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HomeMy WebLinkAboutMAJESTIC VALLEY ESTATES BLK 2 LT 4Majestiec Valley Estates Block 2 Lot 4 #050-731-44 • V Municipality of Anchorage ' ;,• Development Services Department Building Safety Division ..., On -Site Water and Wastewater Program, 4700 S. Bragaw SL P.O. Box 196650 Anchorage, AK 995196650 Page of www.cLanchorage.skus (907) 943-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. SW050283 PID Number. 050-731-44 Name. Bernie Schuyler Wastewater System: ❑ New®UP9 rade ••• PO Box 771074 ABSORPTION FIELD Poon@ Nrrora e.amma: (907) 240-5590 D Da@,, rwc t I(' SW W TranN O So O M"W O OIMr LEGAL DESCRIPTION Sol Ratap o.6 Taal Dept, km atprut grade , F 4.7 F t. abet: La sltd%iw 2 4 Majestic Valley Estates Depl, b ppe edmm tan pighm 0,1410. Gray dap^ b@,radr pp@'. 2 Ft. 2.0 Ft Td mwp Rrw.: 6@mac Fl aadb sedv@*Vo%M Wad@: Wavy LWVM 0.0 Ft. 2 M 53 Ft. Well: New El Upgrade G,avr wv [ 5.0 14 r Mkw 2 Dmrra b01~1 W46 15 Ft. FL crsadwatwt tprnra, A S. cp T"Depes casadw TOW aewpwn rex p°'"Perf: 1810 Ft. FL 5301' FT Dmar oro DNWd: sMecwr.L*. awmr: Data FL Bernie Schuyler 11 — 9/15/05 Y.Wd prop Sn K Casap wqa Am Croutd TANK - Existing GPM FL FL SEPARATION DISTANCES 19 Septic ❑Holding ❑S.T.E.P. ❑Other. To Septic Absorption Litt Holding Pub6UPmaltaanaaacoear, capaotF. From Tank Field Station Tank Sewer the Greer 1000 Gr Watt1001+ 1001+ NA NA 251+ tarmac Steel NamCer a Companmems 1 2 snccewatw 1001+ 1001+ NA NA LIFT STATION- NA sua. Mar W.ar La Mw 58+ 51 NA NA cat 51 101+ NA NA 'flop @n' wan 'Pump ar ia.N at Nph wrnar ram, at-Faagrwn h h N cunrn Drrn NA NA NA NA pop Mak@"mO o El@ " msp@caom pMpmM or R• The h SE end of the lower SAS Trench BENCH MARK Laauo^ w Dasaptwn in 1 from the Property line— the Topof concrete garage slab at west rest of the new AS In 101+ from jts r d E.a.a.a side of garage door. 100.OFL the PL The existing ST is beneath the garage floor. It was inspected with a camera and�,�V.p�a Engineer's Stamp � �OF.AJ %I er, t •'�%`dad the tank and baffles determined to be in satisfactory condition. Inspections performed by: Pinard Engineering Dates: 1' 9/11/05 titg�'. 0* ' 9ZN •: •;d.• 2n° 9/12/05 ee • •• .. al.ete Develop nt Services Department Approval S' '�'� ""'• •' ••'••••' Pani E. Pinard :f Reviewed and approved b : Date: ,3 --�� '. . 6� •; CIE -4703 ; /,, (e.. 1_4141) w� 3 ^ fn \ r� a ►7Y 00 M c%, e W Q ca W _pp^Z w�.w \ e� U H CL Na l0 �S 100 ♦� � ^ (n' 3 W 0 tn W W c • e 7 ^ (U Q co In Z 9 O v=N` c=Mi E°�s � � a m cn Aapyw d C Zy�j �.7 �.� pl•O� {T. 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O O Q'- r CQM O q q 00 E-4 H G1W 0` U Q` 0 O z a� a as / C9 to CO 50 LU z e/ g 41 VG Aw (XV4N S3'1 AHI; WTI lgcMT Stv Wn V7.:)A M 1 0 6 \ Z q o � -xi l� ti �Itf W ca 0 v la.S. ;��K YvG=y 1 V ;r } dddd� C 25 n, n* !Cc lai�l,� • o w �IDa gps yA �f (y, •� [ F• Is f s M .y pan LE"j7B7 �S r�• • J d� � t � Z fispt ore ci s. 7 tYYLLI En 40 rn tr -12N'] uj 41 VG Aw (XV4N S3'1 AHI; WTI lgcMT Stv Wn V7.:)A M 1 0 6 \ Z q o � -xi l� ti �Itf W ca 0 v la.S. 41 VG Aw (XV4N S3'1 AHI; WTI lgcMT Stv Wn V7.:)A -xi �Itf la.S. ;��K YvG=y V ;r } C 25 n* !Cc lai�l,� • o • �t •� [ F• Is f s M w>. 41 VG Aw (XV4N S3'1 AHI; WTI lgcMT Stv Wn V7.:)A PINARD ENGINEERING o P.O. Box 871347 Wasilla, AK 9%87 (907) 357-ENGR (3647) WELL FLOW TEST LOCATION: Lot 4. Block 2, Majestic Valley Subdivision DRILLER: Jay Williams Drilling Co. DATE WELL COMPLETED: 1012179 WELL DEPTH: 170' STATIC WATER LEVEL (top of casing): 22.1' JOB NUMBER: 05.151 DATE OF TEST: 11/10/05 FIELD STAFF: P.J. Pinard Time Elapsed Time Minutes Static Water Level Flow Rate Cumulative Gallons Pymped Remarks 7:35 PM - 22.1' 5.3 - Start Test - Meter 276560 7:50 15 42.5' 5.3 80 276640 8:05 30 59.1' 5.3 160 276720 8:20 45 68.5' 5.3 240 276800 8:35 60 77.7' 5.3 320 276880 8:50 75 85.0' 5.3 400 276960 9:05 90 91.2' 5.3 480 277040 9:20 105 99.9' 5.3 560 277120 9:35 120 106.4' 4.7 640 277200 9:50 135 112.2' 4.7 710 277270 10:05 150 119.8' 4.7 780 277340 10:20 