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HomeMy WebLinkAboutMAJESTIC VALLEY ESTATES BLK 1 LT 2Majestic Valley Estates Block 1 Lot 2 #050-731-13 Municipality of Anchorage Community Development Department Page 1 of 2 On-Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage,AK 99519-6650• http://www.muni.org/onsite•(907)343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP181341 PID Number: 050-731-13 ❑ New ✓❑ Upgrade Name: JOSHUA ROBERTS ABSORPTION FIELD Address ❑ Deep Trench ❑ Shallow Trench 0 Bed EI Mound 25839 LOUINDA CIRCLE ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot Ft. Ft. MAJESTIC VALLEY 1 2 Fill added above original grade Gravel length Township Range Section Ft. Ft. Gravel width Beds:Number of Lines Distance between lines SEPARATION DISTANCES Ft. Ft. To Septic j AbsorptionI Holding Sewer Total absorption area Number of trenches Dist.between trenches From Tank I Field Lift Station 1 Tank Line Ft2 Ft. Well 105.5 N/A N/A N/A N/A TANK pp Septic 0 S.T.E.P. ❑Holding 0 Other Manufacturer Capacity Surface Water 90.7* N/A N/A l N/A ANCHORAGE TANK 1000Gat. I Material Number of compartments Lot Line 90.7 N/A N/A N/A STEEL 2 NA Foundation 28.9 N/A N/A N/A LIFT STATION Manufacturer Capacit� Curtain Drain 50+ N/A N/A N/A Gal. Remarks Pump on level at Pump off level at High water alarm at TANK REPLACE ONLY *SEE WAIVER OSV181075 • in. in. Pump make a odel Electrical Inspections performed by PIPE MATERIAL House to tank Tank to 3034 Installer drainfield 3034 JR'S SEPTIC SERVICES Drainfietd CO/MT Inspector PANNONE ENGINEERING SERVICES BENCH MARK (Assumed elevation) 545ft Inspeection ction 1s' 10/15/18 2w Location and description 10/15/18 3d 4u.' AT HOUSE POINT A COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp OFA( kt Conditional Approval: Date p.. 1 .• 1P• /\ >tr;�t .teven A. ISa*n`nonee �� � 239CEfOf8149 &Aire Approved A•.. ' —_'��/� Date (V- �C }kkP� Inspection Report_1-1-12.doc • \ \ • _ \ \ _ ? \1 - �y�� N ` \ \ — — \ / ^ N \ \ `�?+'- /f 570 \�\�Jy \ ? , rs- - \ \- — \ -- WF — , \ N , \ 1 ,,**t* 'i` — \ - -t5ctn: ...... \ — — f I— --- \ DRI VEW)\Q5.5 N TRUE NbRTN SCALE : TS 50'\ \ \ _ � A� 3 BD ? \ / s55 \ \ R MOVED 1000. SEPTIC TANK E Ilir ? \ ) \ \ \ PER MOA CODEgis ?\� INSTALLED NEW 1000q SEPTIC TANK \ i T1 11 550 \N \ \ — — / ' CONNECTED TO DCO (E lif 9 \ \ N\ \ \ A' \ \ 1 ? \ \ \ \ T2 \ \? l ` 545. \ \ N. t (Jr \ lnr `DCO E • A • \\ ° t\ � 1 1 \ � � \ \ y`� \ \V V r \ \ `� \ `' y ! N N \ Lv Q. N \ I EXISTING SEEPAGE PIT \ \ A. ? I —+� 4 — 1 N t 1 kM \ `7` - ? ^cl / \ I\ \ \N fa \\ - - ' J''S35 - - \ \ j. f � � — 1 \ — ? / I - \ ANTICIPATED OVERLAND FLOW — — C� \ Y N - - N. �\ DIRECTION (TYP) \ \ - 530 - - N. _ _ \ \ \ \ N. WORST CASE SCENARIO OVERLAN I F OW DIRECTION N • \ \ '� \ \ \ — CONSTRUCTED EK-441v1 TO PR-VENT EFFLUENT N \ =\( \ \ — / — \ m N FROM ENTERING SURFACE WATER — \ I \ \ W J - i \ ` \\ - y / \ \ - ?f\ �/ j N 520 \ 525 - -- ` \ — • I \ \ \ \ _ _ r WELL (E) \ \ _ — ` 1. ."-N., �� \ � - x!^. 515\ — � \ / ^ \ N \ O \ \ 1\ � ! - - \ ! \ — — / \ \ N i o • --- _ --` __� .\ 1\ — — 510 - L9l�INDA Cir ` N N ' ? ` ` \ - - --./ -- \ N N /- , — — 1 \'•-• - \ �- I \ \ \\ I! L ''• \ \\ _?'505 \ \ .-. •� I \ \ \\ l \ \ ' 1 \ \ N\ 1 A B N \ \ \ \ i ` Ti 30.6 37.8 `- N \ N ! / / TT2 36.5 42.6 CI -'5 o =o O O a Z 3.0 j =w • •I • E d V V O U 1.a ' .41111111 ,. - - _ I \///\.../\ ki� �Y���� �\ T��i W.\//Ys//V`ii — / 1000g —-- '''-';>.2,•>>,�>,:/ ,,,,, iY':&i, Jai >,• i?/i>/V.'s 538.4 SEPTIC \538 2 SECTION A-A TANK SCALE: NTS NOTES: PANNONE ENG SVC LLC \ Dote RECORD DRAWING P.O. BOX 102954 ANCHORAGE, AK 99510 •�� 10/16/2018 PHONE (907) 272-8218 FAX (907) 272-8211 �'•i• • 1 •, Scale *; Ia %\ ••* 1" = 50' � ,• ,`` MAJESTIC VALLEY ESTATES B1 L2 — ••11• •. P.I.D. NO 050-731-13 JOSHUA ROBERTS •• }•even R: -iinrisfw PERMIT NO. DRAWN ACP 't�;• CE 8149 25839 LOUINDA CIRCLE • OSP181341 SITE PLAN EAGLE RIVER, AK ';''' Sheet 2 OF 2 MUNICIPALITY OF ANCHORAGE menr On-Site Water&Wastewater Program .a,.� PO Box 196650 4700 Elmore Road Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 http:l/www.muni.org/onsite -% )�parttnent 44CH0a PVE On-Site Wastewater Disposal System Permit Permit Number: OSP181341 Effective Date: 9/28/2018 Work Type: SepticTank Upgrade Expiration Date: 9/28/2019 Tax Code Number: 05073113000 Site Legal Address: MAJESTIC VALLEY ESTATES BLK 1 LT 2 G:0363 Site Mailing Address: 25839 LOUINDA CIR, Eagle River Owner: ROBERTS JOSHUA Lot Size in Sq Ft: 48108 Design Engineer: PANNONE ENGINEERING SERVICES Total Bedrooms: 3 This permit is for the construction of: ❑ Disposal Field CEJ Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 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 • Received By: 411 Date: i0/2.-// D Issued By: . k vc Date: • 2.8 Municipality of Anchorage Y" P.O. Box 196650 0 4700 Elmore Road Anchorage, Alaska 99519-6650 0 (907) 343-7904 0 Fax (907) 343-7997 http://www.muni.orq/Onsite DevelopmentServices Department On-Site Water and Wastewater Section **** VARIANCE/WAIVER REVIEW **** Waiver#: OSV181075 COSA#: Permit#: OSP181341 PID#: 050-731-13 Legal Description: Majestic Valley Estates Block 1 Lot 2 Engineer: Pannone Engineering Services Applicant: Joshua Roberts Your request for a waiver of the required 100 feet horizontal separation from the septic tank to the surface water has been approved. The approved separation distance is 90.0 feet. See engineer's waiver request for justifications. Waiver approval is dependent on berm remaining in place, as shown. This waiver approval applies to the proposed septic tank only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. Waiver is Granted: X Waiver is not Granted: llDate: 9/02(9//8 Approved by: 4/4-660.R l Name of Reviewer **** VARIANCE/WAIVER REVIEW **** £PI.4 _ K VE.6bLtigado wiktv MUNICIPALITY OF ANCHORAGE p Community Development Department Phone: 907-343-7904 Development Services Division ��� Fax: 907-343-7997 On-Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 050-731-13 Property owner(s) JOSHUA ROBERTS Day phone Mailing address Site address 25839 LOUINDA CIRCLE Legal description (Sub'd., Block & Lot) MAJESTIC VALLEY ESTATES B1 L2 Legal description (Township, Range & Section) Lot Size 48,108 _Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field ❑ Initial ❑ Single Family(SF) ❑X (w/wo ADU) Septic Tank Q Upgrade ❑x Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE/WAIVER REQUEST FOR: SEPTIC TANK TO SURFACE WATER Dis tance:90.0' I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. __—, 4--2 -, (Signature of property owner or authorized agent) Permit/Rush Fees: a15-- Waiver Fees: 85 1 Date of Payment: q [asp? Date of Payment: G1 ` (r0 Receipt Number: n7-t-9-9 6 Receipt Number: (' a 343'7 _ Permit No. OSP1713(11 Waiver No. v 12 10�s Permit App_:.:•:_.._c Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE Pannone Engineering Services LLC OSP181341.Rebecca Carroll.09/28/1. Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve@panengak.com September 22, 2018 Municipality of Anchorage Development Services Department On-Site Water& Wastewater Program 4700 S. Bragaw Street Anchorage, Alaska 99519 • Subject: Majestic Valley Estates B1 L2 Ladies and Gentlemen: • 1 am writing to request that a permit to install a new 1000 gallon septic tank be issued for this lot. • The proposed systems will serve an existing three-bedroom house. Currently the lot is developed. The existing 1000 gallon septic tank is in failure. The existing tank will be removed per MOA code. The existing tank is located outside the 100' well radius, the proposed tank will be placed outside the 100' well radius. The surrounding lots are served by private wells, and there are no wells within 100 feet of the proposed septic tank. PES will verify all required 1 separation distances at time of installation. 1. Upgrade Tank Design. a. See Sheet 1 of 1 of the plan set 2. Surface Water: There is an unnamed stream approximately 90' from the existing septic tank. The proposed tank will be placed in the same approximate location. A berm will be constructed to prevent possible overflowing effluent from entering surface water. A berm will be constructed as shown on the attached plan sheet and a 15% longitudinal grade to the south such that any spilled sewage will overland flow in excess of 100 feet before it enters the drainage channel. 3. Topography: Lot 2 slopes from north to south at approximately 2-5% in the area of the tank replacement. The proposed installation will be located in the center portion of the lot next to the existing septic tank and absorption system. • Page 2 of 2 4. Waiver: We would like to request a waiver for separation distance between the proposed tank and the surface water. The existing tank is approximately 90' from surface water. The proposed tank will be placed at least 90' from surface water. The proposed installation will not affect the future development of the surrounding or existing lots. There are no wells or septic systems within 100 feet of the proposed septic location. If you have any questions or concerns, please contact me at 272-8218. Sincerely, O*(E 11 `1j i. Steven R.Pannone • ••. 8,49 r 11nor-%` • ♦1%: FSS;�4..... *P Steven R. Pannone, P.E. Owner/Civil Engineer Attachments: Municipality of Anchorage I rslie Wdter ddu d Wd,uewdter I/ EWED FCs7Fz1CODE C�UANCE WELL (E} I I mSP181 :' .C,erroll.09/2&1. �� r I t%* *** 44 44NQ LS J ,�' , . ~ \ \\- y \ � ' N --- _ `\ /\ -1-TRt�E NOd SCA1E : 1"=50' l _ \ OY' \ _ 20 Uti! E _ �� J \ __ - smt 1 -( \ \ N �j 'N- 570 �� \ 1 \ _ _ /rD N N \ \ 't— r 1 /r N \ -1----TIN N1 — ' ` �\ \\ r _ _ 102.8 \ _ _ � \ ` N j - ~ _ 565 \ \ ��1- \ `J� � � N 1 560- \ N \)/ - - - - \ I ` \ \ I ` DRIVEWAY 3 BD \ \ - It '� 1 \ 1 555 \ \ REMOVE AND R PLACE 1000. SEPTIC 8 / SD J \ l , \ \TANK PER MOA CODE \ I !\ \ \ \ � / f 550 I • / 'r 5 i.i--Jen c'i j \ 4�, 9- I IN N. \ N \ 90.9\ J � I \ `\� J \ sas,\ \ c,c- ,:"-----k..12 y •4( U EXISTING SEEPAGE PIT \ -, \ ' ; r\ \ \ \ Ji 540 \ M \ \. ,� \ \ \ �\ N. N. \ 1 S \ v I'S35 � ---.. _ANTICIPATED OVERLAND FLOW — — ' 1 N J '� 1 N \ �� DIRECTION (TYP) N \ �- \ — '530 _ — _ N �� N. I\ N ` WORST CASE SI10ENARIO OVERLAND FL04 N N. I — — r • ` \ I I\ — \ — \.- CONSTRUCT BERM CP) TO PREVENT EFFI ` _,Ni,,\ Y CO \ FROM ENTERING SURFACE WATER —w —w — WATER LINE / WELL RADIUS —SS —SS — NEW SEPTIC — 3.0 — -4111 ABBREVIATIONS 1.0 , ' ' TH TEST HOLE Zvi\i��wi:/7 //7 ..>vA/,\\' i i``>\`�i�`%i`i /> i,r (P) PROPOSED '\! i/N>,h /\>>i�iy,\*Ox >\\/ i�\ �yi� xi`\iV- (E) EXISTING �.i.//A/A/.li:� /,//:,:4/ ?}i?,�i?�/\//iv� ?`//V- /,./.?'"/,� �� CO CLEAN OUT N0. SECTION A-A MT MONITOR TUBE NO. SCALE: NT$ TYP TYPICAL • NOTES: PANNONE ENG SVC, LLC Dote F-9 MOA -REVIEW Or -P P.O. BOX 102954 ANCHORAGE, AK 99510 '(�G 9/22/2018 / l-7.6%.a C'O/iS'c2t-C r Io\J PHONE (907) 272-8218 FAX (907) 272-8211 4Q'••••• ,••. Scale / 'q2-:-- *. i\ '•* 1" = 50' -In1 P.I.D. NO CL,+�hL MAJESTIC VALLEY ESTATES B1 L2 ����\ • �'• 050-731-13 JOSHUA ROBERTS .. /even A. ' 9 .8 PERMIT NO. DRAWN I ACP �.,',. CE 8149 ,• 25839 LOUINDA CIRCLE , • SITE PLAN EAGLE RIVER, AK •• Sheet -" 1 OF 1 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP181341, Rebecca Carroll, 09/28/18 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP181341, Rebecca Carroll, 09/28/18 GRE. ER ANCHORAGE AREA BOF UGH � ,� Department of Environmental Quality aM� o 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME //s "/ S GUAIfI MAILING ADDRESS ��'lG L� �� ��°S�/�� PHONE _ // G LOCATION %F�' N 2& KCG`e/2 ,i 14 LEGAL DESCRIPTION SEPTIC TANK: DISTANCEf ,� NUMBER OF FROM WELL ' MANUFACTURER g'f4e _ MATERIAL 7T COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITYX,,GALLONS. SEEPAGE PIT: NUMBER OF PITS DIAMETER (0 OR WIDTH/-, LENGTH , DEPTH ` 0 CJ L r.jC+✓ _ s LINING MATERIAL CRIB SIZE: DIAMETER_DEPTH DISTANCE FROM: WELL �Z'� [f � TOTAL EFFECTIVE { BUILDING FOUNDATION i NEAREST LOT LINE ' 0 . ABSORPTION AREA (WALL AREA) �C= SQ. FT. ADDITIONAL ABSORPTION WELL: TYPE iP��� �� CONSTRUCTION �� r%�y�7�%��� DEPTH– Z;-7 v DISTANCE FROM: BUILDING NEAREST ,� NEAREST SEPTIC / SEEPAGE 01 FOUNDATION LOT LINE �� SEWER LINE—,TANK SYSTEM CESSPOOL OTHER SOURCES _. APPROVED DISAPPROVED REMARKS w1'/1 DISTANCES: INSTALLED BY: PIPE MATERIAL: �/ �� S7 Ko%o LOT SLOPE: REMARKS: Form No. EQ -031 DIAGRAM OF SYSTEM G.A.A.B. GREs ER ANCHORAGE AREA 1301 UCH DDDII DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO 3330 "C" STREET ANCHORAGE, ALASKA 99503 �TELEPHONE 2746t.�///Yl wAr AJ 4 w", i SEWAGE DISPOSAL SYSTE ® APPLICATION AND PERMIT NAME OF APPLICANT INSTALLATION LOCATION LEGAL DESCRIPTION INSTALLATION OF; SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH SOIL TEST RESULTS/ COMPLETION DATE ANTICIPATED MAILING ADDRESS PHONE NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL 'PEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE A- C) TYPE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT SEPTIC TANK TO SEEPAGE PIT WALL DRAIN FIELD SEEPAGE AREA SIZE SEPTIC TANK SEEPAGE PIT , DRAIN FIELD TO NEAREST LO7 LINE. % WELL TO SEPTIC TANK ! SEEPAGE PIT DRAIN FIELD —, ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK SEEPAGE PIT _ DRAIN FIELD SEPTIC TANK, SEEPAGE PIT , DRAIN FIELD TO RIVER, LAKE, STREAM, CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. G.A .A .B. */ OR LICENSED DESIGNER DIAGRAM OF SYSTEM I I I i I (� I I I I I r !!d �`- -- I I ! I '1-7 4l 1 -T- I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-66 AND THAT THE ABOVE DESCRIBED SYSTEM IS JN ACCORD:N DC—WITH SAID CODE, DATE !