HomeMy WebLinkAboutMAJESTIC VALLEY ESTATES BLK 1 LT 1Majesti*c Valley
Estates
Block 1
Lot 1
#050-731-12
MUNICIPALITY OF ANCHORAGE
DE RTMENT OF HEALTH AND HUMAN SER ES
Environmental Health Division
82.5 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL. INSPECTION
REPORT
DISTANCES
�4'o r --e 7
FROM
SEPTIC
ABSORPTION
WELL
AddressTO
7
_
TANK
FIELD
Phones) Permit No. No. of Bedrooms
WELL
LOT LINE
6
LEGAL DESCRIPTION -
_
Lof
Block
Subdivisione
FOUNDATION
Township, Range, Section
=/y!v ,2/ w sem
AS -BUILT DIAGRAM (Show location of well.
tlnveway, water bodies, etc.)
septic system. property Imes, loundation,
-- �
TANKS
Q SEPTIC ❑ HOLDING
Ertl
–
—
—
-
-
Manu le w1c, --�--
Capacity in gallons
A,;&" 'T/Iwft
/E2
_
i atenal
No. of Gompad menls
TYPE OF SYSTEM
TRENCH L-1RED O W. DRAIN ElOTHER
i
–�
-i _
a
Depth to pipe bottom Isom Total depth from onginal gratle
7G
r
original grade/
S /1_ FT /0 /AFT
–
--
611 added above crigmal gradeGravei
depth beneath pipe
/-f FT--
s^ FT
Gravel length----_^--
Gravel width
Glo
ie,
i
_ KU FT__
FT
Total absorption area Distance between lines
-4-20 SQ FT FT
__ _
Number of lines Soil rating Pipe matenal
/ -4� I /el SQ FT 3
Installer Date Installed - - —
WELLS
PRIVATE O OTHER (Identify) —
7
Classilicanon (A, �.q � Total Ileplh cased to 7,N
i �I Z� �al• 8
ca
------ FT FT
Inslaltei Date Installed: - --
E
REMARKS:
�Gy✓Sict°riYa, 6/Q GCG',y%2. of 1'•!/
scale:
InS�.D CC ngqs P rlorrned by.
— — L gl� niver
EN7"..fNl?�R J'SiA
ngllleering Services
/ P—O:-BOX-77 294 —
Eagle
""C e Dalo: ftiver, A)( 99577
094-5195
s
Yv» C -_Ce-/f �/u �7G n/!_ LG t rG� /nJ lad /
CL''
fr
I -- —r14117" certify that this inspection was perlortned according to all
k7 r ni Buta a /
Municipal and Stale guidelines in ellect an this dale:
Health Department Approval: Date:
Date:
/Z -u to (3/00)
D�PAR|MENT OF
HEALT|> AND ENVIRONMENTAL PRU[ECTION
825 L
S|RE�\, ANC!lOI HK 99501
264-4720
us gA8--IFT
IN 10 1 RL PH & 1� kit 11" QH7 R: K HWH II: "I
PERMIT NO: 870043 UPGRADE
DA[E ISSUEU: O4/06/G7
APPLlCANT: GEORGE ZIOTS
ADDRESS: BOX 1775
EAGLE RIVER
ROAD, AK 99577
(ANI |ACT PHONE: 786-3430
LEGAL DESCRIP: SUBDIV{SION:
MAJESTI� VALLEY EST. LOT: 1 8LOCK:
1
SECTlON: 23
TOWNSHIP: 14N RANGE: 1W
1 5A (SQ FT
LUl SIZE: . .
. OR ACRES>
l i. J.
1 I am J. 1. with the
i L � r on site sewers and wells
requ remen s o �
as set
^ {orth by the Municipality
oge (MOA> and the
Alaska^
2 I will install the system
in accordance with all MOA codes and
regulaiions,
" and in compliance with
the design cria o{ this permit"
I adhere to all MOA
and SLate o� Alaska requirements {or
the seL back
3 will
"
distances [rom any existing
ll t ter disposal system
we , was ewa
or public
sewerage cm this
or any adjacent or nearby lot,
A LIFT STATION IS INSTALLED
IN AN AREA COVERED 8Y MOA 8UILDING
CODES,
IF
THEN (1> AN ELECTRICAL PERMIT
AND lNSPECTION MUST BE OBTAINFD; (2>
AS~BUILTS
WILL NOT BE APPROVED WITHOUT
AN ELECTCAL INS|�ECTION REPORT; AND
RI
(3) THE
c/cr�o�ru/ uIt:'!:: N||9T R� DONE
IN A LICENSED ELECTRICIAN.
muflicipai-.�
/� \\ P.O. E 196650
ANCHORAGE, ALASKA 99519-6650
0�
(907) 264-4111
Anchorage
-�� TONY KNOWLES,
i� MAYOR
DEPARTMENT
OF HEALTH & HUMAN SERVICES
January 9, 1987
George Ziots
PO Box 1175
Eagle River, Alaska 99577
Subject: Lot 1 Block 1 Majestic Valley Estates Subdivision
On-site Sewer Permit #860426 Upgrade
A permit issued by this Department for an individual well
and/or on-site sewer system has expired as of December 31,
1986.
Permits are issued on a calendar year basis by authority
of Municipal Ordinance. A new permit must be obtained from
this Department for any well and/or on-site sewer system not
installed by the expiration date.
If you have drilled the well, a well log needs to be sent to
this Department for documentation of the installation and to
close the permit.
If a private engineer inspected the installation of the on-site
sewer system the original as -built inspection report (three part
form) must be sent to this office for review and approval, and
for documentation.
If there are any further questions, please call this office
at 264-4744.
Sincerely,
R.W. Robinson
Program Manager
On-site Services
RWR/ljw
enc: copy of permit
J!
DEPARTMENT . HEAL[H AND ENVIRONMENTAL .OTECTION
B25 L 5TREET ANCHORAGE AK 99501
264-472O
PERMIT NO: U6O426 UPGRADE
DATE ISSUED: 11/24/86 /a e_p,
APPLICANT: 8EORGE ZIDTS
ADDRESS:
P:, CL. BOX
EAGLE RIIV, ERAK 99577
' �n���� �.� ���" ^^e�a�
PHO
CONTACT NE: 694-9O22 �-'^ / ' �-'~�T
LEGAL DESCRIP: SUBDIVISION: MAJESTIC VALLEY EST LOT: 1 8LOCK: 1
SECTION: 23 TOWNSHIP: 14N RANGE: 1W
LOT SIZE: 1.5A (SQ^FT^ OR ACRES)
I certi�y thaL:
1. I am {amiliar with the requirements r onsite sewers and wells as set
forth by the Municipality of Anchorage (MOA) and the State of Alaska.
2, I will install Lhe system in accordance with all MOA codes and regulations,
and in compliance with the desiyn criteria of this permit"
3. I will adhere to all MOA and State o� Alaska requirements [or the set back
distal rom any existing well� wastewater disposal system or public
sewerage system on this or any adjacent or nearby lot.
STATION IS INSTALLED IN AN AF�"[A COVERED 8Y MOA 8UILDING CODES,
D|EN (1) AN ELECTRICAL PERMIT AND INSPECTION MUSTBE OBTAINED; (2) AS~BUILTS
WILL NOT 8E APPROVED WITHOU7 AN ELECTRICAL INSPECTION REPORT; AND (3) THE
ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN.