165 124.1' 4.7 850 277410 10:35 180 127.3' 4.7 920 277480 10:50 195 129.7' 4.7 990 277550 11:05 210 132.4' 4.7 1060 277620 11:20 225 134.2' 4.7 1130 277690 11:35 240 137.1' - 1200 Stop Test 277760 RECOVERY 12:05 AM 30 111.4` 12:35 60 93.4' 1:05 90 76.2' All well vrotection features are adequate. Average Flow Rate: 5.0 gpm Comments: DURING THIS TEST. THIS WATER SUPPLY WELL WAS CAPABLE OF PRODUCING 5.3 GPM. THIS TEST DOES NOT CONSTITUTE A WARRANTY OR GUARANTEE THAT THE WATER SUPPLY SYSTEM WILL CONTINUE TO FUNCTION AND PRODUCE AT THIS RATE. Reviewed by Paul Pinard l' - Date: 11/20/05 GSSGS/CTBE ENVIRONMENTAL SERVICES Drinking Water Analysis R'edorCfottotal'Cofe rrri Bacterie READ MSTRUCTIONII ON REVERSE SID[EffORE COLLCCTiNO eAMP,Ii MUST BE COMPLETED BY WATER'3UPPLIER ;60; 551 $301 x 1/ 1 ANC HO RAGE, ALASKA` PIS Tat a07.56Z-21'aJ. - Fax 007-661401' ❑ FUSUC WATER SYSTEM me ,RKRNATC WATER SYSTEM . IL Sand Rea„ to 0- senah"Im SA LE C.OLLECTIOM ' /..•.+e. .r r wry Dare: i /D zcc 5 Traneperbd a L,a an Ksame ae eowtor Other. IK= I an RN N& 1�4lllifillit 57559-1/� IUItl SAMPLH TYPE:' KRouarw ❑ Treated Wobr Repeat Sample ❑ UM»ated Water (raferto tab no. spacW Purpose TO BE COMPLETED BY LABORATORY Eamota RaeelvjM. Date: 002vory Mot) ReceMed ❑ samprleverse tvu ell: Pn lw may be uvwbwo ❑ {e lav Weher . / •ri�wrol• LmtEns ❑ RUSH SAMPLE Phone A Fax R ' •................................. .............. .................................... ............................................................ . actorloloclEXI .N MUD-MY" MD•M a RESULTS: ntb - s•ADFC. ..:.,, 4. n'rrm ANC . FW .••,IUN . Atraryara 7 TuW Cet7a. Oetemm. A+M!ti• 7E E. COL.. Aealyecet Methedt : Sent to GAM - MEMSRAVEftI.TERRESULTS: Phoned Q Faxed In Ohm Cant CaortecMOdeL 0001m. . ambreneFlEet VedAwlm SootevAk MMO-MUG(P/A) ewa...:L DO y Satisfactory , EC ❑rUrtsatlsfpctory Reported BY etwe taM'ne' %lu" fiae011ANK Croup0emlPabn=ocuke7WRMsla FoneA Fw-0053 12;17mpl�coa Tann tsnttaxa 1tv l�•�srfl�. A/�t� ��s� SA LE C.OLLECTIOM ' /..•.+e. .r r wry Dare: i /D zcc 5 Traneperbd a L,a an Ksame ae eowtor Other. IK= I an RN N& 1�4lllifillit 57559-1/� IUItl SAMPLH TYPE:' KRouarw ❑ Treated Wobr Repeat Sample ❑ UM»ated Water (raferto tab no. spacW Purpose TO BE COMPLETED BY LABORATORY Eamota RaeelvjM. Date: 002vory Mot) ReceMed ❑ samprleverse tvu ell: Pn lw may be uvwbwo ❑ {e lav Weher . / •ri�wrol• LmtEns ❑ RUSH SAMPLE Phone A Fax R ' •................................. .............. .................................... ............................................................ . actorloloclEXI .N MUD-MY" MD•M a RESULTS: ntb - s•ADFC. ..:.,, 4. n'rrm ANC . FW .••,IUN . Atraryara 7 TuW Cet7a. Oetemm. A+M!ti• 7E E. COL.. Aealyecet Methedt : Sent to GAM - MEMSRAVEftI.TERRESULTS: Phoned Q Faxed In Ohm Cant CaortecMOdeL 0001m. . ambreneFlEet VedAwlm SootevAk MMO-MUG(P/A) ewa...:L DO y Satisfactory , EC ❑rUrtsatlsfpctory Reported BY etwe taM'ne' %lu" fiae011ANK Croup0emlPabn=ocuke7WRMsla FoneA Fw-0053 12;17mpl�coa Tann tsnttaxa Mat -Su Teat Lab 9077463012 11/21/06 1211cpm P. 001 fAat-Su Test Lab of Alaska Water Quality Testing Mile 2.2 Palmer-Wasilla Hwy. P.O. Box 2748 Mldtown Community Business Park Pakeer, Ak. 9%4S Phww:(907)745-100S Entail: mrd 3ute5tlab@rpgenh3a_ygm rax: 1907) 74smili Client Paul Pinard Date Arrived: 11/1ND5 P.O. Bot 871347 Report Date: 111181D5 Wadila, Ak. 99687 Sample Date, 11110/DS Attn.: Sample; Time: 1430 Client ID: Lot 4 Block 2 Majestic Valley Collected By: Pinard PWSID 0: Source: M.S.T.L.i. 82094 Sample Matrix: Cortunerxs: _Method Parameter Unita Results MDL Date Pmparnd Date Anayzed MCL SM 4500-NO3-E Nitrate -N mg/L <MDL 0.50 11118!05 11/18105 10.0 SM 4500-NO3-E Nitrite -N mglL <A1DL 0.05 11118I05 11118!05 1.0 Lead Pb mg/L <0.002 0.002 11/18/05 11/18/05 0 015 Total N'ttratclNitrite mg/L <MDL 0.50 11/18/05 11/18/05 10.0 Legend: MILL a Whod HV0n L*W MCL a Max. Contaminate Law/ B a Presto In Meemd Blank E Estimated Vakre H =Above MCL n a Losl td DluWn Reported By Jon Paul Campbell Lab Manager Lu O CL v 0 Q � W 6 J�^ O o N U 3 ~ � a3 xi yq� w MZ.