�•�APPL ICANT'S SIGNATURE FORM NO. EQ -016 Ss(i�'.nv.!s �:rs--n,:-..,.�Y..,.>:c:rc.-.z..+..z:.awe.+..a.w...v,.nvu:.__u_ymrr.,�••.ar-.eoa..w-+... ,r.�.sa.+sYw.....c..:�..n- -.m.e�.w..'...,�.,a,-.. ' IA 400 �o Pre n4er i t i Kzi 22 be I K 711 Eas ZI PRELIMINARY LIDI hereby certify that I have surveyed the followii u •,_ •. A ro described prropertty,:' lor_2, . i - -._ J.'At1���..�Lsssz.��:r�i-.�'"fti•5.?'_.`a _,��i�� f,,,�.64r :.,. i e Can v� , ' X �.,ti »r. �. �aer.J:', Anchorage Recording Precinct, Alaska, and that tho prr ' r r f posed improvements, as planned thereon by the builde will be within -the property lines and will not.ovorl+'�k" Y;f�, tr%ve _y-r�,� � y�,,n i s or encroach on the property lying adjacent thereto, thV, fi' V1, a no improvements on' property lying adjacent thercpi6 Nr» -acz', encroach on the premises in question and that there no roadways, transmission lines or other visible eas ments on saidproperty ; except as indicated hereon. 1 _ Dated atyEagle River, Alaska - - this__�.�1 .._...day oL [ Iy � 18_%TS. ROBERT C. JOHNSON ox?4} " SCALE: Registered Lard Surveyor No. 880-1 I"= o Box 456, Eagle River, Alaska Phone 834-2543;:... 0 £t E GEC, ^ECHNI CAL DEVELOPMENT CO. Bax 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688.2280 Russell Oyster v'%' 694-2774 � Ste' trj ±; Earl Ellis 1�e Soils Er Foundations 688-2280 Land Development OI�„ L LOG , Performed for: Name:,ls' 'mfr: ,. • -- -- — Tel . Not Mailing Address: Legal Description: l_'or /,jj ssrr Depth (___feed) Soil Characteristic - 0 2 3 4 5 8 9 10 /VIL. T 11 Ground dater Encountered: Yes No _ If yes, what depth yoT' a Proposed Installation: Seepage Pit Drain Field � °"I:46 A" "• �.• �^ Comments: �.«.............:.:...:. z w Earl P. Ellis ' 4 Truffirb Orating lkwg br DOC Co, dba SULLIVAN WATER WELLS P.O. BOX 670272, CHUGIAK, ALASKA 99567 e TELEPHONE 688-2769 f OWNER OF LAND DEPTH OF WELL ADDRESS f STATIC LEVEL OF WATER FF. LEGAL DESCRIPTION i J i')) DRAW DOWN FT. DATE -Started Ended GALS, PER HR PERMIT NUMBER KIND OF CASING KIND OF FORMATION: From Ft. to FL From. Ft. to-- Ft. From Ft. to 0 From —Ft. to Ft. From— Ft. to Ft. i, From —Ft. to-- Ft. From Ft. to Ft. From —Ft. to Ft From Ft. to Fc. i L" From Ft. to— Ft_ From Ft. to Ft. ito Ajj-i From — Ft. Et. From ---Ft. to Ft. - — - From Ft. to _Ft. From Ft. to i Ft. j ? r From_ _Ft. to _Ft. From Ft. to Ft. Froin—Ft. to --_Ft. From Ft. to—Ft. From —Ft. to---, C V L) From Ft. to Ft. 'J From Ft. to "tt Al V Ft. From Ft. to Ft. Froni—Ft. to From Ft. to Ft. From —Ft. to iNfluil'Grdality of Anchorag.e Dept. Health & HUMEAD St" VMOS 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 MISCL. INFORMATION: DRILLER'S NAME MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW920046 DESIGN ENGINEER:S & S ENGINEERS OWNER NAME:GAMMONS DONALD F & OWNER ADDRESS:P.O. BOX 771965 EAGLE RIVER AK 99577 PARCEL ID:05073113 LEGAL DESCRIPTION: MAJESTIC VALLEY ESTATES BLK 1 LT 2 LOT SIZE: 48108 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 DATE ISSUED: 3/27/92 EXPIRATION DATE: 3/27/93 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: EXISTING WELL MUST BE ABANDONED IN ACCORDANCE WITH DNR REQUIREMENTS. RECEIVED BY: - DATE :� ISSUED BY : -�C' tf?q snao-j DATE: E moo, o 2 /0 -3 IZ l_ OCA/A)DA Cf IRCLE vZ O LA z 0 o r O 1 I�IN m p "ooc °;�z d N w a 0 O p Id o ° o a, ❑7. . �? m CL o s p a= n a mN tr a p m a v w N o o D o a a p N .as ab 0 c� '❑ w a w n M• o ❑ c w 0 f• w w w 0 a 9 c O` I -. w OL It`v ., 3 ,., s a p n p, a m a> m p v w a < y Ip n on m c o n o a a H 3 0 p o a n 0 a p w N f• A Oa o ❑ c v o w ° 0 o aw a a• - o __ v � � w M a '! m '^= v ❑ w a y C � O a 0 D m m � o TnU\ Ql- /0 -3 IZ l_ OCA/A)DA Cf IRCLE vZ O LA z 0 o r O 1 I�IN m p "ooc °;�z d N w a 0 O p Id o ° o a, ❑7. . �? m CL o s p a= n a mN tr a p m a v w N o o D o a a p N .as ab 0 c� '❑ w a w n M• o ❑ c w 0 f• w w w 0 a 9 c O` I -. w OL It`v ., 3 ,., s a p n p, a m a> m p v w a < y Ip n on m c o n o a a H 3 0 p o a n 0 a p w N f• A Oa o ❑ c v o w ° 0 o aw a a• - o __ v � � w M a '! m '^= v ❑ w a y C � O a 0 D m m EPLS • Municipality of Anchorage �'' \ ` On-Site Water and Wastewater Program (907)343-7904 Certificate of On-Site Systems Approval Parcel I.D. 050-731-13 Expiration Date: 1. GENERAL INFORMATION Complete legal description Majestic Valley Est. B1 L2 Location (site address) 25839 Louinda Cir. Current Property owner(s) Joshua Roberts Day phone Mailing address 12110 Business Blvd Ste 6 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: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer El WaiverNariance request for: Distance: Received by: LZ IA/t 4 f ( Date: COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ 5a Co Waiver Fee $ Date of Payment i 0/ i q.`i g Date of Payment Receipt Number O 1 i log 1) Receipt Number COSA# n 5Ci'! 558 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. In conducting an adequacy test,I attempt to provide a thorough,conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations.The reported results describe 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 soil condition,ground water 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 this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system,nor do they guarantee that there are no hidden defects or encroachments.Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system.The content of this report is for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services LLC Phone (907) 745-8200 Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R Pannone Date 10/16/2018 6. DSD SIGNATURE #,/ •• ��` ®it!ti • System#1 Approved for S bedroomsSteven .'Panntint • CE-8149 System#2 Approved for bedrooms � 4 )4�6;.. \ " OFESSIu �:�' Disapproved \\w���0 Conditional approval for bedrooms, with the following stipulations: Y ON-SITE o7,� WATER AND m= WASTEWATER �p PROGRAM .: irrSER BY� Original Certificate Date: ) 0 g The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA)based only upon the representations given In paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet`. '. c If more than 1 septic system is on the lot: COSA Checklist# 1 of 1 Structure served by this system 1 Certificate of On-Site Systems Approval Checklist Legal Description: Majestic Valley B1 L2 Parcel ID:050-731-13 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well Log(YIN) Y Date completed 3/92 Sanitar seal YIN Y Y Y ( ) Wires properly protected(Y/N) Total depth 161 ft. Cased to +40 ft. Casing height(above ground) 24 in. FROM WELL LOG AT INSPECTION Date of test 3/92 9/14/2018 Static water level 125 ft. 113.6 ft. Well production 30 g.p m 2.4 g.p.m. WATER SAMPLE RESULTS: Coliform Neg colonies/100 mL Nitrate 0.775 mg/L Arsenic ND ug/L Date of sample: 9/14/2018 Collected by: PES B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel 10/15/18 Date installed Tank size 1000 gal. Number of Compartments 2 Cleanouts(Y/N) Y Foundation cleanout(Y/N) Y Depression over tank(Y/N) N High water alarm(Y/N) N/A Date of pumping NEW Pumper C. ABSORPTION FIELD DATA Date installed 11/05/75 Soil rating2 2 5 (g.p.d./ft o ft/bdrm System type Seepage Pit Length 16 ft. Width 16 ft. Gravel below pipe 6 ft. Total depth 10 ft. Eff. absorption area 384 ft2 Monitoring tube Y Depression over field N Date of adequacy test 9/14/2018 ResultsPass (Pass/Fail) 3 For bedrooms Fluid depth in absorption field before test 0 in. Water added 450 gal. New depth 0 in. Elapsed Time: 140 min. Final fluid depth 0 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment(past 12 mo.)