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Home My WebLink AboutEAGLE VISTA BLK 2 LT 1 ,s04,,,_,,,,,,_,!:,,,, MUNICIPALITY OF ANCHORAGE foent On-Site Water&Wastewater ProgramNo s;i PO Box 196650 4700 Elmore Road Anchorage.Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 http://www.muni.org/onsite 1)111K1111114:111 4h,MOFoE On-Site Water System Permit Permit Number: OSP171249 Effective Date: 8/24/2017 Work Type: Well None Expiration Date: 8/24/2018 Tax Code Number: 05071113000 Site Legal Address: EAGLE VISTA BLK 2 LT 1 G:0805 Site Mailing Address: 32035 EAGLE VISTA DR, Eagle River Owner: KOCH FAMILY TRUST Lot Size in Sq Ft: 125261 Design Engineer: Total Bedrooms: 3 This permit is for the construction of: ❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy 0 Private Well El Water Storage All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing 4, ' i7 Received By: _ � Date: Issued By: /v No Date: .—Y7 ELL5,01 r\,i U ''1CilPALHTY OF {�' NICH F•. ACS Community Development Department '� ,--- ` „; 0MrQUII43= 04 Development Services Division IFr F x: 907-343- -•Dr On-Site Water & Wastewater Program 3 2011 ON-SITE SEWER/WELL PERMIT APPLICATI•�6 �'� ti Parcel I.D. 050 W//Z Property owner(s) a L ()Q YN Day phone ' X53 Mailing address 3'D.,0 E-. p__, v 01/4-„kcv c , cc �,�:\)e..r Ag..ctc-ts-4 Site address ,c). 6tg_ ti, k -� c_p_..N`i--:tog..„ At--,SIG59-3 Legal description (Sub'd., Block & Lot) \e,. v ' ke . o\\L_ \ I Legal description (Township, Range & Section) Lot Size nata(ca Sq. Ft. Number of Bedrooms j APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) ❑ (w/wo ADU) Septic Tank ❑ Upgrade ❑ Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage THIS APPLICATION INCLUDES A VARIANCE /WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. I - b-C-177 Aft@ Ark"(-, • 1X A° SIV _, (Signature of property owner or au • zed agent) Permit/Rush Fees: 03C/c Waiver Fees: Date of Payment: g1 vl 3 fR Date of Payment: Receipt Number: at # (j W,p$6$ Receipt Number: Permit No. 05''ri'fag9 Waiver No. PermitApp_9-1-12.doc i _________________ ?Li? - „,..,6 -,c,c,„.,,,,-.) ....______________... L5., )) 9.00,) 6., 7 \ '/(), 'c,0 ) 0,1 o ,,,,t, , \,‹ i ct ! , ....., ..____________________> c 71 _ _�-”- s max►c��1`e ':'.9 % r � a i �` u' j ''�r� N ' LL Sib 1 ' ')' �l '3 --2J-9-.) no9 ,Ltie-)J ,r____________ ______ ----- \ ,,„• ›2 `,\ �y Jai Nci +'": .2 �— 77f O4. . 0_ DCC:PM01982 Date:03/08/2016 NSF/ANSI Standard 61 -Drinking Water System Components - Health Effects Authorized Registered Formulation This product may require additional evaluation or testing prior to authorization for Listing.Only products included in NSF's Official Listing are NSF Certified and authorized to bear an NSF Certification Mark. Reason For Revision: W0274814-Add alternate polyethylene to PM01982/IA07948. Customer Name: Norwesco,Inc. Facility Location: Washougal,WA Customer Number: 23190 Facility At: Washougal,WA Facility Number: 23792 Trade Name(s) Function(s) Size Applicator Tanks Tanks 20-500 gal Applicator Tanks(Slim Line) Tanks 150-200 gal Below Ground Holding Tanks Tanks 2000-5100 gal Cistern Tanks. >=500 gal Cistern DL Tanks > 600 gal Cistern Sphere Tanks 250-325 gal Cistern Sphere DL Tanks >=325 gal Cone Bottom Tanks 160-10,000 gal Drainable Leg Tanks 710-3210 gal Elliptical Tanks 200-1600 gal Elliptical Leg TanksTanks 335-4035 gal 4111111- 711 1 Flat Bottom Utility Tanks 26-200 gal Horizontal Tanks 35-5025 gal Inductor Tanks Tanks 15-80 gal Loaf Tanks Tanks 50-500 gal Mini Bulk Tanks >= 120 gal PCO Tanks 30-300 gal Pickup Tanks >=210 gal Specialty Water(1000 Gallon Sphere) Tanks 1000 gal Specialty Water Tanks Tanks 250-1000 gal Specialty