SlGNED / DATE: �
ISSUED BY �� ^
�
k
�
�m��'���^�'~��
�
w v
�
yC>o on
0 o
u nici as ity
oil
Anchorage
November 26, 1986
P.O. BOX 196650
ANCHORAGE, ALASKA 99519-6650
(907)264-4111
10NY KNOWLES,
MAYOR
DEPARTMENT OF HEALTH & HUMAN SERVICES
George Ziots
P.O. Box 1175
Eagle River, Alaska 99577
Dear Mr. Ziots:
This Department has reviewed and approved the permit to upgrade
the existing septic system on Lot 1, Block 1 Majestic Valley
Estates Subdivision. This permit expires December 31, 1986.
If the septic system is not installed by this expiration date,
this permit may be renewed by resubmitting the design proposed
by your engineer. No additional requirements are anticipated
for permits issued in the upcoming calender year (1987).
Please note the conditions attached to the Health Authority
Approval for your well and septic system. Funds should be
escrowed to cover the cost of moving the septic system prior to
June 15, 1986.
If you have questions regarding this matter please contact me
at 264-4744.
Sincerely,
Stephen S. Morris
Civil Engineer
On -Site Services.
r
.WIF Al! Q
. 4k , xipz
IWO# "O'C'O"Of F6.0se 0 a
septicplan only..
Ftp V
"0' A4 'M
A
VAT,
...... . . . .
21
AS -BUILT
1. hereby certify that T -have surveved khe. following—
described property:
Anchorage Recording Precinct, Alaska, and that the
improvements sitoatc(l thereon are within the property
linea and do not overlap or encroach on the property
lying adjacent thereto. that. no improvementi on pro
erty lying adjacent thereto encroach on the premi I
ses in
.qu"ticft and that, tht-re are no roadways,'transtnission
lines or other visible easements on said property. except.
as indicated hereon.
Daied-tit F'iPle River, Alaska
this..t _day.
XSOILS LOG
MUNICIPALITY OF ANCHORAGE
• DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 0 PERCOLATION
TEST
825 L. Street, Anchorage, Alaska 99501 264.4720
SOILS LOG - PERCOLATION TEST
PERFORMED FOR: /Y. Geo rte e ZiU tr DATE PERFORMED: I%Z/LI/f6 _
LEGAL DESCRIPTION: J �� C P / y ;7 14/1-V If / I
SLOPE SITE PLAN nvTc
1
I
O'
2 6
3 I r
4 (
O t
t �
5 p
6 �� t
7 `, I
+
• O'
10
11 a
12 '�7 `
13 r G
r
14-
15—
(C-
415
(C- p)
S4� Qrr� �rp✓Pi�
,(,flyers,+fA't-
'V
'1 S- k
16
M
� OF Ak'j
Net
Time
Depth to
Water
e go
�0
17
��
.�+ p
so
18.
O~O.e.f
m... Osseo
19
m •... ..
�4
r
�eo��.
/so.
p •....� ITi.e�
•e .. .
: 4d
R`
Louis A. Butera
20
� S� e
BQ9
do
CE -6736 00
FESS1�N�*d"'�
WAS GROUND WATERr /4 S _
ENCOUNTERED? /y L
0 & % !u ko
P
IF YES, AT WHAT as re a .red E
DEPTH?
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
NAa —
L1jj hal
PERCOLATION RATE /'fs r��R. (r /TMe4)
TEST RUN BETWEEN FT AND -- FT
COMMENTSjp4 r1t c& � I*7a, ,e-St_.o ?ria /OV ' 7 r u i.. Su, r "A c., w447�'✓
PERFORMED BY: Cagle River Engineering Services CERTIFIED BY: -2'0-4 _ DATE: !/ o?V Z6'
V. V. BOX 173294
Eagle River, AK 99577
72.008 (6/79) 694.5195
�A�LE HIVER ENC)NE�k1NC 8ERVlCES
11,0, UUX 7/379/i
EA�LE R{VER, ALASKA 09577
SPEC IFICAlTONS F0R 01\-8I1E SEPTIC SYST[M
LEAAL: Lot l, 8lopk l Majontio Vi�11_loy Eotute:
0. &ENERAL
1.
The
well and septi* pIan mro for a ming]* faim ily
, ,�"idmnce
Vnly
2.
Thu
druwing and vr sitn pl"in ohal} be u puirt ol'
thi-;
opucoificop, tion.
3.
011.
mutmrials "%ind workmonuhip uh:ll memC It. ho requiramooCo
t*t*l dath nf 1 "h(-1 trmnwh nxrmvu
of
i0, not Co mxwad 1i' all,
1ha
0nohorage Dulartint; nt of lost )1:h and St*Lin D. [.C,
i.
All
wViI tins Ls atm advisory Inc U)n doyign ind urr
to
Iu
trunoh.
vet
fied or- mndificic". in tho fje}d by thw nn9inctnr
5[ha
trnn*h QravoI io to bn o"vurmd
3
All
toxc'avx!�.ions und JwpLhs u-: vidvioory and :/o
to bo
vpriiinil or
bosird insu|niLion to at dopth
modifimd
in tha field by Lhm contruotor to mcot
MUA,
DE.0 roqoire-
7. �hw
menW�
bu
Lo prnvnnt pondjny
of
�3vrfoom wator runo|f
[t
i: thm rmsponnibility of tho uwnar to obtain
ull
om�eumu^y
must no 1,
ptrmi�s
ur eu�ementa und to 1o�aLn noy
multi
am1ly wnlls.
7
Hui
on io to ho axu*tly io Cho armu ohnwn
on
thn aite pIa"n'
uny
dmv-I«tion rmquireo onglinnor zpProval
0,
lt
is nlwuys raiommoodmd ihat u curvmyor loc; ; ito
1ho
nam-eo1, )oL linuo
i") (i
jtjnn nod thm looution of any nusnmmnts
8, 0RI0INFIELD
l, The
infinld i� t* follow thu
nabural
lund conLou r to mainCain
unifnrm
totml dopth o[ tho bed
bottom
I? Thu
bottom Pf thCI trencsh ahall
hm Imvml,
p\uw or, mjnvs 1 S'
�ra
t*t*l dath nf 1 "h(-1 trmnwh nxrmvu
It. ion
i0, not Co mxwad 1i' all,
any
puini
4 . The
oawcr linn iu to r:plaoo tho
oxirting
smwci liom thz1, lozdo ��) In
exioting
trunoh.
5[ha
trnn*h QravoI io to bn o"vurmd
with
Cyper nr fnOrin ma0urinl
6. Soil
or, combin4l.inn of yoil m'd
nxtruded
bosird insu|niLion to at dopth
of
4` or nquiv^lont is to hm pl*';nd
over
thw A sinfioil d
7. �hw
ar�a over tho tronoh is to
bu
Lo prnvnnt pondjny
of
�3vrfoom wator runo|f
GThm
tu)k and )oxchfimld
must no 1,
|/n olopcor Chan |O0 fto
wny
exi*Ung privmW wmll, 1 O'
i"o xny Clcoe
"C^ wol), nr 200 {oni
to
wily oommuniLy woll.
C, Sr, PTTC TANK
lThr-, nxist.inQ smPtic tonk it-,.; tn bn by pumpinq und (:aving in
wiVh fil]
DEC0MMENDED LE8CHFIELD DIMNN3IONS
TUTAL 1l^ GQAV[L DEPTH - S' TkUNOH UNG lH0 i ' TRLNCH WIK0|� J0''
�
Undroom CaPaoity I 4 1 /� //�: 1 :0�'
3nptic txnk sj�a1, 000
. of
'
GREA 'R ANCHORAGE AREA BORE GH
Department of Environmental Quality
^Jw 3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME I20 ' �?� �I MAILING ADDRESS � n P,HAONE 4O _2 3�f
LOCATION kAV INo'i ` ixeCk� LEGAL DESCRIPTION &v 7: ZIi�J��I
SEPTIC TANK:
DISTANCE 1 NUMBER OF
FROM WELL MANUFACTURER GC�, MATERIAL �_COMPARTMENTS
INSIDE LENGTH INSIDE WIDTH_ LIQUID DEPTH LIQUID CAPACITY/1606)GALLONS.