(Y/N&type) None KnoWII If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access(YIN) "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 100 + On adjacent lots 100'+ Absorption field on lot 100 + On adjacent lots 1001+ Public sewer main 75'+ Public sewer manhole/cleanout 1001+ Sewer/septic service line 25'+ Holding tank 75'+ Animal containment areas 1001+ Manure/animal excrete storage areas 1001+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5 + Property line 5+ Absorption field 5'+ Water main 10 + Water service line 101+ Surface water 90 Wells on adjacent lots 100 + ABSORPTION FIELD ON LOT TO: Property line 101+ Building foundation 101+ Water main 101+ Water Service line 101+ Surface water 100 + Driveway, parking/vehicle storage 30'+ Curtain drain 50'+ Wells on adjacent lots 100 + F. COMMENTS *Waiver on file OSV181075 G. ENGINEER'S CERTIFICATION Ak s � I certify that I have determined through field inspections and rr''�P• ,./\4>•..-V review of Municipal records that the above systems are in p*; •.*'4 conformance with MOA COSA guidelines in effect on this date. I-• OA Engineer's Printed Name Steven PannoneSleveri 001:1110r1 .:• • �. e 10/16/2018 � �• CE-8149 . ra Date �.. COSA canary sheet_2-6-15.doc { . \`, l'i. 6T II' /O.Dt I x - nn 0. 60 ;�� � 4 .}J 7/ ' 1_.(1._‘1\ °,/... SSS T . 7 ,j 111�'` 0f�2G_ I %J f ! 7 \ R . /ill'f I1. ,: 01 i ;i '4 10 � , (11 ` � 1 ,,f/B9'5--1''C - —' 20../iY.G%', C-ic-iE ASBUILT SEWARD & ASSOCIATES LAND SURVEYING 694-0829 1 I HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE: FOLLOWING DESCRIBED PROPERTY: �``„‹:, -4'1SOF It I% inr7E��..�,-«7�>.sror�-,rlo72 i 14 •DATE. O.• . 9 '� AND THAT NO ENCROACHMENTS'EXIST EXCEPT AS . ;" ��• • •: INDICATED. IT IS THE RESPONSIBILITY OF THE 7 ��"� OWNER TO DETERMINE THE EXISTENCE OF ANY GRID: " •• ..d EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- 0" g,(// Du ,�d VISION PLAT. UNDER NO CIRCUMSTANCESI � Duane . .+s k s,w,re ,* SHOULD FB' f,: ANY DATA HEREON BE USED FOR CONSTRUCTION 7��'�74y tt` • `• _ti '.��• �9. OF FENCE LINES, OR FOR ESTABLISHING BOUND- '� ''rte, ,-• l ARY LINES. DiiAWNr <� �"�':sr r� ":" Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 — www.muni.org/onsite/� (907)343-7904 1 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. _ t�S COSA# Mo /5q Expiration Date: 1. GENERAL INFORMATION 'Complete legal description — 2 - Location Location (site address) 2GJ ID 3'1 --,s ny. A 1>2 Current Property owner(s) h—Ay^ RA 5,Day phone Mailing address a- Sci S � LO%gr6ii,/4 D K Lending agency Mailing address Real Estate Agent Mailing Address Day phone Day phone Unless otherwise requested, COSA 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 03�- 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 Onsite 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 Onsite 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 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 wells 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 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 C(4_57 Phone 491-5795— Address Engineer's Printed Name 5. DSD SIGNATURE __jZ Approved for Disapproved. 6C /o3$7 �1 Conditional approval for Additional Comments Date s CHRWOPHERR.WOOD bedrooms. _�;•.. CE 10187 ; bedrooms, with the following Y OF G`'.•' "o WnTFR anin Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: j r,ti Original Certificate Date: 0R (Rev. 11105) Municipality of Anchorage ' Development Services Department Building Safety Division -nn-Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: 7z- r� t� ' Ef L L Parcel ID: QI:b- 133 13 A. WELL DATA Well type 19,Mw Date completed3ftZ Total depth (L 1 ft. Date of test Static water level Well production If A, B, or C provide PWSID # _ Well Log (Y/N) 16-5 Sanitary seal(1 ) W Wires properly protected ON) Yew Cased to + FROM WELL LOG 3/cl2 IZi ft. 30 g.p.m. Casing height (above ground) -2� in. AT INSPECTION 14- g.p.m. WATER SAMPLE RESULTS: Coliform 4Lcolonies/100 mL Nitrate c°a mg/L : , Other bacteria — c6lonies/100 mL Arsenic: -rt mgA Date of sample:Collected by: 57'tia0T 4.40r&Yt1- B. SEPTICIHGLBtNG TANK DATA Tank Type/Material 56 Pru Z-erza Date installed _ )I /57/75• Tank size 4=2 gal. Number of Compartments / Cleanouts (94) V& $ Foundation leanouutt &%N) YE5 Depression over lank (Y&J "0 High water alarm (Y16) drp Date of pumping 1�Oy !�� Pumper. 54A- -MA A Ph ►+iQ�72 S C. ABSORPTION FIELD DATA Date installedt x I /vs/7� Soil rating (gp d�A.z or ft /bdrm) 12 S_ Length / 6 ft. Width Total depth ,-O ft. Eff. absorption area 3_1'Lfe Date of adequacy test y j %&4 System type A, Prr Gravel below pipe _�_ ft. Monitoring tube 16-� Depression over field _&Q Results (Pass/Foo) P.455 Fluid depth in absorption field before test 15 , in. Elapsed Time: 2"min. Final fluid depth 3-5- in Any rejuvenation treatment (past 12 mo.) (YO& type) _ Water added ??<gal. For 9 bedrooms New depth -9-0 yin. Absorption rate >__ y5_0 g.p,d, MO If yes, give date D. LIFT STATION Date installed -Size in gallon Nj 'Pump on' level at —in. `Pufievel'at in. High water alarm level at in. r1a�y Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: f Septic tank/lift station on lot ikx) t Absorption field on lot t �W 1 Public sewer main + 7 S f Sewer /septic service line ? Animal containment areas lur7 t r On adjacent lots 'i' fvy On adjacent lots f iyo f Public sewer manhole/cleanout 1"/00 / I Holding tank +75 Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HeL-BMG TANK ON LOT TO: f Building foundation 5 I Property line �_f Absorption field S Water main +to Water service line +101 Surface waterer `)/ 56v .,/2 S7 -o38 Wells on adjacent lots "f f xc_? SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: r g f-r� Water main +fU Property line 't'lc� t Building foundation Water Service line1 /U Surface water >' t 00 Ddveway, parking/vehicle storage 3 0 Curtain drain FSn t Wells on adjacent lots +11W r F. COMMENTS {-3o yR c7c� SbPri�T..4nAC PIMP 2Gnv2� SlfowS Wo ST�� G. ENGINEER'S CERTIFICATION I�Mc r��i A$'L� 2ER�C6HIb 1 certify that 1 have determined through field inspections and moi: review of Municipal records that the above systems are in L Q conformance with MOA COSA guidelines in effect on this date. Engineers Printed Name Date S %Z 51060 COSA Fee $ "0_ Waiver Fee $ _ Date of Payment 5/aTp? Dale of Payment Receipt Number 10gJ5,7 Receipt Number (Rev. 11/05) CHO1d, "V ;, N � m DUi ,.1p n v r �,) w � r A S�eab���so >N6� v r �,) w � r A � •' � i o p� a n o w Q � .