��' 0Is 1 \ Ii w U) x N 99-96C.so Z!S n CNI „ z o � m UE U F Q U3 ti y 'V "s V A M d7 eC [7i .r T V D 6i O W i� ew iL 4 / �N Il .'`e s o *-0 Z ' } O MZ.��' 0Is 1 \ Ii w U) x N 99-96C.so Z!S n CNI „ z o � m UE U F Q U3 ti y 'V "s V A M d7 eC [7i .r T V D 6i O W i� ew iL 4 / �N Il .'`e s o �I iA o O 0) e W RC) J o D� 00 oz .- 0 m MZ.��' 0Is 1 \ Ii w U) x N 99-96C.so Z!S n CNI „ z o � m UE U F Q U3 ti y 'V "s V A M d7 eC [7i .r T V D 6i O W i� O D O O i y a a 83 Y Y A a Y tl c v zv Ayo`ae .j Q Pv .4 0--aY '�•pF Ma FtleY S Y" O YMO.Q o. Y Y 9 u A :°oo=°.off oio9 �ci 4740 4 0 0 A O V Y WO 4 C Y Y p : Q A �acp O oa p o� b. ►� a.on w a a Y Y y r Q° Y .0-0 � 7 �u O%d, 6 Y y o C p v A u Q q Nie-.��e av--a 00 ��OQ3�Y tioep be otug.'7 22 ou �a 40- 0 os. bZZOF M.bZ.b�OIS It to / �N Il .'`e NO O D O O i y a a 83 Y Y A a Y tl c v zv Ayo`ae .j Q Pv .4 0--aY '�•pF Ma FtleY S Y" O YMO.Q o. Y Y 9 u A :°oo=°.off oio9 �ci 4740 4 0 0 A O V Y WO 4 C Y Y p : Q A �acp O oa p o� b. ►� a.on w a a Y Y y r Q° Y .0-0 � 7 �u O%d, 6 Y y o C p v A u Q q Nie-.��e av--a 00 ��OQ3�Y tioep be otug.'7 22 ou �a 40- 0 os. bZZOF M.bZ.b�OIS It MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SWO50283 Legal Description: MAJESTIC VALLEY ESTATES BLK 2 LT 4 Design Engineer: 0811 PINARD ENGINEERING Owner Name: BERNIE SCHUYLER Owner Address: PO BOX 771074 EAGLE RIVER. AK 99577-1074 Date Issued: Aug 12, 2005 Expiration Date: Aug 12, 2006 Parcel ID: 050-731-44 Site Address: 026203 VALLIHI CIR Lot Size: 92079 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit Is for the construction of: ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. - THE FOLLOWING NEEDS TO BE DONE TO INSPECT THE INTEGRITY OF THE EXISTING SEPTIC TANK: THE EXISTING TANK NEEDS TO PUMPED. THE SIZE AND NUMBER OF COMPARTMENTS OF TANK NEED TO BE IDENTIFIED. THE TANK INTEGRITY NEEDS TO BE VERIFIED BY LOOKING AT INTERIOR OF TANK AND BAFFLES VIA CAMERA (EXAMPLE: CHUGACH SEWER & DRAIN, CHARLIE HART 929-5072). IF TANK INTEGRITY LOOKS GOOD THEN NEED TO INCLUDE TANK INFORMATION ON AS -BUILT INSPECTION REPORT AND THE AS -BUILT INSPECTION SITE -PLAN WITH STATEMENT VERIFYING TANKS CONDITION. IF TANK INTEGRITY LOOKS BAD THEN TANK NEEDS TO BE PROPERLY ABANDONED AND REPLACED WITH NEW TANK MEETING TODAYS SEPTIC CODE AMC 15.65. Received By. Q-9— f Date: 191, E�E Issued By / I(1 Date: 2-01— Municipality of Anchorage �.� Development Services Department �'�'` Building Safety Division Onsite Water and Wastewater Program - .. .„ 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6850 www.ci.anchorage.ek.us (907)343-7904 ON-SITE SEWERIWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 050-731-44 Permit Number SW Property owners) Bernie Schuyler Day phone 240-5590 Mailing address PO Boz 771074 Eagle, River, AK Zp Code 99577 Site address 26203 Vallihi Circle Zip Code Legal description (Lot, Block& Sub'd.) Lot 4, Block 2, Majestic Valley Estates Legal description (Section, Township & Range) Lot Size 9��, n 9 .� THIS APPLICATION IS FOR: Number of Bedrooms Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade 91 THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzl ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: Waiver Fees: Date of Payment 't/ 6 Date of Payment Receipt Number. 7 2 O Receipt Number. (Rev. 0=4) PINARD ENGINEERING Paul E. Pinard Registered Engineer/AK 6 ID P.O. Box 871347, Wasilla, Ak 89687 (907) 357-ENGR(3647) Dan Roth Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 Bmgaw Street Anchorage, Alaska 996519-6650 August 5, 2005 RE: Lot 4, Block 2, Majestic Valley Estates; Wastewater Disposal System Upgrade Dear Mr. Roth: The owner of the referenced property, Mr. Bernie Schuyler, is planning on selling it and wishes to upgrade the existing wastewater disposal system. I had previously coordinated with you, through Jeff Poet of your staff, on the existing septic tank, which is beneath the garage floor. Since it had previously been approved