TILE DRAIN FIELD:
l 1 /' TOTAL LENGTH /
DISTANCE FROM WELL FOUNDATION_NEAREST LOT LINE _OF LINES 32'
NUMBER OF LINES DISTANCE BETWEEN LINES AVIA TRENCH WIDTH`7� IN. TOTAL EFFECTIVE
ABSORPTION AREA SQ. FT. LENGTH OF EACH LINE
�7` DEPTH OF FILTER 6 C/
DEPTH: TOP OF TILE TO FINISH GRADE MATERIAL BENEATH TILE-7—IN. ABOVE TILE IN.
WELL: �l%O �e�–ic r
T �iv5en
TYPE /V ` �N F CONSTRUCTION — DEPTH DISTANCE FROM:
BUILDING NEAREST NEAREST SEPTIC SEEPAGE
FOUNDATION__, LOT LINE , SEWER LINE , TANK , SYSTEM_
CESSPOOL OTHER SOURCES
APPROVED DISAPPROVED_
DISTANCES:
INSTALLED BY:
SEWER LINE DEPTH:
PIPE MATERIAL:
LOT SLOPE:
REMARKS: �p�� ` "C
Form EQ -032
REMARKS
DIAGRAM OF SYSTEM
At, 64T
DATE
wIfflifflelvin
G.A.A.B.
SID,
IL) ;A/l /].m.
� ��
����NN� `� -01-- 'A. h �'r �^^� " "^~��^ ^` ' ` ^---
DLPHRTEN� OF HEHU�H HND ENVIRONMENl�HL PROlE^CTION
2510 E `r
TUDUR RD/ HNCUOkRGE, HK 99507 u�u.�
276'2221
���^ ���0� ����� �9 � So ��c���� ����-�
i NC). (76031) 6882l90
BOX ]2I - ER
'LHVINDH CIkCLE
^^-���' L1 H1 MHJEST)C VHLLEY EST �UBD
LEGHL
LUT SIZE 69�65 SQF[ �
lYPE OF SOIL h8SURPN !"W
MEM. [RENCH
NUMBER OF B[DkOOMS ] S0IL HRTlNG/SQFT/8R 118
THE REQUIRED SIZK UF THE SOIL H8SORPTION SY�TEM IS�DEPTH� 10 LENG�H�
25.28571428571l�H OF (1161M. 8[TWEEH THE OUlfHLL PIPE HND THE EXCHYHTION 8OTTQM
THE MINIMUM b��
IS 7 F1
lHERE IS NOSET WI0H FOk TRENCHE�FOR [HE 1110111Ili]FT� HND THE
THE DEPTH OF TRENCH 01 Pll� I� T|IE DISTR�CE �E[NEE� THE GROUM� SURFHC�
|�OTTOM OF THEEXCHVHTION.|�HE LENG111 OF EHCH SIDE FOR H SEEPHG� PIT OR THE
'11W LENGTH DIMENSION IS
LENGTH OF THE TR�NCH/ OR DRHINFIB.D
THF REQUlRED SEPTIC THNK SIZE IS 100B GHLLONSEC)�I0N 8y THI� DEpHRTMENl� WILL
BHCKFILLlNG OF ANN"SYSTEM W1THUUT FlN0L IN�Y
BE SUBJECT TU PROSECUTION� TU ugly SFpTIC THNK/pHCKHGE PLRNT OR SOIL HBSORPTION
1111 MUM DlSTHNCE FRUMRWLL/[yHTEWELL RND 200 FT FUR H PUBLIC NB-L
SYSTEM IS 100 F|� ,UKElUr«~0 TO T -E DEpRRTMENlWITHlN ]0 DHYS OF lHE WELL
WELL LOG� MUST 6� � �nLn
CO�PLElIONlONS HN0 CONSTRUCTION DIHGkRMS HR� HYHlLHB|.E TO INSURE PROPE�
6PECIFIC#|
IN�THLLRlIUN.
l CERTIFY l HM FHMILIHR W1TH THt� ��QUIREMENlS FOR Orb -SITE SEMIRS HMD ARQLLS
HS �ETFORTH BY THE IhLITY OF HHCHOkHGE HNk WILL INSTHLL IN �CCORDRNCE
WITH THE CODE
������
SIGNB,���*�~ �� ^� ����� � �
ISSUED BY . . .DHTE��'/��<�!
//Y
�/�~�'�� �,�y��� ��' ��'���� /
® & E GE01 . CHNI CAL 8- DEVELL.AMEN T CO.
Box 90, Davis St., Eagle diver, Alaska 99577
694-2774 or 6BB-2280
Russell Oyster
694-2774
SOIL
LOG
Earl Ellis
688-2280
Soils €r Foundations
Land Development
Performed for:
Name: %�/��, J2�r
J
�' FJiJf"'
Tel. No. �;f' .._rye :3 Ile?
—
Mailing Address: ��,x.
�` � Tv✓. %/lir_ i���` �>e = '. //K.
Legal Description:e
/.� , /,/�!: //V/%✓
ri�/�/rj�lc./
Y J/�,.
Daihjfeet
0
3-
4 _
6
/ e
3
9
e
1-3
-L6
Ground Water Encountered: Yea.._.,, No_-, `--� If Voss what dopth,r'_
Proposed Installation: Seepslg0 �'`ii;�!.-_ Dr&6W
Comments: �cvi.
Performed by,, Date:
__"LL _,"LL�`r
�� 1 .
0 Et E GEOTECHNICAL & [DEVELOPMENT CO.
Box 90, Davis St., Eagle River, Alaska 99577
694.2774 or 688-2280
Russell Oyster Earl Ellis
694-2774 688-2280
Soils Et Foundations Land Development
SOIL LOG
Performed for: Name:, k/'D'C-7 CifA><Cc :S' Tel. No.
Mailing Address:
Legal Description:_ /, !e7-/, ififITFST/c-
Depth lfeet) Soil Characteristics
0
2
3
4
5
6 _
i
8
9�
10�
11�
12_
'� 7S 7/r //6' e,
�Z1J tlIr„4),
OF At It
OA
�� log a. ®°fAai.1•i 8
��)'
Earl P. Ellis s w�
J °.• NO. 1745-E
Ground Water Encountered: Yes k-*� No If yes, what depth
Proposed Installation: Seepage Pit Drain Field
Comments
Performed by:_ Date:
l3rilling fwg
by
A & 1, DRILLING COMPANY
BOX 97, EAGLE RIVER, ALASKA 99577 * TEI,EPHONE694-25BB
OWNER OFLAND >'' = 'r t ` 40 DEPTH OF WELL
ADDRESS STATIC LEVEL OF WATER FT.
LEGAL DESCRIPTION DRAW DOWN FT.
DATE - Started Ended GALS. PER HR
PERMIT NUMBER
KIND OF FORMATION
KIND OF CASING --
From
—Ft. to
Ft. to,-)( Ft.
From
From —Ft.
to
Ft.
From
Ft.
Ft. to > Ft.
to
From
Ft. to
Ft.
From
Ft. to Ft.
From —Ft.
to
Ft.
From
a
Ft. to Ft.
f r i D r.f
From —Ft.
to
_Ft..
From'
/—'Ft.
to i t Ft.
c' ,yjFron'
Ft. to
Ft.
From
—Ft.
to Ft.
From —Ft.
to
Ft.