Water Tanks(wlSteel Frame) Tanks 375 gal Spot Sprayers Tanks 14-25 gal Total Drain Tanks 5-12 gal Tuna Can Tanks 5,000 gal Vertical Tanks 22-20,000 gal Water Hauling Tanks Tanks 1250-2400 gal Listing Notes DL=Domed Lid. Certified Tanks are White,Black.Green.or Blue. 1 This is a copy of the Authorized Registered Formulation. If you have received this ARF in hard copy,you may confirm the most current ARF by contacting your Certification Project Manager or going directly to the secured NSF Online website(http:Ocients.nsf.org)for the latest,most accurate information. Municipality of Anchorage Page of__ · DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 e' Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: t0,-~1J-~ ~ ~'~ PID Number: /~ Name: ~ ~ ~ ~ /~ Wastewater System: D New D Upgrade ~d~.,: ABSORPTION FIELD Phone: No. of B~rooms: ~eepTrench D Shallow Trench D Bed D Mound ~ Other LEGAL D ESC R I PTI O N so, Rating: ~. ~ GPD/Sq. Ft. Total Depth~from. ~°riginal grade: Lot: Block: Subdiv~ion: Depth to pi~ bottom from original grade: Gravel depth ~neath pipe Township: I Range: I S--tion: Fill added above original grade: Gravel length: ~ ~ Ft. Ft. Number of lines: Dis~nce ~n lines: WELL: ~New D Upgrade Gravel width: ~ Ft. ~ /~ Ft. Clarification (Private, A,B,C): Total Depth: Cased To: / Total absorption area: Pipe material: Driller: Date Drilled: SaticWaterLe~l: Ins~ ~~ Date Yield: Pump Set at: Casing Height Above Ground; SEPARATION DISTANCES ~s~.~c ~ Holding ~ S.T.E.P. To Septic A~o~tion L~fl Holding =ublic/Private Manufacturer: Capacity in gallons; From Tank Field Station Tank Sewer Lines ~~ WaIF ,~ ,~ ~ ~ ~ Material: ~ Number of Com~ments: su,aC~w~t~r ~/~ ~ ~ ~ ~/~ LIFT STATION Line J~'~ /~ ~ ~ >'~ ,,Pump on,, level at: ~evel at: Highwateraarma: Lot Size in gall°ns: I Manufact uror: ' t t FoundatiOnc~;a~n /~/~ ~ ~ ~ /~/~ ~ J ~td~l ~ions pe,orm~ by: Remarks: BENCH MARK Location and Description: Assumed Elevation: ~.. Inspections performed by: /~ ~ ~~YDateS:2nd/~/~lst ~/~/~M ;~.,~.L~. ~.~ Department of Healt man Se~ices approval . ~ v~,.:. ..,?.> Reviewed and approved by~ Date: / .. 72-013 (Rev. 9/91) MOA 25 Permit No. Page of Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650° Telephone 545-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description: Lot 1, Block 2, Eagle Vista Subdivision PID No,: 72-015 A (2/91) MOA 25 Permit No. Page of Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650. Telephone 545-4744 On-Site Waetewater Diapoaal Syatem and/or Well Inapection Report Legal Description: Lot 1, Block 2, Eagle Vista Subdivision 72-015 A (2/91) MOA 25 PID No.: Z : Permit No. Page of Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650° Telephone 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description: Lot 1, Block 2, Eagle Vista Subdivision PID No.: I-- O_ W 72-01,5 A (2/91) MOA 25 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE 1 OF 1 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW940185 DESIGN ENGINEER:DOUGLAS T. KENLEY, P.E. OWNER NAME:KOCH ALOYSIUS J III & SUSAN O OWNER ADDRESS:1308 EAST 27TH. ANCHORAGE, AK 99508-3918 DATE ISSUED: 6/21/94 EXPIRATION DATE: 6/21/95 PARCEL ID:05071113 LEGAL DESCRIPTION: EAGLE VISTA BLK 2 LT 1 LOT SIZE: 125261 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 (24 HOURS) 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 PROVISI~S: Douglas T. Kenley, P.E. HC01 Box 6034, Palmer, Alaska 99645 (907) 746-1073 May 18, 1994 A1 and Sue Koch Lot 1, Block 2, Eagle Vista Subdivision Eagle River, Alaska PERCOLATION TEST RESULTS AND GENERAL SITE INVESTIGATION REPORT On May 6, 1994, the above-referenced 125,261.0 square foot site was inspected in conjunction with soil perk tests being performed for application and approval for the installation of an on-site waste water disposal system. The site is located at the intersection of Prudhoe Drive arid Eagle Vista Drive in Eagle Rive~, A~aska. The system is being installed to serve a new foufZl~om home scheduled for construction in the spring of 1994. ~he:s%ptiC ~tank Will be 1,250 gallons. The site is on the east side of Prudhoe Drive with a stope~ ~a~$~i~.