by the Municipality of Anchorage (MOA) at this location, you confirmed that relocation of the tank would not be required. Although Mr. Schuyler states that he has not had any problems with the soil absorption system (SAS), he acknowledges that the system has had limited use from him and his wife. A planned upgrade of the SAS, approved by the MOA in September 1987, apparently was not installed. It appears that the original SAS is still in use although we were unable to locate the monitor tube. As such, an "Adequacy" test was not conducted on the wastewater disposal system. A design for a new SAS has been prepared and is enclosed for your review along with a permit application. A new testhole was dug on the property, supplementing the previous two (2) testholes that were excavated to support the earlier permitted design. The new testhole, shown on the site plan did not support the use of a "Deep Trench" type SAS as I had originally envisioned for this planned upgrade. Excavations at the sites of the earlier testholes confirmed the subsurface soils for the upgrade. Logs for all three (3) testholes are also enclosed. The groundslopes in the area of the new SAS are moderate, but the use of two (2) parallel absorption fields at different elevations allow for the effective utilization of this area. The adjacent properties were inspected for possible impacts or conflicts with the proposed upgrade of the SAS. None were found; the proposed SAS is located outside the minimum protective radius of any known existing drinking water well and its location will not prevent system upgrades or development of adjacent properties. If you have any questions, please do not hesitate to call me. 5 Encl: (as) cc: Bernie Schulyer, w/encl Sincerely, Paul E. Pinard, P.E. a M � � M g SC oa ,Sj.$i HESE g Aga -3 s flHI r� '` w to q wim to � m m w . M 7 a m U b .�14 O.,^ ., wH mg 43 a CO U rq 9t m (II q w to q wim to � m m w . M 7 a m U m O O.,^ ., wH mg 43 4.4 CO U Frml 9t �,_• _�� (II U 00 �3g�Fsz�s-eGn Gest) esgouaay a \ x U q m Fr F U Cd m a 0 Fa q m v m p E 0 0 v Z n tn F O CO U x� N (II U 00 V •:A .� N W ca c i% ClZ Vis. m U' z3w ca o W w , m�era 9 :" fn CL "+ U m •ineuI v a ^ HH uZ � A m b q v O ,C 430 q O 0 rl tka Cd +� -m m gR7U N U 6 amtl a eA .. maq tm m /'3 H Cd 43 m m imi km Q .t ■ q q� m,p / �p /:. 0093 as c •:, +o, r -i m � o �3g�Fsz�s-eGn Gest) esgouaay a \ x U q m Fr F U Cd m a 0 Fa q m v m p E 0 0 v !V n tn F w CO U x� N (II w a 00 V •:A .� N W ca c i% ClZ Vis. m U' z3w ca o o A w m�era 9 W CL !V F w m y W E 0 9 W PINARD ENGINEERING P.O. Box 871347 Wasllla, AK 99887 (907) 357• ENGR (3847) TEST HOLE LOG / PERCOLATION TEST s TEST HOLE # 1 DATE: 7/11/05 JOB NUMBER: 05-151 SLOPE LOCATION: Lot 4, Bk 2. Majestic Valley Fairly Level 5 - 10% FIELD STAFF: P. Pinard DEPTH.FEET SOILTYPE 1 1 1 1 1 1 16., SITE PLAN r— Exist. SFR Garage 1 801 w �\ 871 TH 11 —A ♦—Merrell TH 11 A—Merrell TH #3 Was Ground Water Encountered? Yes / No If YES, Depth to Ground Water. none 7/11/05 tCOLATION TEST DATA 13.91 bgs 7/21/0, ATime Measuremem Drop InLrcl Pero Rate I I (minute) I (inches) I fimheal I min. / Inch I Cnmmwnea )LATION RATE 26.7 mintiinch HOLE DIAMETER 6" RUN BETWEEN 5_ FT and 6.5 FT in DEPTH ENTS' Pere ole was pre-soaked M 5 PM. Perc rate corresponds sizing ® 250 sf/bdrm. PAL1 E. HARD CE4193 • _ Jila�®- )LATION RATE 26.7 mintiinch HOLE DIAMETER 6" RUN BETWEEN 5_ FT and 6.5 FT in DEPTH ENTS' Pere ole was pre-soaked M 5 PM. Perc rate corresponds sizing ® 250 sf/bdrm. PAL1 E. HARD CE4193 CA PERF LEGA 7 8 9 10 11 12 13 14 15 18 17 18 19 20 TEST RUN BETWEEN FT AND FT COMMENTS PERFORMED BY. k4ALU /�/� �.[Z. Cc.� I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE. 3 � 72-008 IR". 4851 Municipality of Anchorage O DEPARTMENT OF HEALTH 6 HUMAN SERVICES 625'L' Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: ' ✓Aot5 /ywv DATE LEGAL e 7 e 9 10 11 12 13 14 15 16 17 16 19 20 COMMENTS z PdAr Ti/ W3 pvultoorder Township, Range, Section: 5A" stLr CSH') (✓r4a:( ►7Fa/trof 5H,(1�folyf' WAS GROUND WATER ENCOUNTERED? A1C s SM CJC h,4 IF VES AT WHAT L t DEPTH? 