�« w 0o v.0 N N C . p ILI ,94 1n In a ••.9 16.1 p -�. .•. o ; DIS oo -;sa=.s LA z Ilk W:8�'` r N N W p a C Municipality of Anchorage .`±j •. Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street ' A I T P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orglonsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 0156-a&1- 13 COSA # 04 0133 Expiration Date: 7— 1 1 — 0 1. GENERAL INFORMATION Complete legal description Location (site address) Current Property owner(s)_Adnry) f Srwik Smijk Dayphone[„q6�—(rS) (n Mailing address Lending agency ,25939 LCtnIr%&i Circle e I��i�cr.A�9015-1*7- C)fo 32 Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested. COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS:_ 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 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 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 wells 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 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 Eagle River Engineering Services Phone Inn 4 — S 116 113421 VI -W butte 201 Address Eagle RW; AKS 99677 Engineer's Printed Name 0iri -Ac ktr- R. 1,Qoc d Date q h7106 5. DSD SIGNATURE __LZ Approved for 3 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Q,�Io, a/.�,�c71r Original Certificate Date: 4-19- O /' rae..>>me) Municipality of Anchorage Development Services Department Building Safety Division ° On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 995196650 www.muni.orglonsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: M A I_-�c \/n I I t q E<J (t+c S L .�- 81 Parcel ID: O. So -7 31-13 A. WELL DATA Well type­a:i_vn-f4- If A, B, or C provide PWSID# _ Well Log &N) Y44- Date completed X -1Z Sanitary seal (PN)Yt4- Wires properly protected (int) ya-2 Total depth J-(aj_ft. Cased to Casing height (above ground) _X L4 n. FROM WELL LOG AT INSPECTION Date of test 3 PI 3 /8 /.2 00(p Static water level I ;t-5 ft. 113 ft. Well production 30 g.p.m. S 9 P•m• WATER SAMPLE RESULTS: Coliform _Z, , colonies1100 mL Nitrate . b 15 m91L Other bacteria a colonies/100 mL Arsenic: _Q1 m9N Date of sample: jW.1oo(o Collected by: r l .nrit -i 73alz(tr lull B. SEPTICMG6DMG TANK DATA Tank Type/Material f i C' _ Date installed I I S 17S Tank size IDQQ gal. Number of Compartments I Cieanouts ON) Foundation cleanout CM) yam- Depression over lank (Yl 19 %-flQ High water alarm (Yl64 W) o Dateofpumping 0Il1(0/05 Pumper Sani-ictrK -T rAm erS C. ABSORPTION FIELD DATA Date installed k llrbSoil rating (g.p.d.e or /bdrm I Z 5 System type Se TJ Rd. Length ((c ft. Width I (A ft. Gravel below pipe to ft. Total depth 10_ ft. Eff. absorption area 3afe Monitoring tube y� Depression over field '710 Date of adequacy test 313 / .�- Results 5 ail) For _3_ bedrooms Fluid depth in absorption field before test ;. In. Water added-4510gai. New depth in. Elapsed Time: -i,41Qnin. Final fluid depth, in. Absorption rate >= 'I SO g.p.d. Any rejuvenation treatment (past 12 mo.) (YkP& type) none, Izrx)ab'l If yes, give date n A D. LIFT STATION Date installed Size in gallons 'Pump on' level at _ in. 'Pump off" level pti Datum -----Cycles tested v E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/101-sialion on lot +-100' Absorption field on lot i I CO' Public sewer main -15, Sewer /septic service line +-,7i.S ' Animal containment areas +-10 c. Manhole/Aooess (Y/N) I� F H water alarm level at in. Meets alarm & circuit requirements? On adjacent lots -r 10(- , On oc- On adjacent lots -t-100 Public sewer manhole/cleanout +100, Holding tank + "15 ' Manurelanimal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/1-19tBlN9 TANK ON LOT TO: Building foundation + -� ' Property line + 5 Absorption field -+-5 ' Water main -4--(o ' Water service line + In' Surface water Wells on adjacent lots +- I co' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property tine +- 10' Building foundation tl O' Water main -1 10' Water Service line -+ I O ' Surface water •, --1 (X.), Driveway, parkingivehicle storage 30 Curtain drain t• C;O ' Wells on adjacent lots +- r cyU' F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name 1"14 Date 9 Za/0 6 COSA Fee $ y Waiver Fee $ Date of Payment _ 4� j�I ��O Date of Payment Receipt Number 3 Receipt Number, (Rev. 11/05) c LU wl /; ge oa���3so ow v, v< 1 om � nCY e mw N � 00 � a e w n s ��« �� •�'•• �•' �� vl �•1Vn C • O• w M y -;t ,•, • i • P. , :on •V \ � � fffnnn � n e o �• o' o a • • �� � �.�� m .3°0,00 00 � • � , .• ;a ' Ar \ I LA � Q •.� a �: ^ n ..i •i o s , s•�• COS fe o �w=P =a 0 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES �ccei�es� b Division of Environmental Services s' On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Lir /( J./ y CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 050-731-13 HAA #i1 L k LS� 1. GENERAL INFORMATION Complete legal description rni- 2, R1ock 1,, Majestic valley Estates Location (site address or directions) 25839 Louinda circle Property owner David Frieswyk Day phone 696-7997 Mailing address 25839 Louinda Circle, EagleRiver, AK 99.577 Lending agency Day phone Mailing address Agent-. Address Day phone Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 4 3. TYPE OF WATER SUPPLY: Individual well XXX_ Community well Public water 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: XXX Individual on-site 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 121 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 S & S ENGINEERING Phone -6 g! l/ — Z _7'� 17034 Eagle River Loop Road No. 204 Address Eaale River. Alaelra amr7m Engineer's signature 6. DHHS SIGNATURE — Approved for7--�E bedrooms. By: Disapproved. Conditional approval for Additional Comments C UJITIr Date - 'I � T Z 'T V-!