~~%~.~.~?~n the northeast to the southwest direction. The immediate area that has been selected The site is heavily treed Wi~h birch, spruce and alders. It appears that there are no obstructions that would prevent surface water runoff. On-site observation and physical survey shows that there are no water wells nor private waste water disposal systems within a 100' radius of the proposed system. No surface water was observed at the time of the inspection, and it appears that there is no potential for contamination of adjacent water wells or streams. Five percolation tests were taken at the site to assess the adequacy of subsurface soils to accommodate both the primary and replacement on-site waste water disposal system. The results of two tests chosen for the primary and secondary absorption trench areas are attached to this report. A1 and Sue Koch May 18, 1994 Page 2 The test site had adequate percolation rate to support the proposed four-bedroom residence. Subsurface soils were found to be silty sand with some gravel overlain by 12" of surface organics. Hard pan depths varied betweeen 7' and 9' Some seepage occurred at the 8 1/2' level in test hole number 1. No water was observed upon measuring the monitor tubes in test holes two, three, four, and five on May 18, 1994. The percolation rates for test holes four and five were found to be between 6 and 15 minutes per inch. If there should be any questions concerning the percolation rate or characteristics of the site, please call me at (907) 746-1073. Sincerely, Douglas T. Ko~ PE#8176 Perr~it No. Page ~ of ~ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Descr, pt,on: UT [ g~tJ~ '~ ~,~(, ~),~[ T PID No.: 72-013 A (1/93) * Pern~it No. Page '5 of ~ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description: 0 ~ /3 z IP-r~l. U;, ~- ,RbJ, PID No.: ............. ~.~.,.,.V.....~ .............. : ~-..~..:..~.~ .................. ,~...~:.....: ....... 1~.,: ............................. : ...................... / ~ ~;;; ::~ ..... ~ ............. Al~. : t . , .... , .:: . : , .. : 72-013 A (1/93) * Municipality o! Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: ~ ~ ~/~ ~ DATE LEGAL DESCRIPTION: Z / ~ Z ~2~ ~'/Township, Range, Section: 1 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O COMMENTS SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT ,~.[,~ OL DEPTH? p E Depth to Water Alterx..)/. Date: Monitorino? ,/*'7 . Reading Date Gross Net Depth to Net Time Time Water Drop ~ ~/'~/~.~t ,~ .~ ~ _ ~ .. _ PERCOLATION RATE ~ ' ' ~'"(minutes/mch) PERC HOLE DIAMETER TEST RUN BETWEEN ~." FT AND 9' FT ACCORDANCE WITH ALL STATE AND~UNtOIPAL GUIDELINES ,~EFFE'CT ON THIS DATE. 72-008 (Rev. 4/85) Municipalily of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: .¢. / .~"......~ ~,¢. ,,-~.---" ,..._ .-.: t"'..--/ Township, Range, Section: SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 S IF YES. AT WHAT ~.,~ ~) DEPTH? p E Moni~ring7 ~ Date: Gross Net Depth to Net Reading Date Time Time Water Drop ..~ ,, ~ '; .¢ ~ ~ , ~ ~ ~ ~ '~ ~ ,, ~ ~ ~.~. / ~ ¢ '~z" PERCOLATION RATE __ TEST RUN BETWEEN ~/' ~'~ (m,nutes/~nch) PERC HOLE DIAMETER FTAND ~' ~ ~5. FT COMMENTS PERFORMED BY' "~::~""'~'~, ~'~"~'~'~? :~.,,,c-.'~'~.'