From
—Ft.
to Ft.
From
Ft. to
Ft.
From
Ft. to Ft.
From
Ft. to
Ft.
From
Ft. to Ft.
From
Ft. to
Ft.
Froin—Ft.
to Ft.
From —Ft.
to
Ft.
From Ft. to Ft. From Ft. to Ft.
Froni--Ft. to Ft.
From —Ft. to Ft.
From
—Ft. to
Ft.
From
Ft. to
Ft.
From
Ft. to
Ft.
FroniFt.
to
Ft.
MISCL. INFORMATION:
Prom —Ft. to_Ft
Froin—Ft. to_Ft.
From
Ft. to ---Ft.
From
Ft. to
Ft.
From
Ft. to
Ft.
From
Ft. to_
Ft.
DRILLER'S NAME
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.cl.anchorage.ak.us
(907)343-7904
ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET
To: Paul Pinnard
Legal description: Maiestic Valley Block 1 Lot 1
The attached paperwork has been reviewed and Is being returned for the following reasons:
Original signature or stamp missing on
Calculation error in design. _
Additional soils Information needed. _
Water monitoring results inadequate.
Discrepancy in information submitted.
Topographic information missing or inadequate.
Incomplete; missing
Incomplete; missing
Additional adequacy test information needed.
Water sample unacceptable. _
Measured/proposed distances/dimensions missing.
Locations of all soils, percolation and water monitoring tests not shown.
Proposed system too deep for soils information submitted.
Well log required. _
Omission in narrative. _
Insufficient fill over tank or field.
Other. Need Survey
Name of reviewer. Jeff
Kee,�e e -,a S✓� �f
vvc -30-01f, /t%.� r�re.l Pa
/ ..
�'-"'• SC/r✓c(, S�c.✓
J Date: 9/9/2004
A IL Lv o7^rtDhvloI�c,7r-r•.. wcc-S -'1.t<iic
7C!^ p { 1 t -t .7-- kid-, c
Please supply the necessary information and re -submit your request.
LEAVE THIS FORM ATTACHED TO THE PAPERWORK
Municipality of Anchorage <
On -Site Water & Wastewater Program
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 050-731-12 Expiration Date: U1�1
1. GENERAL INFORMATION
Complete legal description MAJESTIC VALLEY ESTATES; BLOCK 1, LOT 1
Location (site address)
Current Property owner(s)
Mailing address
Real Estate Agent
2. TYPE OF DWELLING:
25865 LOUINDA CIRCLE, EAGLE RIVER AK 99577
VICTORIA MCCANNE Day phone 441-2969
P.O. BOX 771882, EAGLE RIVER, AK, 99577
N Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
Day phone
3. NUMBER OF BEDROOMS:
3
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Individual On-site
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
f
Received by: Z,- Date: #
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $--C.
Date of Payments f //3
Receipt Number 7�yS�C2 �S
COSA#
Waiver Fee $ _ eo
Date of Payment`
Receipt Number C -
Waiver#
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, l 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. t further verify that based on the
information obtained from the Municipality of Anchorage files and from my investigation and inspection, the
on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal
and State codes, ordinances, and regulations in effect at the time of installation.
Name of Firm
GARNESS ENGINEERING GROUP, Ltd.
Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507
Engineer's Printed Name
Engineer's Comments:
JEFFREY A. GARNESS, P.E.
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 & 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. 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 sole benefit of the owner listed above. Any reliance upon or use of this report by any
otherperson or party is not authorized, nor will it confer any legal right whatsoever.
6. DSD SIGNATURE
System #1 Approved for
System #2 Approved for
Disapproved.
Conditional approval for
bedrooms.
bedrooms.
bedrooms, with the following
337-6179
Date It `� h
ooboOpO
o OFA �4p
A, �p�G
A�"•8c�ra�ss
tt(ts
.o f essl
\����«uuittrrrrr
j= ON-SITE G�
Z WATER AND
ons:WASTEWATER o�
Original Certificate Date: 1
Tha-Municipality or Anchorage Develop, emt 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. ATTCHMENTS:
COSA Checklist / Nitrate Advisory
Septic System Advisory _ Arsenic Advisory
Well Flow Advisory Other
(RP iimal
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:
MAJESTIC VALLEY ESTATES; BLOCK 1, LOT 1
Parcel ID: 050-731-12
A. WELL DATA *ASSUMED BASED UPON SURROUNDING WELL LOGS.
Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES
Date completed 5/5/1976_ Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES
Total depth 134 ft. Cased to *40+ ft. Casing height (above ground) 12+ in.
FROM WELL LOG AT INSPECTION
Date of test 5/5/1976 6/20/2013
Static water level 90 ft. 72 ft.
Well production 7 g,p,m, 5.45+ g,p,rn,
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 ml. Nitrate 0.953 mg./L. Collected by: GEG, Ltd.
Arsenic: ND ug./L. Date of sample: ?4g: - T 11012,812-4)13
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC/STEEL Date installed 4/30/1987
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 (YIN) N/A
Date of pumping 6/24/13 Pumper JR'S PUMPING
C. ABSORPTION FIELD DATA *BELOW EXISTING GRADE
Date installed4 30/1987 _ Soil rating (g.p.d./ft2or /bdrm 145 System type TRENCH
Length 60 ft. Width 3-4 ft. Gravel below pipe 5 ft.
Total depth *11.8 ft. Eff. absorption area 570 ft2 Monitoring tube YES Depression over field NO
Date of adequacy test 6/20/2013 Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth in absorption field before test 38 in. Water added 550 gal. New depth 44 in.
Elapsed Time: 180 min. Final fluid depth 38 in. Absorption rate >= 450+ g_p,d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date
D. LIFT STATION
Date installed
"Pump on" level at in.
E. SEPARATION DISTANCES
Size in gallons Manhole/Access
"Pump off" leve larm level
Cycles tested Meets alarm & circuit requirements?
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tanknift station on lot 100'+ On adjacent lots 100'+
Absorption field on lot 100'+ On adjacent lots
Public sewer main
Sewer /septic service line _ 25'+
100'+
Public sewer manhole/cleanout N/A
Holding tank
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main N/A Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line
*1'+
Building foundation 10'+ Water main N/A
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
*WR#OSP1311.94
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 JEFFREY A. GARNESS
Date t I4.b h I
(Rev. 11/05)
i:UPS STORE EAGLE RIVER ALASKA
2-
To:3363246
0
05/30/2013 14:46
#613 P.001/001
s
Municipality of Anchorage
P.O. Box 196650 • 4700 Elmore Road
Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997
hftp://www.muni.org/Onsite
Development Services Division
On -Site Water and Wastewater Program
"Neut S
n
i~. r
Department
**** VARIANCE/WAIVER REVIEW ****
Waiver#: osp131194 COSA#: osc131313 Permit#:
PID#: 050-731-12
Legal Description: Majestic Valley Estates B-1 L-1
Engineer: Garness Engineering Group
Applicant: Victoria McCannie
Your request for a waiver of the required 10 feet horizontal separation from the absorption field
to the property line has been approved. The approved separation distance is 1.0 feet.
This waiver approval applies to the existing absorption field only. Any future upgrade to the on-
site wastewater disposal system will require all separation distances be met or another approval
from this department.
❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this
waiver.
❑ Notarized letter(s) of nonobjection have been received from the owner(s) of the affected
adjacent property.
❑ Adjacent properties are not affected by this waiver.
......................................................... a . . . . . . . . . . . . . . . . . . . . .
Waiver is Granted: X Waiver is not Granted:
Date: / Approved by: /& .
N f fewer
................ a ............ ................ .. .. ......... a................