� OF C7 .I ROBERT C. COWAN CE-8801�i�, 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 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 (Rw. 1/91) Beck MOA 021 • ECEIVED Municipality of Anchorage APR 0 9 1999 DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division `'"N4'IY Of ANCH rNk1Y�l ���/t SERVICES 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 344A4 Health Authority Approval Checklist Legal Description: L u T a r3Loc.,c I Parcel 1. D.: 0 S- o --- 71 ( 3 Mn 7'ESrc v�;La �y iTHi� S A. WELL DATA Well type Log present(9N) Total depth Sanitary seal (ON) Date of test Static water level Well production _ If A, R, or C, attach ADEC letter. ADEC water system number Y Date com feted 3 / 9 Z - 161 P Cased to �f V KL I FROM WELL LOG 30 Casing height (above ground) Wires properly protected (DN) _ AT INSPECTION Li Ci lfS� Y'4 Y' s g.p.m. � , 0 f g.p.m. A, c,ifLd 4y 11ur. P 4- Fi-ur„9o,•✓G- WATER SAMPLE RESULTS: Coliform 0 Nitrate /'0 / `I Other bacteria Date of sample: q/l Collected by: S & a ENGINEERING 7034 Eatil"rver Loop toad LaUle giver, Alaska 99577 B. SEPTIC/HOLDING TANK DATA Date installed 1 I 1 5-/ 7 S Tank size 1 � n � Number of Compartments _ Foundation cleanout (3/N) Date of Pumping 't l -7 C. ABSORPTION FIELD DATA Cleanouts (9l) Ye J'_ Y�I Depression (Y&wo High water alarm (Y/0_ /V0 1 ct ` Pumper T ✓t .S p�r�.� �G Date installed C f S / S Soil rating (g.p.d./ft2 or %bd m i aS _ System type Chi t3.�� Length N Width ) 6 Gravel thickness below pipe -Total depth Effective absorption area $W rr Monitoring Tube present&N) yr 5 Depression over field (Y/(9 r" 1) Date of adequacy test _ Results Pas /Fail) P 53 For _ 3 bedrooms If i ,/ to Fluid depth in absorption field before test (in.); a9 Immediately aftery�) gal. water added (in.): 3 3 � Fluid depth 3 -J- +/M (ins) Minutes later: 110 Absorption rate = _ t� 5 y _g.p.d. Peroxide treatment (past 12 months) (Y/N) N aN k KtJo„✓ rJ If yes, give date 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Manhole/Access (Y/N) _ High water alarm level at' "Pum "Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot �O0 r Absorption field on lot 0 Public sewer main N / Size in gallons evel at' On adjacent lots D U r _ On adjacent lots / n d Public sewer manhole/cleanout PJ Sewer /septic service line 'a- F -f- Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: i f r Foundation S Property line Absorption field S- -4 Water main/service line l0 a Surface water/drainage /00 `F Wells on adjacent lots /00 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line ) D r_)'_ Building foundation i0 Water main/service line Surface water % 0 D r4 Curtain drain 0 w W F. ENGINEER'S CERTIFICATION Driveway, parking/vehicle storage area r _ Wells on adjacent lots i 0 D 4 i certify that l have determined thru field inspections and review of Municipal in conformancewit�ideft es in effect on this date. Signature '� Engineer's Name / J 13 6,e)- C. C o �✓�F' Date `iI cd e) HAA Fee $ 7, d 0 ' Waiver Fee $ Date of Payment 0 �/- — ©/ f `,, 1 Date of Payment / Receipt Number 0 7� _ a 4 7`�S / Receipt Number 72-026 (Rev. 3/96)` Alltw, L ROBERT C. COWAN'' t,r aPiJl:, CE -8801 r a'r are MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES u� 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 1. D. # (11)Ri - i q—, 1 — t HAA # LEA 9_aLD. 1. GENERAL INFORMATION Complete legal description Lot 2; Btoch 1; Ma9utic Vattey Ea.tate6 Location (site address or directions) MHN Loui.nda Property owner Donatd F & Atyce J. Gammo" Day phone 694-2861 Mailing address P.U.Box 771965 Eagte Riven, Ata6ka 99577-1965 Lending agency Day phone Mailing add Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well XX Community well Public water 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: XX Individual on-site — 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 MOAN21 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 Phone Address 17034 Eagle River Loop Road No 204 Eagle River, Alaska 99577 Engineer's signature 6. DHHS SIGNATURE / Approved for bedrooms. Disapproved. Conditional approval for Additional Comments 0 C_ 1UTW Date 5-8-1:�AZ OF .�eg •aa°9p�� Y° i C'3?S.R Pio. iAy•••00 Otl>t••• \, GH bedrooms, with the following stipulations: Date Za47 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 n21 o Municipality of Anchorage Department of Health & Human Services 1 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L --'r 2- FA -w to 4 I F parcel I.D. A. WELL DATA Well type If A, B, or C, attach ADEC letter. ADEC water system number Log present ON) Total depth Sanitary seal &N) Date of test Static water level Well flow Pump level Date completed Cased to FROM WELL LOG 125 utl _ • SEPARATION DISTANCES FROM WELL TO Septic/holding tank on lot 1 ba 0- 0 3-17- Driller_.SJJ .- r �J" Casing height Wires properly protected (35/N)�r (� N AT INSPECTION oL� _ N L I°- LU tz.) g.p.m. g.p.m.SJ z o g � Z ; On adjacent lots �vc,�\~ Absorption field on lot bn t� _ ; On adjacent lots __ 100 Public sewer main 'SIA Public sewer manhole/cleanout F'\�� Sewer service line 7,5- Petroleum tank 25 1 + WATER SAMPLE RESULTS: Coliform L� (,oV�bD Q .'" ri/ Nitrate 0, 53h Other bacteria N'lJ�E Date of sample: �' s' % -Z- Collected by: 5 & S ENGINEERING 17034 Eagle River Loop Road No. 203 E3. SEPTIC/HOLDING TANK DATA ramie 1'lver, Alaska 99577 Date installed 1-57_J<�- Tank size 1 �C-p L;� Compartments I / Cleanouts &N) _ __. Foundation cleanout (?/N)�/Depression (Y/ J� t High water alarm (Y64) fl� Alarm tested (Y/N) ' d 1A Date of pumping Pumper sit , / l EA S SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot I o 0 14- __ On adjacent lots I b�_-) V4 --Foundation '34, To property line I,0 k~ Absorption field 2 r Water main/service line 10 ,I� I \' /Surface water/drainage —�f 9 I 2-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent(Y/N) High water alarm level Meets MOA electrical "Pump on" level at Manufacturer Manhole/Access (Y/N) SEPARATION -5 STANCE FROM LIFT STATION TO: on lot D. ABSORPTION FIELD DATA On adjacent lots Pump off" level at Cycles tested Surface water _ Date installed "'S' -7s Soil rating �--S ���� System type Pjr Length ��� Width 1 Gravel thickness Total depth 91 Total absorption area �i8`f-d' Cleanouts presentdY.)N) �l Depression over field (Yo r� Date of adequacy test Results as_ fail) PAgS for bedrooms Peroxide treatment (past 12 months) (Y& f4!,^I4 Khlot^!nl If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot t o o %�_ On adjacent lots Ino t Property line l t 4 - To building foundation -7'4 t To existing or abandoned system on lot 'S/,' On adjacent lots So f-'-- Cutbank /J1,k Water main/service line /0 f+ Surface water 00 17L_ y, parking/vehicle storage area Drivewa 2.0 14- Curtain drain �J 1A E. ENGINEER'S CERTIFICATION 1 certify that l have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. S & S ENGINEERING Signature 17034 Eagle River Loop Road No. 204 Eagle Piver, Alaska 99577 Engineer's Name Date HAA Fee $ 170 Date of Payment Receipt Number? 72-026 (Rev. 3/91) Beck MOA 21 Waiver Fee: $ Date of Payment Receipt Number 9R 60 Z/�C7d/Q�C� Sf S rn . o � o f1 r n U 1 rn t7 (� Z I�a -3/ (0O 47'GV- o �� <1J 0 m oN o O O O O A r l N O .0 o. & N cn m A ? -+ a a ° ° N N In c u (� �. �. �. u V` r �j1t1�' Q '; a p° Y o o �� t� m o 0 0 0 0 m 1.4 • 5�.,' m l 0 A V� ° a m06 a m< o ui i • �i•• 7¢ r rn o C c O n o -7a.. N a d .