0 AN A�Iwtay) E L6 'd f a h) thplit to waw AAer NaNhrig7 Jolt Reeding Dat* Grow Not Time Time Depth to Water Not Drop 'Jae & 2 1// /per Z7! w 7, _710,40 L7/ r/ r —1000 t% r, . s.;. -d"60 eJ 1 A1 A .n4' 7 / 33/ ✓ .nr PERCOLATION RATE L (nmr1everb) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND 4" FTC &.9 l /S+Aan /S/rin /�iiLrJrlF S�.1 /8'�i»e�C /�/_.'�,./,,rra/—.fov,C/m a✓i>firn/raflPriei /o. f PERFORMED BY: CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE. / 72-00e IRov. 4M) •. M.O.A. DEVELOPMENT SERVICES DEPT. RECEIVED JUL 2 7 Zoo ONSITE WATER & WASTEMTER PROBRW July 25, 2005 On Site Services Municipality of Anchorage 4700 Bragaw St. Anchorage, AK Sirs: I would like to install my own septic system at 26203 ValliHi Circle, Eagle River, Ak 99577. The installation will be under the supervision of Paul Pinard of Pinard Engineering, P.O. Box 871347, Wasilla, Ak. 99687, Phone: 907-232-1347. I own a Hitachi 120 Excavator and a D31 E-18 Komatsu Bulldozer and have experience running both machines. Sincerely, Bemard W. chuyler P.O. Box 771074 Eagle River, AK 99577 (907) 694-5832 Home (907) 240-5590 Cell mom-c�. Val � ���a LT4 MUNICIPALITY OF ANCHORAGE _ Building Safety Division <� 511 aT MEMORANDUM DATE: August 12, 2005 TO: FILE lite FROM: Joe GoodallEngineer II, Water Wastewater Program SUBJ: MAJESTIC VALLEY ESTATES BLOCK 2 LOT 4 I TALKED TO PAUL PINARD ABOUT THE LOCATION OF THE TANK. PAUL INFORMED ME THAT HE TALKED TO DAN ROTH AND AND JEFF POET. THE OPENING LETTER OF PERMIT APPLICATION SUBMITTED BY PAUL STATES DAN WAS CONSULTED AND CONFIRMED THE RELOCATION OF THE TANK UNDER THE GARAGE FLOOR WOULD NOT BE REQUIRED. I APPROVED THIS PERMIT ONLY WITH THE FOLLOWING PROVISIONS: - THE FOLLOWING NEEDS TO BE DONE TO INSPECT THE INTEGRITY OF THE EXISTING SEPTIC TANK: THE EXISTING TANK NEEDS TO PUMPED. THE SIZE AND NUMBER OF COMPARTMENTS OF TANK NEED TO BE IDENTIFIED. THE TANK INTEGRITY NEEDS TO BE VERIFIED BY LOOKING AT INTERIOR OF TANK AND BAFFLES VIA CAMERA (EXAMPLE: CHUGACH SEWER & DRAIN, CHARLIE HART 929-5072). IF TANK INTEGRITY LOOKS GOOD THEN NEED TO INCLUDE TANK INFORMATION ON AS -BUILT INSPECTION REPORT AND THE AS -BUILT INSPECTION SITE -PLAN WITH STATEMENT VERIFYING TANKS CONDITION. IF TANK INTEGRITY LOOKS BAD THEN TANK NEEDS TO BE PROPERLY ABANDONED AND REPLACED WITH NEW TANK MEETING TODAYS SEPTIC CODE AMC 15.65. Municipality o1 Anchorage January 8, 1988 P.O. BOX 196650 ANCHORAGE, ALASKA 99519-6650 (907)343-4200 Tgwxtfl32%xx-g Tom Fink MAYOR DEPARTMENT OF HEALTH & HUMAN SERVICES Fannie Mae 3201 C Street Anchorage, Alaska 99503-3994 Subject: Lot 4 Block 2 Majest' alley Mates Subdivision Permit #870256, Ta #050-731.-44 '�� - .._r— A permit issued by this Department for an individual well and/or on-site sewer system has expired as of December 31, 1987. 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. Effective January 1, 1988, a new fee schedule is in effect. When re -applying for a new permit, the new fees are; $90.00 for an on-site sewer permit; $50.00 for a well permit; $140.00 for a combined sewer and well permit. If there are any further questions, please call this office at 343-4744. Sincerely, Robert W. Robinson Program Manager On-site Services RWR/ljw enc: Copy of Permit / /�� �lC>��'7 �����^� ��� l P A L l T Y O F A N C H O R A G E ps 0epartment o� & Human 825 L Street, Anchorage, Alaska 99501 343~4720 /��yV�~~ ON-S�TE SEWL�R PERMIT Permit Number: 870256 i�pgradeAA Owner Name: FANN[E MAE Owner Address: 3201 C S[HEET ANLHDRAGE� AK 99503~�994 Day Phorle: 349-6451 �arce1 Id: O50~731-�4 LoQ L l: Subdivision: NEW SFlC VA}],EY ES[ Lot: 4 Block: 2 Lot Size 2"25A (sq.[t. or acres) Max 8edrooms: lhis Permi�: 4 Total Capacity: 4 DAlE / X TABLE 3-8 FALLING HEAD PERCOLATION TEST PROCEDURE 1. Number and Location of Tests Commonly a minimum of three percolation tests are performed within the area proposed for an absorption system. They are spaced uniformly throughout the area. If soil conditions are highly variable, more tests may be reouired. 