Rec#: 07662G Amount: $200.00 Date Paid: 7/9/13
**** VARIANCE/WAIVER REVIEW ****
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS_......-.
July 1, 2013
Municipality of Anchorage
Development Service Department
Building Safety Division
On -Site Water & Wastewater Program
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Lot Line Waiver for Majestic Valley Subdivision; Block 1, Lot 1,
To whom it may concern:
Upon inspection, it was found that the drainfield serving the property was located less than 10
feet from the south property line. It also happens to be located in an easement. Attached are
letters of non -objection from all relevant utility companies.
We request that your department issue a 1 -foot lot line waiver from the south property line to the
existing drainfield. I am unaware of any adverse impacts this waiver would have on adjacent
wells or septic systems.
If you have any qu"tions, please contact us at 337-6179. Thank you for your assistance
.E., M.S.
3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507-1259
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.gamessengineering.com
MATANUSKA ELECTRIC ASSOCIATION, INC.
LETTER OF NON -OBJECTION
June 20, 2013
Victoria L. McCanne
P.O. Box 771882
Eagle River, AK 99577
Re: Lot 1, Block 1, Majestic Valley Estates Subdivision (Plat 75-106, Anchorage Recording District)
i
Dear Ms McCanne:
MEA has no objection to the encroachment of a septic system located in the utility easement as depicted on
the attached as -built survey drawing, subject to the following conditions:
1. The improvement 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.
2. MEA will be held harmless by the landowner from liability for any and all damages or injury to any
person or property that may result from the existing and future use of the easement by MEA, its
contractors, or assigns. -
3. MEA will be held harmless by the landowner for any and all liability arising out of or relating to any use
of the easement by others under a Letter of Non -Objection.
4. The landowner will be liable for any damages caused to MEA facilities by the improvement in the
easement.
5. The landowner will be responsible for any special construction costs incurred by MEA due to the
improvement in the easement.
6. The landowner will assure compliance with all applicable safety codes relating to the improvement in
the easement. _
7. Use of this letter by the landowner, their successors or assigns will constitute acceptance of these
conditions.
8. Alteration of these conditions shall invalidate this letter.
9. This letter is not effective unless it is recorded in the Anchorage Recording District before ownership of
the referenced property is changed from the above named landowner.
Sincerely,,
Keith Quintavell
Right -of -Way Administrator
STATE OFALASKA)SS-
THIS IS TO CERTIFY that on this 20 day of June , 2013 before me, the undersigned, a Notary Public in
and for the State of Alaska, duly commissioned and sworn as such, personally appeared
A[[
;) k (a USX �a V-(/
Known to me and to me known to be the individual(s) named in and who executed the foregoing instrument
and acknowledged to me that he/she/they signed and sealed the same as a volunt�%p find deed for the
uses and purposes therein mentioned. ne";c. GCE rr,�Y
IN WITNESS WHEREOF, I have hereunto set my hand and official seal the 3 and year first abo`ye written
SEAL
Notary Public in and of Alaska My commission expires r:
(V ✓ .• .;
Return to: MEA, PO Box 2929, Palmer, AK 99645
FA
=N
Natural Gas Company
June 5, 2013
Victoria McCann
25865 Louinda Circle
Eagle River, Alaska 99577
Grid: SW363
Re: Letter of Non -Objection
To whom it may concern:
ENSTAR Natural Gas Company
P.O. Box 190288
Anchorage, AK 99519-0288
(907) 277-5551
ENSTAR Natural Gas Company has no objection to the existing septic encroachments into the
Twenty Feet (20 FT) utility easement lying adjacent to and coincident with the south boundary
of Lot 1, Block 1, Majestic Valley Estates Subdivision, Records of the Anchorage Recording
District, Third Judicial District, State of Alaska.
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:
• Landowner/Contractor working near ENSTAR gas facilities shall contact the Alaska
Digline, Inc., (907) 278-3121 or 811 for line locating two (2) business days prior to any
related excavation.
• 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 land 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,
J"�4axv�
Andrew Fraiser
Right of way Agent
ENSTAR Natural Gas Company
Anchorage Water & Wastewater Utility
Engineering Division
Mayor Board Chair
Dan Sullivan Timothy M. Sullivan, Sr.
May 31, 2013
Victoria McCanne
25865 Louinda Circle
Eagle River, AK 99577
Re: Majestic Valley Estates BLK 1 LT 1 (Grid SW363)
Request for Letter of Non -objection to Encroachment (Tax [D# 050-731-12)
The Anchorage Water and Wastewater Utility received a request from you on May 30, 2013
in regards to an existing on-site septic system pipe encroaching into the utility easement
along the southwest property lines of Majestic Valley Estates BLK 1 LT 1,
AWWU is currently not using this utility easement and has no objection to the
encroachment. AWWU hereby issues this letter with stipulations to allow the encroachment
of an existing on-site septic system pipes into the utility easements, the property owner(s)
agrees to the following:
1. AWWU will be held harmless, now and forever, for any damages or injury to any
person as a result of the encroachment;
2. The property owner(s) shall call for utility locates before excavation in the
easement;
3. All applicable codes and regulations will be observed and maintained within the
easement;
4. This letter will in no way preclude AWWU from full use and enjoyment of its rights
within any portion of the easement;
5. The property owner(s) shall pay any additional and/or extraordinary costs incurred
to accommodate the encroachment during any future required construction or
reconstruction of AWWU facilities;
6. AWWU`s non -objection does not imply other approvals that may be required for this
encroachment; and,
7. AWWU does not provide a position for any other parcel or utility impacted by the
encroachment.
Should you have any questions, please call the AWWU Planning Section at 564-2739.
Respectfully,
Shawn -0 ell
Engineering Technician
Anchorage Water & Wastewater Utility VW01 Clearly
3000Arctc Sonievard • Anchora8e.Alaska 99503 - - -
Phone 907-564-2774 • Fax 907-562-0824 - Nm v.amyubiz ..
June 3, 2013
Victoria McCanne
25865 Louinda Circle
Ragle River, Alaska
Dear Anthony Chen:
GCI
Subject to your agreement to indemnify the company as set forth below, GCI
Communication Corp has no objection to the 5 septic pipes encroaching into the 10 -foot
utility easement at Lot 1, Block 1, Majestic Valley subdivition, also known as 25865
Louinda Circle, city grid SW0363.
This letter of non -objection in no way precludes GCI Communication Corp 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 Communication Corp harmless,
now and forever, for any damage, costs, expense (including reasonable attorney's fees),
liabilities and injury to any person or property occurring as a result of the encroachment.
Please indicate your acceptance by signing and returning this letter to me at the address
below.
Sincerely,
Acceptance
Date
Markus Kofoid
OSP Design Engineer
GCI Communication Corp
5151 Fairbanks St.
Anchorage, AK 99503
907-868-6168 Office
907-868-8580 Fax
NON -OBJECTION TO EASEMENT ENCROACHMENT DOCUMENT
By this document Matanuska Telephone Association, Inc. (MTA) declares that it has no objection to the
encroachment of a portion of a septic system (5 pipes) within the 20' utility easement located upon Lot 1,
Block 1, Majestic Valley Subdivision, Plat 75-106, Anchorage Recording District, Third Judicial District,
State of Alaska, situated in Section 23, Township 14 North, Range 1 West, S.M., Alaska.
Please be advised that MTA through the issuance of this document does not forfeit any of its rights to the use
of the area cited. In the exercise of these rights MTA will, if needed, upgrade, maintain, repair, and/or replace
buried or aerial telecommunications facilities within the easement. Any repairs that may be required to the
encroachment as a result of utility construction will be borne by the property owner of record. This document
does not authorize the placement ofany additional encroachments within the easement area. Property owners
are required to obtain utility locates before doing any kind of work in the utility easements and will be liable
for any damages caused by their construction work in the easements.
