HE& RAl7/QT EnsluoQ�'IluP �Sennkloz Louis Butera, P.E. Registered Civil Engineer June 4, 1992 John Smith, P.E. Manager, On -Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Hylen Crest #1, Lot 6, Block 3 Narrative Dear Mr. Smith: The proposed septic upgrade will have very limited impact on adjacent properties for the following reasons: 1. The area has large lots allowing sufficient room for septic sites. 2. Immediate neighboring septic systems are all +30' distance. 3. Reserve space is adequate, due to community well system. 4. Drainage will not be effected and is not a major consideration in our design. If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. P.O. Box 773294 • Eagle River, Alaska 99577 • Telephone (907) 694-5195 • fax (M) 694-3297 EAGLE RIVER JOB Hylen Crest #1, Lot 6 Blk 3 92-060 ENGINEERING SERVICES SHEET NO. OF P. 0. Box 773294 EAGLE RIVER, ALASKA 99577 CALCULATED 8V— I. . B • DATE 06/04192 Phone 694-5195 CHECKED BY DATE SCALE Calculations for four beciroom system 4 bedroom 6.00 GPD I Percolation :rate = 2.2 nein/inch Soil rating 1.2 GPD/ftz (Drainfield) 600/1.2 5:00 square feet Dramfield Dimensions: Gravel depth .= 2.5' Length W 64' Width = 5' .. �a n�. i�rdA� a n. o. -..... °•.i � q W, -i A. ;Terri Gt �' i CE -6736 • AV PKVM fiN/SDs I.. Wm. Nin 01111. SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM LEGAL: LOT 6, BLOCK 3, HYLEN CREST #1 A. GENERAL 1. The well and septic plan are for a single family residence only. 2. The drawing and or site plan shall be a part of this specification. 3. All materials and workmanship shall meet the Anchorage Department of Health and State Department of Environmental Conservation requirements. 4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer. 5. All excavations and depths are advisory and are to be verified or modified in the field by the contractor to meet Municipality of Anchorage, Department of Environmental Conservation requirements. 6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi -family wells. 7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. 8. It is always recommended that a surveyor locate the nearest lot line position and the location of any easements. B. DRAINFIELD 1. The drainfield is to follow the natural land contour to maintain uniform total depth of the drainfield bottom. 2. The bottom of the drainfield shall be level, plus or minus 1.5". 3. The total depth of the drainfield excavation is not to exceed 4' at any point. 4. The drainfield gravel is to be covered with typar fabric material. 5. Soil or combination of soil and extruded board insulation to a depth of 3' or equivalent is to be placed over the leachfield. 6. The area over the drainfield is to be finish graded to prevent ponding of surface water runoff. 7. The septic tank and leachfield must not be closer than 100' to any existing private well, 150' to any Class "C" well, or 200 feet to any community well. RECOMMENDED LEACHFIELD DIMENSIONS: TOTAL DEPTH = 4' GRAVEL DEPTH = 2.5' DRAINMELD LENGTH = 64' DRAINFIELD WIDTH = 5' SOIL RATING = 1.2 GPD/ft2 BEDROOM CAPACITY = 4 SEPTIC TANK SIZE = 1,250 Insulate with 2" 35 PSI burial foam. Twenty-four (24) hours notice required for all inspections. (ENGINEER'S SEAL) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION PEST PERFORMED FOR: �45�� ^I''�� li1PvF�gU/*rr.�t 14LIS DATE PERFORMED: •�/'z `�� LEGAL DESCRIPTION:A/" '-asf L!t 4161 3 Township, Range, Section: 7-1 /.v ,e/ 4.1 -r6-,, � N SLOPE SITE PLAN 1 2 3 O ' O 4 5 6 - 7 8- 9 10 11 12 13 14 15 16 17 18 19 r6l- Jo r/ — Ory 4,f'c (6 P) n 1 -o C CGY"� s, 1/3 Grr- //,f4 rGNuI �N CNI WAS GROUND WATER m�/rt ENCOUNTERED? N o 5ecp'.)e ._+ 8//etet/ I -)'d IF YES, AT WHAT no+- slow i..1 DEPTH? 0oou ooyya4p DaD�anocoo.:Y se"lroe V�/J yjpC `� �yY�Oo�pC�nYIP^.P CP 4lY!'°i� {% LryeiE A, BV40 rrs 51 Depth to Water CE�736 .`.i .