2. Preparation of Test Hole The diameter of each test hole is 6 in., dug or bored to the proposed depths at the absorption systems or to the most limiting soil horizon. To expose a natural soil surface, loosematerial iissremoved froom the bottomhof thehtesthhole. Twodinchesuofn112ntoinstrmet adt3he /4 in. gravel are placed in the hole to protect the bottom from scouring action when the water is added. 3. Soaking Period The hole is carefully filled with at least 12 in. of clear water. This depth of water should be maintained for at least 4 hr and preferably overnight if clay soils are present. A funnel with an attached hose or similar device may be used to prevent water from washing down the sides of the hole. Automatic siphons or float valves may be employed to automatically maintain the water level during the soaking period. It is extremely important that the soil be allowed to soak for a sufficiently long period of time to allow the soil to swell if accurate results are to be obtained. In sandy soils with little or no clay, soaking is not necessary. If, after filling the hole twice with 12 in. of water, the water seeps completely away in less than ten minutes, the test can proceed immediately. Measurement of the Percolation Rate Except for sandy soils, percolation rate measurements are made 15 hr but no more than 30 hr after the soaking period began. Any soil that sloughed into the hole during the soaking period is removed and the water level is adjusted to 6 in, above the gravel (or 8 in. above the bottom of the hole). At no time during the test is the water level allowed to rise more than 6 in. above the gravel. Immediately after adjustment, the water level is measured from a fixed reference point to the nearest 1/16 in. at 30 min intervals. The test is continued until two successive water level drops do not vary by more than 1/16 in. At least three measurements are made, After each measurement, the water level is readjusted to the 6 in, level. The last water level drop is used to calculate the percolation rate. In sandy soils or soils in which the first 6 in. of water added after the soaking period seeps away in less than 30 min, water level measurements are made at 10 min intervals for a 1 hr period. The last water level drop is used to calculate the percolation rate. Calculation of the Percolation Rate The percolation rate is calculated for each test hole by dividing the time interval used between measurements by the magnitudeof the last water level drop. This per rate in terms of min/in. To determine the calculation results in a p percolation rate for the area, the rates obtained from each hole are averaged. (If tests in the area vary by more than 20 min/in., variations in soil type are indicated. Under these circumstances, percolation rates should not be averaged.) Example: If the last measured drop in water level after 30 min is 5/8 in., the percolation rate = (30 min)/(5/8 in.) = 48 min/in. 41 CJ Nr Gti>i.e!' H F N www www xxa 00 � 00 �n vas ririri rrvN \�o 3b�1 a �F i \t ��,pp yn7 goo '-do :4 e Municipality of Anchorage = DEPARTMENT OF HEALTH 8 HUMAN SERVICES 4 825 "L" Street, Anchorage, Alaska 99502-0650 r A.CCr• •• •. • •• •"4 SOILS LOG — PERCOLATION TEST Dale R. M roll /Vi *I As No. 205 �•� PERFORMED FOR: DATE PERFORMED: LEGAL DESCRIPTION:'¢ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Z ''4� Yo//, -Ifl P�f, T� Aoi Y i y:, 4- 5M — 121 1• 5At1� 5owt6 Co(obieS&Cks{) SA -0-- 5,14 �jn CoW e.5 Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? - N� S IF YES, AT WHAT L DEPTH? 0 P E Depth to Water Alter Monitoring? Date: SITE PLAN Reading Date Gross Time I I Net Depth to Time Water Net Drop 0100 1, ¢ L a r /0'/ S •r�rr ooi7 I'L-JII PERCOLATION RATE /rC� (minutesnnch) PERC HOLE DIAMETER GG /�• TEST RUN BETWEEN FT AND FT ' COMMENTS r5otai 'I� I?�i�YOoR(— C /f'/oi-raiz-.