This document is, in no way, an agreement to vacate any portion of the utility easement and should not be
interpreted as such.
Issued for Matanuska Telephone Association, Inc. this 31 st day of May, 2013, by,
Real Estate & Properties Supervisor
THIS IS TO CERTIFY, that on this 31 st day of May, 2013, before me the undersigned, a Notary Public in and for
the State of Alaska, duly commissioned and sworn as such, personally appeared Bonnie Bailey known to me
and to me known to be the individual named in and who executed the foregoing instrument and acknowledged
to me that he signed and sealed the same as a voluntary act and deed for the uses and purposes therein
mentioned.
IN WITNESS WHEREOF, I have hereunto set my hand and official seal the day and year first above written.
t _
Karen S. Alden
i
tary Public - State of AiasaNot Public in and forire$ Oct 10, 2014 ary Comm. My commission expires: c7 , L�
GRANTOR:
Matanuska Telephone Association Enc.
PO Box 3550
Palmer Alaska 99645-3550
800.746.9510
907J61,2510
907.781 .26-06 (fax)
Local
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DTV
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 050-731-12
1. GENERAL INFORMATION
HAA # / Jq UA55
Expiration Date:
Complete legal description Lot 1, Bk 1 , Majestic Valley Estates
Location (site address or directions) 25865 Louinda Circle
Current Property owner(s) George Ziots Day phone 696-0405
Mailing address
Lending agency
Mailing address
Real Estate Agent
PO Box 770543 Eagle River, Alaska 99577
Day phone
Day phone
Mailing Address
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
3
3. TYPE OF WATER SUPPLY:'
TYPE OF WASTEWATER DISPOSAL:
Individual Well
®
Individual On-site
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 sample results. (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 weds or a public water system. The
Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's 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 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. I further verity 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.
IU.^.mC of f iTl Pinard Engineering - Phone (907) -357-3647
Address PO Box 871347 Wasilla, Alaska 99687
Engineer's Printed Name Paul E. Pinard Date alai""
5. DSD SIGNATURE
Approved for
Disapproved.
Conditional approval for
1Q,"M (iL.MW E • rreZl 11iC.Tit�
Attachments:
HAA Checklist X
Septic System Advisory .
Well Flow Advisory
M
(R..ovoz)
bedrooms.
bedrooms, with the following stipulations:
Maintenance Agreements
Supplemental Engineer's Report
Other
Original Certificate Date:
41
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water 8 Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
HEALTH AUTHORITY APPROVAL DIECI<LIST
Legal Description: Lot 1 , Bk 1 , Majestic Valley EstatesParcel ID: 050-731-12
A. WELL DATA
Well type Private If A, B, or C provide PWS ID #
Date completed,L5/76 Sanitary seal (Y/N) Y
Total depth 134 L Cased to 134 ft.
FROM W ELL LOG
Date of test 5/5/76
Static water level 90 ft.
Well production 7 g.p.m.
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 mi. Nitrate ND mg.A.
Well Log (Y/N)
Y
Wires properly protected (Y/N) Y
Casing height (above ground) 16 in.
AT INSPECTION
8/4/04
81.3 ft.
5-3 g.p.m.
Other bacteria 0 colonies/100 ml.
Arsenic: _ mg./l. Date of sample: Nitrate Collected by: Pinard Engineering
8/4/04
B. SEPTIC/HOLDING TANK DATA Bacteria — 8/24/04
Tank Type/Material Septic/Steel Date installed 4/17 — 4/30/87
Tank size 1250 gal. Number of Compartments 2 Cleanouts (YIN)
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N
Dateofpumping 5/18/04 Pumper JRa Pumping
C. ABSORPTION FIELD DATA
Date installed 17 — 0/$711 rating (g.p.d./fl? or ft2/bdrm) 145 System type Trench
Length 60 ft. Width 3 — 4 ft. Gravel below pipe 5 ft.
Total depthl0. 5 ft. Eff. absorption area 570 fe Monitoring tube Yes Depression over field �jil o
Date of adequacy test 8/4/0/` Results(Pass/Fail) PARA For 3_bedrooms
Fluid depth in absorption field before test 28 in. Water added2.5Q gal. New depth 28 in.
Elapsed Time:Z40 min. Final fluid depth 28 in. Absorption rate >= _ 450 g.p.d.
Any rejuvenation treatment (past 12 mo.) (YIN 8 type) None known If yes, give date
D. LIFT STATION NA
Date installed
"Pump on" level at —in.
Datum
Size in gallons
"Pump off level at _ in.
Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankAift station on lot 1001 +
Absorption field on lot 1001+
Public sewer main NA
Manhole/Access (Y/N)
High water alarm level
Meets alarm 8 circuit requirements?
On adjacent lots 1001+
On adjacent lots 11001+
Public sewer manhole/cleanout NA
Sewer /septic service line 251+ Holding tank
NA
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 501+ Property line --2Q 1 Absorption field 101
Water main 101+ Water service line 101 + Surface water
Wells on adjacent lots 1001+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
1001
in.
Property line 101 Building foundation 501+ Water main 101+
Water Service line 101 + Surface water 1001 Driveway, parking/vehicle storage 1101+
Curtain drain None Known Wells on adjacent lots 1001 +
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and 4"y*r e
r; �9I!0
review of Municipal records that the above systems are in r;.. o 0 0 0 . 0 00 0
conformance with MOA HAA guidelines in effect on this date. f:
pod 1. P60sed
Paul E. Pinard '» i •/`'
Engineer's Printed Name }
t? .
Date 8/28/0c'T, CE -4793
4
HAA Fee $ TJC/ ' Waiver Fee $
Date of Payment 30/�cF Date of Payment
Receipt Number -5 r?n, Receipt Number
(Rev. 12/01)
Mat-Su Test Lab of Alaska
Water Quality Testing
=�
M
Mlle 3.2 Patmer-Wasilla Hwy.
P.O. Box 2749
Midtown Community Business Park
Palmer. Ak.99645
Phone: (907) 745-3005 Email: matautestlabPronershsa.com
Fax: (907) 745-3010
Client: Paul Pinard
Date Arrived: 8/4/04
P.O. Box 871347
Report Date: 8/6/04
Wasilla, Ak. 09687
Sample Date: 8/4/04
Attn.:
Sample Time: 1900
Client ID: Lot 1 Block 1 Majestic Valley
Collected By: P.P.