• :� • �: ' _', ro ° ' V "' Qz y m P- n v; In o° a =. _= o y " m m .�� a 0 o 0 y o 'y � + f � ry n o '� , • irs \I I nn 41i D ° c u y o n v o �♦� ••. •a• 5 •� 3 ft 0 CL "Ni o1�cc�'• N N n A O O ,a o* W�ro a� o�_� *3w "N N IE MUNICIPALITY OF ANCHORAGE O DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES m CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVALn OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date r 1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Z /"S -I e- I MA3L-: S7/LP141-1-CIV L 57 Location (address or directions) L-. (b) Property Owner Telephone: Home Business Mailing Address (c) Lending Institution Telephone Mailing Address (d) Real Estate Company and Agent Address 27 o,/^'v a l/ /Cn JAS C. /Z tc- 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. I ERING 17034 Fant u•„ r'oaa_.QvzB�- Eagle River, Alaska 99577 2. TYPE OF RESIDENCE Single -Family CY Number of Bedrooms 3. WATER SUPPL�Y� Individual Well L 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. SEWA77u OSAL Onsiteblic ❑ 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 8/861 Front 13U@ (9818 AOU) SLO-LL e to Z aSed ')IJOM S'Aaeulbuo !euo!ssaloid all ui suo!ss!wo ao saoaaa Aol a!q!suodsai lou si abeaolouy to tl!!ed!o!unln! all •pansyi si aleo!1!uao a eAolaq elep azAluue Ao suo!loadsui lonpuoo lou op SHHQ to saaAo!dw3 sluawaa!nbei alels pue !eaapal u!elaao Alspes of aapio ui suo!lnl!lsui bu!pual a!all pue sawoy to siaseloind of Asalanoo a se s!gl saop SHHO a41 •else!y to alelS agl u, paaals!bai aaau!bua !euo!ssalo.(d luapuadopu! ue Aq anoge 9 4dea6e.(ed u! UOA16 suo!leluasaadaa all uodn A!uo paseq salea!l!laao !enoaddy (luoUlnb ll!eaH sonss! (SHH4) Sao!nJaS uewnH pue ll!eaH to luawliedaQ abeaogouy to Al!!ed!ownw all NOI1f1V0 !enoaddy !euo!i!puo0 to swaal !euo!l!puo0 panoaddes!Q X panoaddy ale � Aq swooapaq aol panoaddy lVAOaddV SHH4 '9 :a ,',', �•d,ql Yp ' us I l YY a,4J t.YF\ae\n li air\e• LLG" ejselV'.aenlb a16e3 algia Par"ONaan!a 01 e3 4fOLL ssaappy auolda!awa!d to aweN •uo!loadsui sill to alep all uo loalla ui suo!le!nbaa pue'saoueu!pio 'sapoo alelS pue !ed!o!un!n! !!e ll!M eoue!!dwoo ui s! wags (s !esods!p aalumalseM ao/pue Alddns aalum al!s-uo all 'uo!loadsui pue uo!le6!lsanu! Aw woal pue sap 96eaolouy to Sl!!ed!o!unlny aql woal pau!elgo uopewaolui all uo paseq legl Al!JaA aalunl ! •u!aaal paleo!pui ainlonjls to adll pue swooapaq to aagwnu all aol alenbapepue !euo!lounl'alessiwalsl(s!esods!pialumalseMao/pue(!ddnsaaleMal!s-uoalllellsMogs!enoaddy (l!aollny ll!eaH S1141JO u01le611sanu1 AW legl Aj!aan ! 'Mo!aq uMols alep uoµep!!en all to se pue olaJal pax!)le !eas lw (q pai ppeo sy NOIIVWIdOdNI ONV V1VO `HOHV3S 3'11d `S1S31 `SNO1103dSNI UNIMAObld Wlild ONIl133NION3 '9 A. WELL DATA MUNICIPALITY OF ANCHoICIPALITY OF ANCHORAGE (MOA) DEPT. OF HEALTH &HEALTH AUTHORITY APPROVAL (HAA) ENVIRONMENTAL PROTECTION CHECKLIST -FEBRUARY 1984 264-4744 �pUj2`1987 RECEIVED Legal Description:(- o rr �5 6.1 f _ M la sr e VAL"Sy L -s: . Well Classification �� If A, B, C, D.E.C. Approved (Y/N) - (1A Well Well Log Present) Date Completed Yield `/ ayPA Total Depth I Z Cased to i Z 3 Depth of Grouting _ Static Water Level /Uo' (/ Pump Set At l �• /� /! Casing Height Above Ground Electrical Wiring in Conduit Y(6 1) Separation Distances from Well: Sanitary Seal on Casing (O/N) — Depression Around Wellhead (Y& To Septic/Hofdirnl-T-ank on Lot A? �1 2-r ; On Adjoining Lots '4 To Nearest Edge of Absorption Field on Lot /IZ ; On Adjoining Lots 14 To Nearest Public Sewer Line KLA To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot 25,4 Water Sample Collected by Date Water Sample Test Results fh %JSF4(TUi7 F0A NITfib)'ES COL. Comments :t )'JC'L F4 -ow r��2�iznnr 6'8 q- 1--0& y/VZ-5 SC-Ze TV, e -"a'6 Iti�A-ivr-`ft �2tra�c`si B. SEPTIC/HOLDING TANK DATA Date Installed // -S- 7 � Size /000 No. of Compartments Standpipes{( l?N) Air -tight Caps&) Foundation Cleanout ON) Depression over Tank (Y/b - Date Last Pumped j6 to - 5 - 5'-4- Pumping/Maintenance Contract on File (Y/N)%/1 ; for W/A Holding Tank High -Water Alarm (Y/N) ��8 Temporary Holding Tank Permit (Y/N) �A Separation Distances from Septic/Holding Tank: To Water -Supply Well 'ta To Property Line To Water Main/Service Line Course !'P i/ To Building Foundation To Disposal Field 3Y/ 3a' To Stream, Pond, Lake, or Major Drainage Comments V�v �aA r�✓ -S e rS �� -5? 8 i -bZ2 4 cY> WAlyo2 %�t7�ycS i Page 1 of 2 72-0261Rev 8/861 Front C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata/ ZS 91/4 L Type of System Design s6'b'Oh �c Date Installed Length of Field Z& + i Width of Field Depth of Field 9 , Gravel Bed Thickness Co Square Feet of Absorption Area 38`� Standpipes Present/N) Depression over Field (Y& Date of Last Adequacy Test B Results of Last Adequacy Test S� tiB,F Gf?�2y F02 3 Q �, Separation Distance from Absorption Field: To Water -Supply Well / Z To Property Line /d ` To Building Foundation L To Existing or Abandoned System on Lot � On Adjoining Lots S014 To Water Main/Service Line /b /4 To Stream/Pond/Lake/or Major Drainage Course _ To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION To Cutbank (if present) Date Installed Dimensions Size in Gallons Manhole/Access (Y/N) "Pump On" Level at "Pump Off' Level at High Water Alarm Level at Vent (Y/N) Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed S & 3 ENGINEERING Date CompaJ7034 Eagle River Loop Road No te No -2 `_3 Eagle River, Alaska 99577 Receipt No.� Date of Payment 1 CX7 / U� '..J—�, Amount: $ Page 2 of 2 72-026 (Rev 8/86) Back Municipwity ®f Anchorage June 30, 1.987 P.O.. OX 196650 ANCHORAGE, ALASKA 99519-6650 (907) 264-4111 TONY KNO WLES. MAYOR DEPARTMENT OF HEALTH & HUMAN SERVICES Robert A. Shafer, P.E. S & S Engineering 17034 Eagle River Loop Road 4204 Eagle River, Alaska 99577 Subject: Waiver Request For Lot 2 Block 1 Majestic Valley Est. Waiver Number WR87-038 Dear Mr. Shafer: Your waiver request for the subject lot has been approved for the well and the stream. The required 100 foot separation for septic tank to well and septic tank to stream has been waived to 72 feet: and 91 feet respectively. A positive point to this waiver is in the event the septic tank were to leak effluent it would tend to flow in a parallel direction with the stream because of the slope of the terrain. This would be the case for the well also. This waiver applies to this existing septic tank only. In the event of a future upgrade, all minimum setback requirements would have to be met. Sincerely,, Daniel J. Roth Civil Engineer on -Site Services cc: Gus Andress, P.E., Manager on -Site Services/Water Quality Programs n9itr\ HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSAL SYSTEM DESIGN ROBERT A.SHAFER CIVIL ENGINEER 694.2979 June 