°° a'- a'16 e7 Depth to Water Alter / Monllorhtll? f 70 Date: S L O P E L Reading Data Gross Time Net Time Depth to Water Net Drop a'- a'16 e7 z '• y. yr /. -J —J. PERCOLATION RAT E 6 (minutes/inch) PERC HOLE DIAMETER b TEST RUN BETWEEN FT AND 3 —FT COMMENTS %FSI PERFORMED BY: E'er' S' I _�CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-OOB (Rev. 4/85) (ENGINEER'S SEAL) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES R 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: 57 /' 1(',''er QP�P/q/t /Z77154- DATE PERFORMED: LEGAL DESCRIPTION: z&/" e-^Jf 2.7'6/Q/k3 Township, Range, Section: T/yrY /e//nlJ•Ec — SLOPE SITE PLAN rte 1�1- , 1 2 3 4- 5 6 7 ; 8 ` 9- 10 F 11 - 12 - 13 14 15 16 17 18 19 20 7G'01- . ri / / - '54" S'/� - sw) 5a" S/�-sw) SaN�P /-'iyQri� I. (S m S/� eeeeeneneeeaaa.. " �... Louis A. Butores sv CE -6796 � r; 'hraa.Nos' ?ROFES910�.,,t�' COMMENTS rfE- WAS GROUND WAFER ENCOUNTERED? ytS S L IF YES, AT WHAT i O DEPTH? P E Bepih to Water Alter, ' Monitoring? li9 Bale: K Reading Date Gross Time Net Time Depth to Water Net Drop SO4 Pf S a y 0 s_ ,_ S - PERCOLATION RATE 'Z' a (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN s FT AND —FT PERFORMED BY: E'er'/" s' I "�''�'� CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: —�� 1-D- — 72-008 (Rev. 4/85) (ENGINEER'S SEAL) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: 4u57/e lei � iDPr,F/rjp/+�e�t' //`RSA+' 4le"lh,cJ DATE PERFORMED: • LEGAL DESCRIPTION: ale, lr^f� �/ L•t 6/Qik ? Township, Range, Section: 7-1 y,v ,e/ TH 3 SLOPE II SITE PLAN [7/ X7�' 11 12 13 14 15 Q 16- 17 18- 19- 20- COMMENTS 81920 COMMENTS sr Sc.,..{ 15 .,,e( Cs cy rS.owN S Sr7 1i •..c(� G✓/)r.✓cl lei DO 00Dp�,t0GN1,D°°Y °D°owoC-"' a'tr: Louis A. Butera E' CE -6736 Q,O {C` °000 e. °a °°D°°• ��iaw yR ©�'OROFESSI�N_� WAS GROUND WATER ENCOUNTERED? �h J IF YES, AT WHAT & i DEPTH? _. Depth to Water Alter Monitoring? - P,r Dale: Fq NNINNOMMIN , n1e, Reading Date Gross Time Net Time Depth to Net Water Drop SOq/'r S p ..Z • 7: q 1 rr ��G 9/i6 F//6 e 3 7;sr 41 //1,' 07 s//C S/6' rt� PERCOLATION RAI E 3-1 (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN 3 FT AND FT PERFORMED BY: E'�'�� ' s I � ^ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: - 72 -008 (Rev. 41851 LOT 3 SEPTIC 1-30' LUT 2 SEPTIC +30' ti 1250 TANK L❑T I �J LOT 6 L ❑ T 4 r 50'x24' CD CD Ln TF® 5'x24• -0 � REPL. AREA O bd�TLIJ VACANT LOT NO KNOWN CURTAIN DRAINS N 82427 172, '17 W LOT 5 ECI< HOUSE LOT 7 N o� VACANT LOT EXISTIN"111 LEACH FIELD 6' GRAVEL DEP\tN 1 KEY BOX LO❑N CIRCLE ® – -TEST HOLE • – MONITOR TUBE o – SEWER CLEANOUT ¢ – WELL +1+1+1+H+– PROPOSED LEACHFIELD — — – EASEMENT SEPTIC SITE PLAN LEGAL: LOT 6 BLOCK 3 HYLEN CREST #1 OWNER: EAGLE VENTURES,�J`t''y*, CONTRACTOR: EAGLE VENTURES JOB # 92-060 DATE: 05/15/921 SCALE 1" = 50' EAGLE RIVER ENGINEERING SERVICES' P.O. Box 773294 EAGLE RIVER, AK. 99577 (907) 694-5995 FAX: (907) 694-3297 GRAIN,SIZE DISTRIBUTION TEST REPORT C C C\ C O O o O O o R O 100 \ \ o ry v N 90 80 70 Lu H 60 LL z 50 w U 40 a 30 20 10 0 200 100 10.0 1.0 0.1 0.01 0.001 GRAIN SIZE — mm % +75mm % GRAVEL % SAND % SILT % CLAY • 0.0 7.3 92.1 1 0.6 LL PI D85 D60 D50 D30 D15 D10 Cc Cu 0 N/A NP 2.34 0.88 0.67 0.414 0.2738 0.2252 0.87 3.9 MATERIAL DESCRIPTION USCS AASHTO • POORLY GRADED SAND SP A -1--b Project No.: 92-060 Remarks: Project: N/A • Location: HYLEN CREST T.H.2 LOT 6 BLK 3 .