~-' ~' I '~'~t~U3T' !~~TIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GU . u~J ~: 72-008 (Rev. 4/85) LOT 4 $4'0S'4.3" : 130.00' LOT 1_ 2 C2.S75G AC3 ~ FOUN9 5/6' REBAR [] FOUND 2' DIA PVC MONITOR TUBE ) RECORD DIMENSION5 CSEE NOTE LOT .3 ~glas T. Kenle¥ CE-8176 b_ NOTES 1_. RECORD DIMENSIONS AND EASEMENTS SHOWN ARE TAKEN FROM PLAT N0.74-204. EAGLE VISTA SUBS. 2,NO CORNERS SET TI-ilS SURVEY FOUND CORNERS WERE USED 3, DATE OF SURVEY HAY 1_0, l_qq4 4. NO STRUCTURES WERE EXISTING AT THIS TIME. 5. IT 1S THE OWNER9 REDPONDIBILTT TO DETERMINE THE EXISTENCE OF ANY COVENANTS. OR RESTRICTIONS WHICM DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT, G. TI-tiS SURVEY DOES NOT VERIFY ACREAGE OR BOUNDARY LOCATION )RAWN TPI CH~P l~ DATE MAT_ SCALE ~'= Go'I ALASKA SURV/TEQH 5U~VEYOI~5-PLAMN~I~ ~-HYDF~ OC, RAPIdER~5 H. C. 34 BOX 2057 WA~ILLA, ALASKA qciG54 PM 3?G-G740 'WASILLA 522-24~3 ANCPtORAO~ LOT 1 BLOCK 2 EAGLE VISTA SUBDIVISION PLAT NO. 74-204 ANCHORAGE RECORDING DISTRICT GRID 5E BO5 PRJ.NO q4-002. DWG. NO. 1 OF 1 WELL LOG )]ate Drilled; 7-6-94 Static Water Level 170 'Draw Down N/A feet feet A1 Koch Prudhoe Bay Dr. Eagle River, Ak. LOt 1 Blk. 2 Gallons Per Minute ' Total Feet of Casl,ng_.l'5'l'-6"' 2j7-5" Type Ma~er~91 Drilled: 0 feet to 20 Rock w/little sand 20 ft. to 160 ft. Rock 160 ft. tO 163 ft. Rock w/H20 163 ft. to 180 ft. Rock 180 ft. to 182 f,t, Loose Rock 182 ft. to 237,~,~Rock to HEFTY DRILLING 3540 AKULA DRIVE ANCHORAGE, AK 99510 (907) 345-0593 B 9 7p ,G£• Municipality of Anchora -� .. �� On-Site Water and Wastewater Progra Ilittfiffr (907) 343-7904 - SAFETY AUG 1 8 2017 Certificate of On-Site Systems A. •val w Parcel I.D. 050-711 -13 Expiration D L :6 s �� 01,7 P 1. GENERAL INFORMATION Complete legal description Eagle Vista, Block 2 Lot 1 Location (site address) 32035 Eagle Vista Drive Current Property owner(s) Al Koch Day phone 362-1532 Mailing address 32035 Eagle Vista Drive, Eagle River, AK 99577 • Real Estate Agent Day phone 2. TYPE OF DWELLING: 0 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 E Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: ' • �� Date: /l 0 7 COSA to be released to the engineer,unl--otherwise requested by ngineer. r COSA Fee $ S2S- Waiver Fee $ Date of Payment 81 a-e2111 Date of Payment Receipt Number C61(0 IC- Receipt Number COSA# O'C l`� 1373 Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Anderson Engineering Phone 522-7773 Address 1399 W 34th Ave #203, Anchorage, AK 99503 Engineer's Printed Name Benjamin Schiller, PE Date 8-15-17 yQ .. •Ig 4q TH % r °7 • a4 6. DSD SIGNATURE r< °°°°° ••. o°•sa System #1 Approved for " bedrooms c< •moo I41 J S,tiit e System #2 Approved for bedrooms � 1.i-12592 e,e4.6z1 � ,� nal/ Disapproved kl• r :aslot%'� 'c'' Conditional approval for bedrooms, with the following stipulations: a� 01A1- ! ; >= •r�rAT -R AN �f‘ff-\STEV`Jf\T c-: By: /4i,-,7GU may, Original Certificate Date: 5/V77 The Municipality of Ancarage 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 blue sheet f c If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: Eagle Vista Sub, Block 2 Lot 1 Parcel ID: 050-711-13 A. WELL DATA Well type PrivateIf A, B, or C provide PWSID# Well Log (YIN) Y Date completed 7/6/94 Sanitary seal (YIN) Y Wires properly protected (YIN) Y Total depth 237 ft. Cased to 151.5 ft. Casing height(above ground) 24 in. FROM WELL LOG AT INSPECTION Date of test 7/6/94 8/19/17 Static water level 170 ft 27.3 ft 21 * Well production 3 g.p.m _ g p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate 1 .58 mg/L Arsenic ND ug/L Date of sample: 7/28/17 Collected by: Anderson Eng B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic / Steel Date installed 