PWSID #:
Source:
M.S.T.L.#: 2004568
Sample Matrix:
Comments:
Method Parameter Units Results MRL Date Prepared
Date Analyzed MCL
SM 4500-NO3-E Nitrate-N mg/L <MRL 0.50 8/6/04
8/6/04 10.0
I
Legend: MRL . Method Report Level
MCL - Max. Contaminate Level
B - Present In Method Blank
E - Estimated Value
H - Above MCL
D - Lost to Dilution
i
R6ported By Jon Paul Campbell
Lab Manager
PINARD ENGINEERING
P.O. Box 87.1347
Wasilla, AK 99687
(907) 357-ENGR (3647)
ADEQUACY TEST
LOCATION: Lot 1, Block 1, Majestic Valley Estates
APPLICANT: George Mots
25855 Loulnda Circle
Eagle River, Alaska 98571
SEPTIC TANK TYPEISIZE: Steel/1260 gallons, per MOA Records
ABSORPTION SYSTEM: Deep Trench, per ADEC Records
DAILY FLOW:
3 BEDROOMS x 150 GAL/BR - 460 gallons
TEST DATA
JOB NUMBER:
04222
DATE OF TEST:
814104
FIELD STAFF:
PJ Pinard
NUMBER OF BEDROOMS:
3
SCUM: 0.0'
SLUDGE: 0.0'
NEEDS TO BE PUMPED: Yes No XX
CURRENTLY IN USE: Yes XX No
Time
Flow
Rate
Volume
Cumulative
Volume
Septic Tank
Septic
Tank
Soil Absorption System
Comments
pM
(GPM)
(GALS)
(GALS)
Liquid Level
'
a Level
Monitor
Tube 1'
a SAS
Level
Monitor
Tube 2-
a SAS
Level
2:25
5.3
4.0'
-
0.0'
-
2.3'
-
Start Flow - Meter 141460
3:40
5.3
80
80
4.0'
0.0'
0.0'
0.0'
2.3'
0.0'
141540
3:55
5.3
80
160
4.0'
0.0'
0.0'
0.0'
2.3'
0.0'
141620
4:10
5.3
80
240
4.0'
0.0'
0.0'
0.0'
2.3'
0.0'
141700
4:25
5.0
80
320
4.0'
0.0'
0.0'
0.0'
2.3'
0.0'
141780
4:55
5.3
150
470
4.0'
0.0'
0.0'
0.0'
2.3'
0.0'
141930
5:25
5.3
160
630
4.0'
0.0'
0.0'
0.0'
2.3'
0.0'
142090
5:55
5.3
160
790
4.0'
0.0'
0.0'
0.0'
2.3'
0.0'
142250
6:25
160
950
4.0'
0.0'
0.0'
0.0'
2.3'
0.0'
Stop Flow- 142410
'ALL MEASUREMENTS IN FT.
TEST: PASSED XXX 'FAILED
COMMENTS: There was 2.3' of measurable liquid in one SAS MT prior to beginning the test. With the
addition of 850 gallons to the system (twice the design daily flow) the levels in all three MTs remained
0a same.
Reviewed by: Paul Pinard KF
Date: 8110104
LOCATION: Lot 1, Block 1, Majestic Valley Estates
DRILLER: A& L Drilling Company
DATE WELL COMPLETED: 815176
WELL DEPTH: 134'
STATIC WATER LEVEL (top of casing): 81.3'
PINARD ENGINEERING
P.O. Box 871347
Wasilla, AK 99687
(907) 357-ENGR (3647)
WELL FLOW TEST
JOB NUMBER: 04222
DATE OF TEST: 814104
FIELD STAFF: PJ Pinard
1d�1
Toe
Elapsed
Time
(Minutes)
Static
Water
Level
Flow
Rate
Cumulative
Gallons
Pumped
Remarks
2:35 PM
-
81.3'
4.7
-
StartTest- Meter 140200
2:50
15
89.4'
5.3
70
140270
3:05
30
95.4'
5.3
150
140350
3:20
45
95.8'
5.3
230
140430
3:35
60
94.9'
5.3
310
140510
3:50
75
95.9'
5.3
390
140590
4:05
90
96.0'
5.3
470
140670
4:20
105
96.0'
5.3
550
140750
4:35
120
96.0'
4.7
630
140830
4:50
135
96.1'
5.3
700
140900
5:05
150
96.1'
5.3
780
140980
5:20
165
96.2'
5.3
860
141060
5:35
180
95.9'
5.3
1 940
141140
5:50
195
96.1'
5.3
1020
141220
6:05
210
96.3'
5.3
1100
141300
6:20
225
96.2'
5.3
1180
141380
6:35
240
96.2'
1260
Stop Test 141460
RECOVERY
measurements not
Average Flow Rate: 6.3 qpm
Comments: DURING THIS TEST. THIS WATER SUPPLY WELL WAS CAPABLE OF
PRODUCING 5.3 GPM. THIS TEST DOES NOT CONSTITUTE A Reviewed by: Paul Pinard
WARRANTY OR GUARANTEE THAT THE WATER SUPPLY SYSTEM
WILL CONTINUE TO FUNCTION AND PRODUCE AT THIS RATE. Date: 8110104
2.
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
DIVISION OF ENVIRONMENTAL SERVICES
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4744
Application Date
1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL)
(a) Legal Description (include lot, block, subdivision, section, township, range)
Lor_1 Block 1 Majestic Valley Estates Subdivision
Location (address or directions)
(b) Property Owner George Ziots Telephone: Home 694-9822 Business 786-3430
Mailing Address PO Box 1775, Eagle River, Alaska 99577
(c) Lending Institution First National Bank Telephone 694--2103
Mailing Address PO Box 770548, Eagle River, Alaska 99577
(d) Real Estate Company and Agent
Address
Telephone
(e) Mail the HAA to the following address: or: Check here ❑, if hold for pick up
List contact person and day phone number below.
TYPE OF RESIDENCE
Single -Family
Number of Bedrooms three (3 )
3. WATER SUPPLY
Individual Well ax Community ❑ Public ❑
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsitel5cx Public ❑ Community ❑ Holding Tank ❑
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2
72-025 (Rev 8i861 Front
5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health
Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained
from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on
the date of this inspection.
Name of Firm Eagle River Engineering Telephone 694-5195
Address PO Box 773294, Eagle River, Alaska 99577
Date
Engineer's Seal
This department has received written confirmation from the engineer
(Eagle River Engineering Services) regarding the Conditional Approval
of November 26, 1986. The upgrade has been completed and inspected
and now meets with the Municipal codes. This property is now approved.
6. DHHS APPROVAL
Approved for three ( 3 )bedrooms by _2V_0� Date Ma
Approved XXXXXXXXXX Disapproved Conditional
Terms of Conditional Approval
CAUTION
1, 1987
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.
Page 2 of 2 72-025 fRev s/esi Back
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL -� ?� b
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date November 4 , 1986
1. GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section toVQ0jpWange)
Location (address or directions)
Eagle river.