$E/✓ar a� f'E,¢G, NOtE /JOq G�±/e7L Date: 6/11/92 GRAIN SIZE DISTRIBUTION TEST REPORT EAGLE RIVER ENGINEERING Figure No. 1 GRAIN SIZE DISTRIBUTION TEST DATA Test No.. 1 ---------------------------------------------------------I---------------------- Date:" 6/11/92 Project No.: 92-060 Projecti N/A Sample Data Location of Sample: HYLEN CREST T.H.2 LOT 6 BLK 3 Sample Description: POORLY GRADED SAND USCS Class: SP Liquid limit: N/A AASHTO Class: A -1-b Plasticity index: NP Notes Remarks: &W.9. m ® se,v�- Orl� )aorc 1-f.4` Fig. No.: 1 -------------------------------------------------------------------------------- Mechanical Analysis Data --------------------------------------------------------------------------------- Initial Dry sample and tare= 1152.20 Tare = 271.60 Dry sample weight = 880.60 Tare for cumulative weight retained= 271.6 Sieve Cumul. Wt. Percent retained finer # 4 335.70 92.7 # 10 428.50 82.2 # 20 637.50 58.4 # 40 884.60 30.4 # 60 1043.80 12.3 # 100 1118.90 3.8 # 200 1147.00 0.6 ------------------•-------------------------------------------------------------- Fractional Components --•------------------------------------------------------------------------------ % + 3 in. = 0.0 % GRAVEL = 7.3 % SAND = 92.1 % FINES = 0.6 D85= 2.34 D60= 0.876 D50= 0.672 D30= 0.4145 D15= 0.27384 D10= 0.22516 Cc = 0.8710 Cu 3.8905 Municipality of Anchorage Development Services Department Building Safety Division +• On -Site Water & Wastewater Program n 4700 Bragaw Street P.O. Box 196650 211 Anchorage. AK 99519-6650 f 4nY www.muni.org/onsite �L u (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 1)50 - Ll qq-DP COSH# 1. GENERAL INFORMATION Expiration Date: A-1-7 — 08 - Complete 8 Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address HYLEN CREST 01 LOT 6 BLOCK 3 10118 LOON CIRCLE • EAGLE RNER AK 99577 GUST PANOS Day phone 301-8972 10118 LOON CIRCLE * EAGLE RIVER AK 99577 Day phone KATHI OLMESTEAD w%REMAX Day phone 244=8020 16600 CENTERFIELD DR. * EAGLE RIVER AK 99577 Unless otherwise requested, COSA 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 a ❑ 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 On -Site Systems Approval (COSA) based only upon the representations given In paragraph 4 by an independent professional civil engineer registered In the State of Alaska. Certificates of On -Site Systems 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 COSAs upon request to homeowners. Certificates of On -Site Systems 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 engineers work. 4. 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 watersupply 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 riles and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 337-6179 Engineers Printed Name JEFFREY A. GARNESS, P.E. Date 8 b 0,10 Engineers Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines 6 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 alf wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and Me 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. GEG, LTD. 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 solo 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. S. DSD SIGNATURE Approved for _-V bedrooms. Disapproved. Conditional approval for bedrooms, with the fllowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineers Reort Other ffAJorn s.- ON-SITE WATER AND WASTEWATER �•,. PROGRAM ; By: Original Certificate Date: 17 — 0 7 fP.v 111151 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water 8 Wastewater Program 4700 Bragaw Street P.O. Box 196850 Anchorage, AK 995196650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: HYLEN CREST 111, LOT 6. BLOCK 3 Parcel ID:050 — 4 7 3� —0-2 A. WELL DATA Well type PUSUC If A, B, or C provide PWSID# _ Date completed Sanitary seal (Y/N)_ Total depth ft. Date of test static water level Cased to FROM WELL LOG Q ft. WATER SAMPLE RESU Coliform coloniesN00 ml. Nitrate mg./L. ug /L. Date of sample: _ B. SEPTIC/HOLDING TANK DATA Well Log Wires properly protected Casing height (at gnwnd) in. AT Other bacteria colonies/100 mi. Collected by: Tank Type/Matedal SEPTIC/STEEL Data installed 7/6/1992 Tank size 1250 gal. Number of Compartments E Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping 8/10/2007 Pumper JRS C. ABSORPTION FIELD DATA NORTH TRENCH/SOUTH TRENCH Date InsWfled 7/6/1992 Soil rating .p.d or ftlWrm) 1_2 System type SHALLOW TRENCH Length 24/40 ft. Width 5/5 ft. Gravel below pipe 2.5/2.5 ft. Total depth +S. 5"7 ft. Eft. absorption area 500 fe Monitoring tube YES Depression over field NO Date of adequacy test 8/7/2007 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test **5 in. Water added 600 gal. New depth 110 in. Elapsed Time: 1120 min. Final fluid depth 5_5 In. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N 3 type) NONE KNOWN If yes, give date **TEST SOUTH TRENCH NOTE: 17 INCHES OF LIQUID IN NORTH TRENCH D. LIFT STATION Date installed "Pump on" level at —in. E. SEPARATION DISTANCES Size in gallons Manhole/Access (YIN "Pump off" I Hlgh water alarm level at in. Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAiR station on lot Absorption field on lot Public sewer main Sewer /septic areas PUBLIC WATER On adjacent On adjacent sewer manhole/cleanout Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 25'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 200'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 25'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 2006+ F. COMMENTS G. ENGINEER'S CERTIFICATION 4 V I certlly that I have determined through field inspections and +T90,6, review of Municipal records that the above systems are in"conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS dryp',U�'fDate B/Io�07 ` COSA Fee S y U. O 0 Date of Payment 11 5 1 0 7 Receipt Number -,17- 7 (re. >>as) Waiver Fee $ Date of Payment Receipt Number LOT.. I a Ifa�uo Th� 4rre- CTlrw�� ts' CL97-Tr"G Ttdi.V 7 0%m, PLOT pLAX AS BIIJLT X SCALEt+°� G2ID"S7 JOB No !4 L 1731 Gaarl a Batt Ci•<la 08 Lamm a 1 I.•a1T ow dfy that na a .T.d Ha (pU i.q d mKWd F.wq: .: 6 �:.li q f 3 Hvuz.+ t•KSr su iu�� i tluir N i Q" S 1 ew U.o2aC.! Aaoralaq ItLo4n. ♦Waa. d tact taa lrpnramaav elmn.d taus ua 0 y ••.�j .'f' Int" Ha P qJ m D.b d L Nt a ae h wr taa p.PLM W j..t th.rab. Hat a. V.�.e.w.aa w H. Tt'T•••71TlM .dj.rat Harar asewra w ta..s..lad Trami....sd /... ... ..1,. ta.t .+...... r nsawl•. ►wvtw:.a LL.0 ...Hr ri.lal..ua.ban ....LL T^M�q % sem'.. S� aav*t.. latteaW l..ta �.••• �•l-'f]�, h V Ha rupulalltry d Ha acv b 4tvmiaa Ha asfwta of uT ai.emmo, u•aaaau, ar wvistim..hka 4..t fvlsar ., Ha r•e.rl.d t.hdl•f.i.. pl.t. ,+,1 "''t'abttA�� tata�r••� MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 0 SO —N7q-0 o- HAA# 1. GENERAL INFORMATION Complete legal description Lot 6; Btock 3; Hy.Cen Cues, #1 Location (site address or directions) 10118 Loon C.Lnc2.e Property owner Mit. Kim Etta'cd Day phone 696-1613 Mailing address 10118 Loon C.CneZe Eagte R.ive%, AK 99577 Lending agency Day phone Mailing address Agent Lohi Cn.ou6e/ REMAX OF EAGLE RIVER Day phone 694-4200 Address 16600 CEntenh.ietd Drive -. Eag.Ce R.iveA, AK 99577 Unless otherwise requested, HAA ill'be held for pickup. 2. NUMBER OF BEDROOMS: v 3. TYPE OF WATER SUPPLY: Individual well Community well ,I Public water 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: - 72-025(Rev. 1/91) Front MOA#21 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 furtherverify 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 17034 Engle River Loop Road No. 204 Address Eagle Riv9r„Alaskr99577 / Engineer's signature DHHS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for Additional Comments By: 4t1TIC Date It 41-- / c7V C OF r .... ..... ..... ... 1 ROBERT C. COWAN F c;- Gj'•� CE -8801 1ttV0 Pn'OF'E5S10����4: bedrooms, with the following stipulations: Date 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 orderto 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-M (Rey. 1/91) Back MOA 821 - Municipality of Anchorage AL Mam Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: `--o-r CP e>01- ,� L i C40(Parcel I.D. U S-0 .