25, 1r9,&ICIPALITY OF ANCHORAGE 0,pT' OF HEALTH & U,IVIRONMLNTAL PROTECTION k30R4 2 61987 �E(-EIVED Muvu.c.i.pa.P.i..ty ab Anchorage Department o4 Hea2.th and Human Services 825 L Street Anchorage, Atasha 99501 REFERENCE: Lot 2; Btock 1; Majestic Vattey Estates Request you .issue a Heakth Authority Approval and grant a waiver flak the har.izontat separation distances between an existing septic tank and a pkivate wet and a sur4aee water source. The existing on -.site wastewater dispaaat system was in.6ta ted on the 4e4ereneed property .in November, 1975, with the G.A.A.B. granting a waiver between the private wett and septic tank ab 65 4eet. No reUerence was made .in the m g.inat .inspection report to the sur4ace water source. Attached bar your review are the 4ottow.ing documents: A. Health Authority Approval apptication and check sheet. B. wet log. C. Coti6orm and nitrate analysis taken 4rom the private we t. V. Plot plan. E. A waiver review check sheet. In accordance with the risk anatys.is per4ormed by us it .is aur opinion that the, horizontal separation distances prescribed by 18AAC72.021 are not required .in this case. The exi.6ti.ng septic tank .is 72 fleet 44om the private wetl and 91 fleet 44om the zur4ace water source_. 14 we May*e o4 4u4ther 6eu ice, please contact us. /'S's A. SHAFER, P.E. SRB 196X EAGLE RIVER, ALASKA 99577 I MUNICIPAIA �',' '!. " A-h t.- .() I I 0"-1. DEPARTMENT OF HEA1,11i AND HI'XAN �EPVICHS WAIVER 'ACMSHF,1"1' DATE RECEIVED:_ --8'4 -LA vNG I N F.EK: SK B 196X fiAGLE RIVER, AK 9t W !%!)PLICANT; 4crcc WAIVER REQUESTED:— ry 91' 6 �Q'Kp CE 1n�i Clt I TER [A: 1) Geology: A. Water Table B Soil Sorption C. Permeability D. Water Table Gradient N., E. Horizontal Separation 2) Special Conditions: 3) Other: . ......... WAIVER graaCed , wi Ch cend c ic,w,; :I -;t -eel below: riot &CnaLed ce.:i�-ntm) � i,ciow. moo Z2T. a 2 a S -S-ENGINEERING-- -- - - -. - - I _ - - ---. - -- -- ----- 1 434 Eagle River Loop Road No. 20 .ogle River, Alaska 99577 W J vz ! tcwc'si Z Fz&, Wdcc iC, 5&PTlc_ n1!c : 9/ ' 1- �I Scpn.JC if}n/!C %O jvRF•9/cC fi4T�YL C572�i3 +7 1 WA) V=17 A kiA,Y V S %02 N�ni �c> 17�9L �cPII P-,9?tcr / OJCiW�7 wJ I fnu_ AAIA [err -o. r'2aM t.✓�'z.� �c�• 30T7Z'or 5c[c Svsra 9[ 18) JbrL C/9 /a v LC/}Yet Y (,2.Avczc. SA,vAY (�eA 84- K/IR-6 J>A.-[ Jw Cl. 2 i e 1, r� ,oe 3 0 0,V's 4,r M4 71 VE �/r4L[(,' a ' /c, `o C l I�ldn, on[,7aL S,�-PA-iL✓rTir�„! 7Z Sc?/4211-7oiJ � [,�riv'Yz_t%Cl�,%� (D.c'l lei S c0,o�,;s OWNER OF LAND ADDRESS Tprtifirb 43rilting lkxg by A &,L DRILLING COMPANY BOX 67, EAGLE fiIVER, ALASKA 99577 • TELEPHONE 694-2688 DEPTH OF WELL / n/ STATIC LEVEL OF WATER FT. LEGAL DESCRIPTION k—o; /jC/c/ �/IS 5�7LI/I�L �S% DRAWDOWNFT. DATE - Started / : -' Ended GALS. PER HR f } i PERMIT NUMBER KIND OF CASING —L• KIND OF FORMATION: Ft. to Ft. From From From Ft. to < <� Ft. ' a l,) �' :E �'; ' / From Ft. to_ Ft. From From ' Ft. to Ft. -s / - From Ft. to__ Ft. From _.) `! Ft. to i , ; Ft. °%? " i' [ 1 /c From Ft. to_ Ft. From E'.._5' Ft. to Ft. i-% . 'sr0 From Pt. to__Ft. From i `' Ft. to Ft. From--- Ft. to——Ft- From Ft. to Ft. From Ft. to Ft. Prom_ Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft.- From Ft. to F From Ft. to Ft. From Ft. tot+ x Froin—Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From— Ft. to Ft. From From Ft. to Ft. From From Ft. to Ft. From Ft. to Ft. MISCL. INFORMATION: From Ft. From Ft. From Ft. From Ft. to_ -p. From Ft. to Ft. From Ft. to Ft. From —Ft. to _Ft. r DRILLER'S NAME MUNICIPALITY OF ANCHORAGEMUNICI LITY OF ANCHORA C� / DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIT OC i` a - 825 L Street - Anchorage, Alaska 99501 - ENVIRON1mL, ; i,..t. ,.- i _(CTION'��` - ENVIRONMENTAL ENGINEERING DIVISION II/1A'i3 930 0* Telephone 264-4720 1 t7 '- REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND !R%FCRE +� jIf 1 S DIRECTIONS: Complete allpartson page 1. Incomplete requests will not be processed. Please allow ten -(10) days for processing. - -- 1. PFiOPERTYOWNER PHONE' MAILING ADDRESS -77 PROPERTY RESIDENT (If different from above) PHONE 2. BUYER - - - PHONE MAI1-1NG ADDRESS /l /7 E%lO/>ll�%���%C7GG ~��iJ���t� ?HONE 3. LENDING NSTITUTI N MAILING ADDRESS 4. REALTOR/AGENT PHONE MAILINADDRESS 0 911 I 5. LEGAL DESCRIPTION LCA-"_` r-:?_ 0 STREET LOCATION / 2 FF 6. TYPE OF RESIDENCE NUMBER OF BEDROOM ❑ One ❑ Four El Other - SINGLE FAMILY_ ❑ Two ❑ Five ❑: MULTIPLE FAMILY E2�_ Three: ❑ Six 7.- WATERSUPPLY fINDIVIDUAL* _ * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM **If individual/on-site, give installation date ����_ • INDIVLDUAL/ON-SITE** If system is over two (2) years old an adequacy test is required 0 PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FEE MUSTACCOMPANYEACH REQUEST BEFORE PROCESSING CAN 13E INITIATED. THIS SIDE FOR OFFICIAL USE ONLY - INSPECTION APPOINTMENTS DATE RECEIVED - TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS; 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY O MULTIPLE FAMILY NUMBER of BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED — LOG RECEIVED Oj 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON-SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATEINSTALLED- _7� INSTALLER ❑Septic Tank or ❑Holding Tank Size:1000If Tank is homemade give dimensions: SOILS RATING Sr TYPE OF TANK - MANUFACTURER - l TOTAL ABSORPTION AREA MATERIAL r 4. DISTANCES WELL TO: Septic/Holding Tank S._ Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line -- 5. COMMENTS nn _ EU--APPROVED FOR .S BEDROOMS ❑ CONDITIONAL APPROVAL (letter must a co pany certificate) E4--DISAPPROVED DATE f /� _ (_ - BY (Titl - r LEGAL DESCRIPTION c-v�v �nev. oil 01 Yr. Broderick P.O. Box 1201 Eagle River, Alaska Dear ter. Broderick, DAVID A. SLENKAMP MECHANICAL ENGINEER 694-9055 August 2.2,`1980 99577 ROBERT A. SHAFER CI vv ENGINEER MUNICIPALITY OF ANCHORAG j4-2979 DEPT. OF 1{ -;J_ -i',.-; CTION ENVIRONiJ:EN1AL : � - Reference:- Lot 2; Block l; Majestic Valley Estates A ,J G 2 2 11 Wi0 RECEIVLI) An adequacy test was performed on the sewage system serving the referenced property in accordance frith your request. The septic tank was pumped and verified by Municioality records to have a capacity of 1000 gallons. The seepage pit was chrrged with approyi— mately 1000 gallons of water and after a period of 4 hours all the water which had been added had percolated out of the seepage pit. It can be concluded from this test that the sewage system (septic tank and seepage pit) is adequate to serve your three bedroom home. If we may be of further assistance, please do not hesitate to cal -l. Sincerely, I cc: I,unic-4ality of .Anchorage Department of Health and Enviornmental Protection Totem Realty ATT�Mcw: Audrey'Ja son National Bank of Alaska SRB 196X EAGLE RIVER, ALASKA