9/30/94 Tank size 1 250 gal. Number of Compartments 2 Cleanouts(YIN) Y Foundation cleanout(YIN) Y Depression over tank (YIN) N High water alarm (YIN) N Date of pumping WI( 17 Pumper J R,`S Rirr P,f,,J6 C. ABSORPTION FIELD DATA Date installed 9/30/94 Soil rating (g.p.d./ft2 or ft2/bdrm) 0.8 gpd/sf System type Trench Length 74 ft. Width 2 ft. Gravel below pipe 6 ft. Total depth 9.5 ft. Eff. absorption area 888 ft2 Monitoring tube Y Depression over field N Date of adequacy test 8/10/17 Results (Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption field before test 4.5 in. Water added 600 gal. New depth 19 in. Elapsed Time: 1440 min. Final fluid depth 4'5 in. Absorption rate >= 600 g.p.d. Any rejuvenation treatment(past 12 mo.) (YIN &type) No If yes, give date D. LIFT STATION Date installed__ Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm &circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot >1 00On adjacent lots >100' Absorption field on lot >100' On adjacent lots >100' Public sewer main >75' Public sewer manhole/cleanout 100 Sewer/septic service line '25' Holding tank >75' Animal containment areas >50' Manure/animal excrete storage areas 100' SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5 Property line >5 Absorption field �5 >10' >10' >100' Water main Water service line Surface water Wells on adjacent lots >100 ABSORPTION FIELD ON LOT TO: Property line Building foundation Water main 10 >10' >100' Water Service line Surface water Driveway, parking/vehicle storage >10' Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS *Low well flow requires a 500-gal potable water tank 1 w o . 00-("iii— W ftt 6 S'Coe.-ac.,E i s''iks iN S r AL'-G-0 - .› G. ENGINEER'S CERTIFICATION ...,„74”1'1" ti 4.i ....• - ! certify that ! have determined through field inspections andMI `��f`a+ review of Municipal records that the above systems are in a • conformance with MOA COSA guidelines in effect on this date. F.417:::::1''.x I '11\—.... ...-.7.16:::::41.4:1:j► Benjamin Schiller, PE 0 """"" Engineer's Printed Name0^ . ••*� Date 8/15/17 • �i .. in COSA brown sheet 10-10-12.doc i � I Lot 4 ii S 84'06'43"E N 130.00' - - - 0 Lot 1 z 125,261 s.f. C o o \ 0 / cn 1'4- 13.0'X24.8' \ `PROTECTIVE RADIUS CT GARAGE I WELL \ RETAINING WALL m (0 GRAVEL ...alb R=10s' S'A Lot 3 a DRIVEWAY '' ,A , . Ate. 175.4' �� Ab�L i5Li% - F` –10' UTILITY ' s� EASEMENT ` %TV 9- L=28.37' SEPTIC PIPES — R=20.00' 8.1'x12.1' GREENHOUSE 8 L'2 ` SEPTIC PIPES OUSE DETAIL �� y/ 4. 20 ' // H ,s,„.. SCALE: 1"=30' �S SS ii 41b1. \ o 5' UTILITY I^ ss e._., tis, EASEMENTS ', ' ops �'��. g �000� a Lot 2 9�0 o• �(,_ ,Q O L N 0 oGT�F,L Ls\eggs I t o 74 2-2' CANT \ \\ \ NX fiCk 0 PLOT PLAN AS BUILT X SCALE 1" = 100' GRID SE 0805 Project No. 17-259/A1 & Associates , Daryl Avenue, Anchorage, Alaska 99515-3049 LangAssociates , inc . (907) 522-6476 Phone 44000p4k (907) 522-4625 Fax o Q ProfessionaI Land Surveyors kenOlangsurvey.com 4 FAL %1 j jonathanOlangsurvey.com " ..,. �snaA I hereby certify that I have surveyed the following described property: ��a�q �� v LOT 1, BLOCK 2, EAGLE VISTA (PLAT 74-204) i 49T it T' vo Anchorage Recording District, Alaska, and that the Improvements situated thereon are VA VA within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the surveyed KENNETH G. LA o ip premises and that there are no roadways, transmission lines or other visible easements on sold property except as indicated hereon. Q sls �jj�� 1. p .j 4p "P� .L5– 202.••• y;p� Dated this the Day of 6j UST , ___�___, at Anchorage, Alaska A •... �O 4O4R0 SION PA-�o It is the responsibility of the owner to determine the existence of any easements, 0444goQ4 covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963 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. # 1. GENERAL INFORMATION Complete legal description -/= "' / ~ ~z ~, ~',.