-Y-7 9-0 A. Well Data Well type L- If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Total depth Sanitary seal (Y/N) Date of test Static water level Date completed Cased to FROM WELL LOG Driller Casing height Wires properly protected (Y/N) AT INSPFC`TION Well flow g.p.m. Pump levell SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line WATER SAMP,L'E RESULTS: Coliforgv Nitrate of sample: On adjacent lots ; On adjacent lots Public sewer manhole/cleanout tank Collected by: Other bacteria E3. SEPTIC/HOLDING TANK DATA Date installed to - 9 Z 1 Tank size I ZSo \V/ Compartments v ,V Cleanouts(dk Foundation cleanout a) ,Depressionl( (Ql High water alarm (yo. Alarm tested (Y/N) �\A Date of pumping _ JC/y� 9� _Pumper Ir/Fo0L SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot '`�`� On adjacent lots `l/ Foundation 9 To property line S_7- / Absorption field Water main/service line / o 4 - Surface water/drainage 72-026(3M)•Front CONTINUED ON BACK PAGE fit o z c J n ,��'d y e ' Y m D r r. 0 7T T 70 v o z—_ Public sewer manhole/cleanout tank Collected by: Other bacteria E3. SEPTIC/HOLDING TANK DATA Date installed to - 9 Z 1 Tank size I ZSo \V/ Compartments v ,V Cleanouts(dk Foundation cleanout a) ,Depressionl( (Ql High water alarm (yo. Alarm tested (Y/N) �\A Date of pumping _ JC/y� 9� _Pumper Ir/Fo0L SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot '`�`� On adjacent lots `l/ Foundation 9 To property line S_7- / Absorption field Water main/service line / o 4 - Surface water/drainage 72-026(3M)•Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons Manhole/Access (Y/N) Vent (Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (YIN) SEPARATION DIST D. ABSORPTION FIELD DATA LIFT STATION TO: On adjacent lots "Pump off" Surface water Date installed %- 6, - 92 Soil rating (GPD/Ft) _System type S -/4 -4 -c -a wt Length 6 4 Width Gravel thickness 2-,S-- Total depth 5/ J' Total absorption area 5'-b o 0 Cleanout present CON) �_ Depression over field (Y/ice Date of adequacy test /! / o - 9 '7 Results �s�s ail) ��ss for -/ Bedrooms Water level in absorption field before test C) a After test Y Peroxide treatment (past 12 months) (lz,�6�../,J If yes, give date '`// SEPARATION DISTANCE FROM ABSORPTION FIELD TO: N / ' �� Pro e line /0/11 - Well o � Well on lot .r On adjacent lots P rty To building foundation to To existing or abandoned system on lot On adjacent lots 7-a ` Cutbank A/,a- Water main/service line /d / Surface water /a o c Driveway, parking/vehicle storage area / Curtain drain E. ENGINEER'S CERTIFICATION 1 certify that 1 have checked, verified, or conformed to all MOA and HAA guidelines in effect on tplp date of this inspection. Signature /� `.�� Y>•.,.<:< Engineer's Name A 13 ROURT C. cow N ^�,^ ,� Date cl.-801 % �r HAA Fee $ 300- DD Waiver Fee $ _ Date of Payment �J �/ �7 J Date of Payment Receipt Number. Receipt Number. 72.026 (3/93)' Back Parcel I.D. # MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES M} i Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 050-474-02 HAA# HA920610 1. GENERAL INFORMATION Complete legal description Lot 6 Block 3 Hylen Crest Subdivision #1 Location (site address or directions) 10136 Loon Circle, Eagle River 99577 Property owner Eagle River Valley DevelopmentDay phone 696-5534 Mailing address PO Box 141907, Eagle River, Alaska 99577 Lending agency Day phone Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water four (4) 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 XXXX x Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 Rev, 1/91) Front MOA 021 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I furtherverify 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 Eagle River Engineering Services Phone Address PO Box 773294, Eagle River Alaska 99577 Engineer's signature This is to replace a Certificate that has been misplaced. The original copy is on file with the DHHS, On-site Services Section office. If