� �vA�//i' r�/�, / � s •— ir/o �%',��c,,�- �% -r�u6cs 9 a ,�7 3,e�vts PERFORMED BY: CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAI c i IInFI INFR IN FFFFCT ON THIO nATF neTF S'7 72-008 (Rev. 4/85) 0 Municlpality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: /CZN/c LEGAL DESCRIPTION: ZO-14161 2. DEPTH 116+/%'ey vQl/i /+lyh C7/2 (FEET) // 1 6A;r 2 ovm- poide-p 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 DATE PERFOR Township, Range, Section: -5h'OD`f S,l.T L5�� �l/Sua� �a/OrIq 5 M A `�mx6e( # l SLOPE WAS GROUND WATER , / ENCOUNTERED? _ O S IF YES, AT WHAT L 0 DEPTH? P E CkAed �O K) Depth to Water After Monitoring? Date: SITE PLAN /y17 Reading Date Gross Net Time Time A- i; '{ENLi1rVCY�HIC l F) Net Drop .. • eV l� a9 7Q00 Z7/ et 9i. 700 9 % ✓ IF 1f,9 Le M1Y14s e•'• s 1." 1. /i40Ja Dale R. b1 roll 33/j7 DATE PERFOR Township, Range, Section: -5h'OD`f S,l.T L5�� �l/Sua� �a/OrIq 5 M A `�mx6e( # l SLOPE WAS GROUND WATER , / ENCOUNTERED? _ O S IF YES, AT WHAT L 0 DEPTH? P E CkAed �O K) Depth to Water After Monitoring? Date: SITE PLAN /y17 Reading Date Gross Net Time Time Depth to Water Net Drop 7Q00 Z7/ et 0r7 700 9 % ✓ 4700 .'2 7/77 s 1." 1. 97 33/j7 20 t__] PERCOLATION RATE 1'S (minutesimch) PERC HOLE DIAMETER //� TEST RUN BETWEEN 4- FT AND 7 FT 6 r l COMMENTS Wu- � o /t/�! 7 r1hGt' B s of /L pe -c /5 i//�n //it2ND 'Ar C-4 /27 le-ve SOPk7r,!7 Gs/a�Gr/7<v�%r!y/rr.r6/Ori PERFORMED BY: 7��'2 •"�'� 1 / / (/. Kw , CERTIFYTHAT HAT/THIS TEST -7WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE. 72-008 (Rev. 4/85) i 9 � 25__atream .Main>Luinace Eslrf. \ c� / .-lJot..t�e¢rm�ne� .. By-Threo.al carr \ ti6vo col 7V Lij sF LsV-I Noua4 7 48= 0 ' �l l -wood p._ .. •``, ry � / 'arm AQ ING 1 Dnle R ° y�. .�•°321.2 L VLL E I0'� / . L COR E S OUNDAT�ON — �iRAINADE -A! RQW -N 77 72? .L.. 7 2 .. ; NOTES 1...... VAC(/Nj Crr•. �1" 1. IT •HALL BE THE RESPONSIBILITY OF THE BUILDER OR OWNER TO VERIFY THAT BUILDING LOCATION SHOWN MEETS ALL SUBDIVISION COVENANTS AND ZONING ORDINANCES, S. IT IS THE RESPONSIBILITY 0P THE BUILDER TO VERIFY ALL ELEVATIONS WITH RESPECT TO ALL UTILITIES, B DRAINAGE. t. THIS PLAT REPRESENTS THE PARCEL OF PROPERTY DESCRIBED BELOW TAKEN FROM THE RECORDED PLAT DESCRIBING THAT PARCEL. INSTRUMENTS RECORDED PRIOR TO OR AFTER THE FILING OF THE RLCOROED PLAT ARE NOT SHOWN ON THIS PLAT. 4. THE INFORMATION ON THIS PLAT IS FOR THE USE OF LENDING IHITITUTIONS iii*ECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES OR EASEMENT• , THE PLAT IS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES OR FENCES. a 5 v. i �r/q�lJ favoas�<t/ GYc// /03 J J.SIRVEYOR I CERTIFICAuQb —----' -'--- I HERESY CERTIFY THAT 1 HAVE SURVEYED THE PROPERTY DEICRIBEO ON THIS PLAT AND THE IMPROV9M1MTl SITUATED THEREON AMC LOCATED Lor L4 �JIe CSG K AS SHOWN ON THIS PLAT. / OATED THIS 24 DAY OF.It MAJESTIC' YALI.EY ESTATES 5U>3 U E' v SESSE, EPPS 81 POTTS 2220 E. assn, AVE. 349.6461 ANCHORAGE , ALASKA 99507 344.1352 DRAWN BY, SCALE, I" • 5f7� C -C DWG. NO. CHK. BYFLD. BK., MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264.4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME �^' / PCU PHONE NEW UPGRADE MAILING AAD ESS 6, .. !� ��< �Ci U4e V i� LEGAL D CRIPTION46 �% r 1 5 / . / / LOCATION t NO. OF BEDROOMS Well�b Absorption area 7- N Dwelling �/ PERMIT DISTANCE TO: V Uy i ZQ Manufacturer � �✓Or �'[[ Materia�C�„ ,� / J �•C�.• No, of compac{ments -I rLU n ~ Liq. ca cit in gallons IF HOMEMADE: Inside length Width Liquid depth Well Dwelling PERMIT NO. O y DISTANCE TO: __ J D Z Material Liquid capacity in gallons Tz Manufacturer p J S DISTANCE TO: Well Q© Foundation I Nearest lot line f PERMIT NO."']�ip / %% w JLL Z Z No. of lines Length of ch Ipe � Total lengt Af,l�es Trench' %h tS �tv inches Distance b�itwe n ies IC% w F F' Top of tile to finish grade - , r— Material beneath the `��� inches Total effec)+ur.