(b) Applicant NameGeOrge Ziots Telephone: Home 694- 822_ Business 786-3430
Applicant Address P.O. Box 3.775 Eagle river, Alaska 99577
(c) Applicant is (check one): Lending Institution ❑ ; Owner/builder ® ; Buyer ❑ ; Other ❑ (explain);
(d) Lending Institution First National Telephone _ 694--210'
Address P.O. Box 770518 Ra,gle River}Alaska 99577
(e) Real Estate Company and Agent
Address
Telephone
(f) Mail the HAA to the following address:
pickup by engineer
2. TYPE OF RESIDENCE
Single -Family ® Multi -Family ❑ Other
Number of Bedrooms
3. WATER SUPPLY
Individual Well ® Community ❑ Public ❑
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsite ® Public ❑ Community ❑ Holding Tank ❑
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Pagel of 2 72-025 (11/84)
5. ENUINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DA i A AND INFORMATION
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health
Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained
from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on
the date of this inspectio0approval conditional on escrowing funds to replace septic
Name of Firm system +100' from cregEl'ephone
Address EAGLE RIVER ENGimEi:RMU' ;; WGES
Date EAGLE RIVER, AK 99577
X7
694-5195
?`�
? Engineer §pSeal:�
/i'0 crit cyA Sz
n
f '+tl aoa on o� eGo-'oo cc , �
/ter' -(:/_S .: 6
4C�
6. DHEP APPROVAL
rOAW !9'/oNA`L. 11
Approved for �A^�� bedrooms by �' '�' Date
ADDroved �`r Disapproved — Conditional
Terms of Conditional Approval
,51p9G7'C- 5YSS -e- -ten
11—MO-26,
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
72-025t11/84)
prior fo
buy
7��
l4�eIIT
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
72-025t11/84)
A. WELL DATA
�gyp,(
P�4 ON��R E 0vO"
Sao �4
MUNICIPALITY OF ANCHORAGE (MO^)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4720
Legal Description:o
�1'cl m' 71F If A, B, C, D.E.C. Approved (Y/N) /�`
Well Classification PP
Well Log Present (Y/N) �l Date Completed �7G — Yield �3, -Z 6P, T~,rAr/
Total Depth 3 Cased to y3y Depth of Grouting
lee
Static Water Level -7 y �D" o7P " `" ��-- Pump Set At
Casing Height Above Ground _ Sanitary Seal on Casing (Y/N) _
Electrical Wiring in Conduit (Y/N) y Depression Around Wellhead (Y/N) AU
Separation Distances from Well:
To Septic/Holding Tank on Lot On Adjoining Lots �iuu
To Nearest Edge of Absorption Field on Lot SOD / ; On Adjoining Lots oda
To Nearest Public Sewer Line y0(' To Nearest Public Sewer
Cleanout/Manhole /1�' To Nearest Sewer Service Line on Lot —
Water Sample Collected by �45Ce �" L' C°s"�"� r ; Date
Water Sample Test Results f1 s- 7`0, 7dr y
Comments
B. SEPTIC/HOLDING TANK DATA
(ter✓� Yi�ria / 6/e-,
Date Installed
Standpipes (Y/N)
Depression over Tank (Y/N)
Size
Air -tight Caps (Y/N)
Pumping/Maintenance Contract on File (Y/N) _
Holding Tank High -Water Alarm (Y/N)
Separation Distances from Septic/Holding Tank:
To Water -Supply Well —
To Property Line
To Water Main/Service Line
Course
Comments
Page 1 of 2
72-026(11/84)
No. of Compartments
Foundation Cleanout (Y/N)
Date Last Pumped
;for
Temporary Holding Tank Permit (Y/N)
To Building Foundation
To Disposal Field
To Stream, Pond, Lake, or Major Drainage
C. ABSORPTION FIELD DATA -Gty� •��/ f�e�iy
4dy��4�
Soils Rating in Absorption Strata
Date Installed
Width of Field
Square Feet of Absorption Area
Depression over Field (Y/N)
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water -Supply Well
To Building Foundation
Lot
To Water Main/Service Line
To Stream/Pond/Lake/or Major Drainage Course _
To Driveway, Parking Area, or Vehicle Storage Area
Comments
D. LIFT STATION V14
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Comments
Type of System Design
Length of Field
Depth of Field
Gravel Bed Thickness
Standpipes Present (Y/N)
Date of Last Adequacy Test .
To Property Line
To Existing or Abandoned System on
On Adjoining Lots
To Cutbank (if present)
— Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent(Y/N)
Pumping Cycles during Adequacy Test, Meets MOA
** Check Permitted Bedroom Rating Against HAA Request **
I certify that
..I�hav�he ed, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signed Date 1%-k1
Company MOA No. 5 T r X63"
Receipt No. �� / O 0
Date of Payment
Amount: $�� eP ° n.ineer'a, q
Page 2 of 2
72-026 (11184)
C99°GO�e°vppoe e°°a. YV a°m e•
Louis A. 1300 Ci
° C[:-673600
o a c
i�^°J° •• �\ l
00,
�] P\ar �
EAGLE RIVER ENGINEERING SERVICES
P.O. Box 773294
EAGLE RIVER, ALASKA 99577
RESIDENTIAL WELL, FLOW TEST
LEGAL: Lot 1. Blk 1, Majest.i.c Valley
LOCA`T'ION: Eagle River
OWNER/AGENT: Ziots
TYPE OF WELL: Private
WELT., LOG AVAIJ,ABLF.: yes
PUMP YIELD: 6 GPM
WELL RECOVERY RATE: + 3.2 GPM
DATE OF TEST: : November 12, 1986
'VEST PROCEDURE: The well was pumped at a steady flow rate of 6 GPM. Total
drawdown .from static water level was 17 feet after. 25 minutes of pumping. At
this point the water, surface _level in the well was at 89' below the top of
well casing. With the use of an electronic sonar. the recovery rate of the
sael-1 was monitored and calculated at an average rate of 3.2. GPM for the first
stage of recovery, this recovery cycle was repeated to verify results.
COLIFORM WATER QUALITY SAMPLE: 8/7/86 satisfactory
TEST RESULT: This well exceeds the D.E.C. daily requirements of 150 gallons
per day per bedroom for a 3 bedroom residence and meets FHA requirements of 3
GPM for 4 hours of flow. The assesment of the condition of this well applies
only to the conditions as of this date. The flow rate of any well may change
due to subsurface conditions that may not be observed from the surface,
changes in land use and other factors that may :impact, the conditions of the
aqu:i_fer supplying the well.
� g a�9%09AGL SPL
S
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
0 Date Received _ June 25, 1976
Time of Inspection
yV Date of Inspection _
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
Conv. �1
1. Approval requested by: Alaska Mutual Savings Bank % Chris -
Mailing Address: Post Office Box 1120, 99510 Phone: 274-3561
2. Property Owner: Wade Charles - Gary Pogany Phone: 694-2334
Mailing Address:
3. Legal Description:. Lot 1 Block 1 Majestic Valley Estates
4. Location: Mile 5.5 Eagle River Road
5. Type of facility to be inspected Single Family_ No. of bedrooms 3
6. Well Data: Individual
A. Type B. Depth
C. Construction _ D. Bacterial Analysis
7. Sewage Disposal System: On-site system
A. Installed B. Installer
C. Septic Tank: 1. Size 2. Manufacturer _
D. Seepage Pit: 1. Absorption Area 2. Material
E. Disposal Field: Total length of lines —
8. Distances:
A. Well to: Septic tank Absorption area Sewer Lines
Nearest lot line Other contamination
B. Foundation to septic tank , Absorption area _
C. Absorption area to nearest lot line
EQ -034 (1/74) Page 1 of two pages
Page 2 of two pages - Rec, ;t for Approval of Individual S )r & Water Facilities
Legal Description Lot 1 Block 1 Majestic Valley Estates
Comments
Approved
i
Date 'h `7-t 76
Approval,Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
II certify that the information contained in this request for approval to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED
EQ -034 (1/74)
Date
r
2( lig MUNICIPALITY OF ANCHORAGE111p I
(p, DEPARTMENT OF ENVIRONMENTAL QUALITY
�t,l`llP,gr.�a.i!t; J_1 i -I101'-1
3330 "C" Street, Anchorage, Alaska 99503 - 274.4561
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
1. Type of Inspection: CMRO VA _ FHA CONV
2. Property Owner: _ 'aade Charlet/ Gary Po�any
Mailing Address: Day Phone 6114-2331:
3. Name of Buyer: _ Frank and Ilona Grubb
Mailing Address: 31442 A. Citrus l-mendorC AFB Day Phone 753-6196
4. Name of Lending Institution: _ Al.raka Muturd Savings ;;aril.-- Chri_s
Mailing Address: 11.0• i3ox 1120 Anchorage Phone 214-3561.
5. Name of Realtor or Agent: ;done
Mailing Address: Phone
6. Legal Description;
Location: _
L 1 R 1 Najesti_c Valley Estates S/D
llil.e 5.5 Eziele River Rd
7. Type of Facility to be inspected: SF
B. Water Supply
Type of Supply: Public Utility
If Individual, number of dwellings presently served
If Individual, depth of well
9. Sewage Disposal System
Type of System: Public Utility
If Individual, date of installation
EQ -037 0/74)
No. Bdrms. 3
Individual XXX
Oue
Individual (on-site) `�`"x