~. ~-* /_///s~',~~ ~,~',~'. Location (site a(~dress or directions) Property owner Mailing address Lending agency Mailing address Agent Address Day phone Day phone Day phone Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: ,f* 3. TYPE OF WATER SUPPLY: Individual well ~'~' Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank '--' Community on-site 72-025 (Re~.1/91) Fro~t MOAii21 ~ - - . Public sewer :~ , ~.-- ' .," '.: -. ~'-~,, NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. .,; .::.., ~},.: ~ .~, ~ ~*~ ~::-~,?~ .>. Se 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 further verify that based on the information obtained from the Municipality of Anchorage flies 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 Engin~dssignature ~~- t~ DHHS SIGNATURE ~ ~'~ Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments 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 pumhasers of homes and.their lending institutions in orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analy~e 'data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ~' .~ Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ~/ / ~',~' ~-. ~'.,~'/-,~" /--~/"-~ Parcel I.D. A. Well Data Well type ~,~,~,~ ~' If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Y Date completed ,-~'~ >' ~ /~'~/Driller '",~,~"Y ~ ~.~.,x.~'~ Total depth ~ ~ Cased to ~ ~,~ ~,, Casi~ height ~. ~ San~a~ seal (Y/N) ~ Wires properly prote~ed (Y/N) ~ FROM WELL LOG Date of test .~,z. y ~ ,'~'~" Static water level / ~'~'~'~ Well flow Pump level1 SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot / ~,~- Absorption field on lot /.~'~ Public sewer main Sewer service line ~'~"~' g.p.m. AT INSPECTION ~ ~ g'p'm' ~1--~ ~ , ~ ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform '~ Date of sample: Nitrate Collected by: Other bacteria B. SEPTIC/HOLDING TANK DATA Date installed Cleanouts (Y/N) High water alarm (Y/N) /'~'~//Tank size Foundation cleanout (Y/N) Date of pumping Compartments Depression (Y/N) Alarm tested (Y/N) xt~ Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot /~r" ~"~'~ To property line /~ ~',~"~ Sudace water/drainage On adjacent lots Absorption field /.~ '*,~','~ Foundation .~/~"~ Water main/service line ~' 72-026 (3/93). 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/N) ~ SE~I:t~~TION TO: WelC6n lot On adjacent lots Manufacturer Manhole/Access (Y/N) "Pump Surface water D. ABSORPTION FIELD DATA Date installed .5~,~,,- ..,/~ / ~ ~/ Length ~,5/,~"~ Total absorption area Date of adequacy test Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) Soil rating (GPD/FF) ~, Width ~ Gravel thickness ~ ~' Cleanout present (Y/N) /C~ ,4/~-~' .~,~-~-.~=,~-4 Results (pass/fail) System type ~ ,~'/' Total depth Depression over field (Y/N) for ~ After test Bedrooms If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot /-~ .~',~ On adjacent lots To building foundation On adjacent lots Surface water Cutbank ,'.~'~ ",~'"~' Property line To existing or abandoned system on lot .~'j,,c',~. Water main/service line Curtain drain +,w't Driveway. parking/vehicle storage area -~ ~'~'~' E. ENGINEER'S CERTIFICATION I cerO'fy that I have checked, verified, or conformed to all MOA and HAA guidelines in effecj~..~~f~this inspecson. · ,-.' e,~". · - Signature ~-~/~l~ T' ~-~-~- ~'{ii~~~.'~:~"/~ Engineer's Name t;"~'~ I ~% ! _ /c.,~,~ ~ ~.~,.. DOUGLAS T. HAA Fee $ ~ ~ · d~ Waiver Fee $ Date of Payment //- ~ 5 ---~zT~' Date of Payment Receipt Number ~'-'/'7 ('~-"7'~-~' ? Receipt Number 72-O26 (W93)' Back