there are any questions, please call 343-4329. Laura 6. DHHS SIGNATURE xxxxx Approved for four (4) bedrooms. Disapproved. Conditional approval for Additional Comments 'fink,, Date 694-5195 bedrooms, with the following stipulations: Date Sept 24, 1992 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 421 MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 050-474-02 \ HAA # 1. GENERAL INFORMATION Complete legal description Hylen Crest #1, Lot 6, Block 3 T14N R1W Section 8 Location (site address or directions) 10136 Loon Circle, Eagle River Property owner Eagle River Valley Development Day phone 696-5534 Mailing address 2-0- Box 141907 Anchorage, AK 99514 Lending agency N/A Day phone Mailing address Agent N/A Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual well Community well Public water X 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 X Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1191) From MOA 1121 0 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I furtherverify 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 Eagle River Engineering Services phone Address P.O. Box 773294, Eagle River, AK 99577 Engineer's signature 6. DHHS SIGNATURE Approved for u � bedrooms. Disapproved. Conditional approval for Additional Comments In 694-5195 Date bedrooms, with the following stipulations: Date 1�1l� 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 orderto 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 021 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Cls Legal Description: dyl-LV UC6CS *Z 1-0-r&. & k 3 Parcel I.D. 050 -741 -02— A. WELL DATA Well type PU30C, If A, B, or C, attach ADEC letter. ADEC water system number Log present(Y/N) Total depth Sanitary seal (Y/N) Date of test Static water level Well flow Pump level Date completed Cased to FROM WELL LOG SEPARATION DISTANCES FROM WFCL TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service lin WATER SAMPLE RESULTS: Col of sample: B. SEPTIC/FKX-B4*G TANK DATA Nitrate Dri Casing Wires properly protect (Y/N) r„ T INSPECTION p n M y 7 �I !V c � D .p.m. g•p. r 6 D M _N O rn :L ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank Collected by: Other bacteria Date installed Tank size / 2 5(' Compartments 71 Cleanouts (Y/N) YES — Foundation cleanout (Y/N) YCs J . Depression (Y/N) No High water alarm (Y/N) __yVI k Alarm tested (Y/N) Date of pumping At 1,4 NrGJ Pumper SEPARATION DISTANCES FROM SEPTICAi@t�I TANK TO: NIA 0 Well(s) on lot N!,4 On adjacent lots ZED Foundation To property line 21 Absorption field—/5 Water main/service line Surface water/drainage IVA 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent(Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y Manufacturer Manhole/Acc�1-(Y/N) SEPARATION DI§TT-,'kNCE FROM LIFT STATION TO: Well D. ABSORPTION FIELD DATA On adjacent lots "Pump off" level at Cycles tested Surface water _ Date installed ��%?�`�� Soil rating System type SNAU OW r26NCll Length CDS Width Gravel thickness 2 5 Total depth 1Y y Total absorption area 50(,) lel Cleanouts present (Y/N) % S Depression over field (Y/N) NO Date of adequacy test /V C- to Results (pass/fail) IDA s S for te" ' — bedrooms Peroxide treatment (past 12 months) (Y/N) N//I If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: J Well on lot A(I M On adjacent lots ZUD Property line 16.1 J To building foundation 5 To existing or abandoned system on lot J'V./1 On adjacent lots �4 So Cutbank AJ /l Water main/service line _ J Surface water /�/ A Driveway, parking/vehicle storage area Zo Curtain drain 1A E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and MAA guidelines in effect on the date of this inspection. Signature Engineer's Name'" Date/Gl HAA Fee $ (� Waiver Fee: $ Date of Payment % �� - 1Z- v Date of Payment Receipt Number �/�rf'"y Receipt Number 72-026 (Rev. 3/91) Back MOA 21