�jWrption area 1, LJ O —LLL Length Width -- Depth PERMIT NO. w Q F- Type of crib Crib diameter Crib depth Total effective absorption area wa Lu Well Building foundation Nearest lot line N DISTANCE TO: — Class Depth Driller Distance to lot line PERMIT N0. J J w Building foundation Sewer line Septic tank Absorption area(s) DISTANCE TO: e OTHER ILI PIPE MATERIALSy, L [J SOIL TEST RATING /76 LLER e6 REMARKS APPROVED DATE LEGAL - - - - — 72-013 fQ.3/78) 2. ref OWN H Kim A -A it: 10 TH H > N& H 0 04 1 - . , I , TWO PKI It< n5 1: Q. ., , : , I.. i!il if ii v .': T R,.- 11,.... . If V. 1! .."0 IJAPPI. I CAPAT I IAS 1`1 IF 10119000,14; 1 P I I . TP! M 1 KAFTIRP1 III I S KNATRA&M MAQ 1 VJq 11'•I::': I A I I Cod f NVATT 10045 OF" ANY E417US OHMACEY I -ro i I I j s ono x -I 9, rar) ivp: FLIM T1 TE 1,11%. Ed I U. "JARWY. -11 - A I C? < Own 1,1 14H A 11 �� & � � Q -1 A 1. V P44 T.,.v x? Ii.:;; V 1 Q H 1: AR H To 11(1::Ja:1_ I. I E-41ii ()1_7 !-;Y,: I FJ -i OIT MOM f! :1 OUT A VA S F1 FAV T I ME III. 11.::' Fal' 1 :, Ii:!' I :! 1- 1`: ,.I, '1 H 1:HA11 IT104] 1 -Lf. 1-1 1;I::: !��JJB-J I -f ( I 44"LARTA X "If, USA, 1: PRTHTa 02, H T-� Fl.: HT 117� M OR �M . , Y11- Y:u ��s :11 March 24, 1978 X77898 Gary PoUanv Dox 323 "aglO RiVerr Alasim 99577 Silojec::t: ;_or)'At Lxpirat:ioli A Permit iissuec.. I)y till.E; ct€;partpient for 1 odj. axscl/car 011--t.;ite cxw€'r i.n stallrati(7n o;.I Lot; 4 Block a MaJOSti.c Valley Subdivision hart wxpi.rua i `a'jTifa)Li�G3 �k3.111E? Ci F.1V La ,�;C.'. C:± CIF; Ono � y�lara Xyl CIO event v011 still plan to i n. t:a j, -I. t:hr rqcq1. aa, /o .- Oil site- t5ew 7. sygt;cC.M, to neV7 P€?]:Mit: is reCJlli.%f_d. The o.rigi.nal soil test. TIT.1 330 11se(I to Obtatin c"± tluxronf-- pgl:rli.t. !.' the we 1. has betm (Ir•i_ljeoj, c1 well lr.,q shotild. I e sent to this department to r.Ic7r lir.ial�t the i nsta7.l a;:i.nsl. eiai.e, I4 ," u have any <alt esg—�'.E�]1s rE3Ctt'r(limr th(1 flhc�jf.3 pjattcir, t)lej1 O € Ontart this, €}f_. ' CO ilfti(ie ii.rltelv at 264- 47 0. Sincerely, Les M. Buchholvo, 1, Senior B'T;vir€an'n€ssaLal Sae€:i�tli.�st TAIIIT jl1 ���T *JE D___ X -U I -el C' -p 0---- "P-41C.l 9p-­iF.-,FH�� DEPHR�MENT G HEM LTH AND ENVIR0NMENTHL JTECl. TION G25 'L' STREET/ HNCHORHGE/ H@i 279-2511 F-0 P -A V V4 �� ����w=,." 1�1UF:'K V �Il" PERI -11T NO. ( 77098 ) HPPLICHNT GARY P013ANY BOX E.R90 L(-'ICH|,ION SPRUC�'l���_� LEGAL i.4 B2 MAJESTIC VALLEZE 92079 SQUHRE FEET TYPE OF SOI[. HGSORBTION SYSTEM IS� TREWCH MHXIMUN NIJMBER OF BEDROQNS = ] SOIL RATING (SQ FT/BR)­ 148 THE REQUIRED SIZE OF THE SOIL HBSORFIT ION SYSTEM IS� ����'� �� �L�� ������~�= �� ������ �� THE LENGTH DIMENSION IS THE LENGTH IN FEET) OF THE TRENCH OR DRHINFIELD THE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BETNEEN THE SURFHCE OF THE GROHND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE 8RHVEL DEPTH IS THE MI�IMUM DEPTH OF GRHYEL BETWEEN THE OUTFHLL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). ������������ ������� ���� ������ ������ ���K��P.-d A- T �F;_�` �IIJ JE F;;! I---- U BRCKFILL ING OF ANY SYSTEM WITHOUT FINAL HND HPPROVHL 8Y THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSHL 5YSTEM IS 100 FEET FOR H PRIVATE WELL OR 200 FEET FOR H PUBLIC WELL WELL LOi*3S HQT: REQUIRED AND m(,.iST BE RETURNED TO THE DEPARTMENT WITHIN OF THE WELL COMPLETION. SPECIFICHTIONS HND CONSTRUCTION DIHGRHMS FIRE HYHILHBLE TO INSURE PROPER INSTHLLAl" I8N. ������1� ���I� �� ��� ��� F��� ����� I CERTIFY THAT HM FHMILIHR WITH THE REQUIREMENTS FOR 8N -SITE SEWERS AND WELLS HS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE 2� I WILL INSTALL THE SYSTEM IN HCCORDRNCE WITH THE CODES. ]� I UNDERSTHND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLHRGEMENT IF THE RESI�ENCE IS REMODELED TO INCLUnE MORE THAN � BEDROOMS. HPPL0CHNT Q�FY OGANY 0 Et E GEC .'ECHNI CAL & DEVE. 3PMENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster Earl Ellis 694-2774 SOIL LOG 688-2280 Soils Et Foundations Land Development Performed for: Name: Tel. No. Mailing Address:__ Legal Description: Depth (feet) Soil Characteristicl. 0 1 2 3 4 5 6 7 e _. 8 9, 10� 11 12 13 14 15 16� .:' 4F At %I • � V�7 �I Hqq NgUg9 •.q Hr•HgHN•i.. Earl P. EllisW �•qq NO. 1745-E ,e AVA t,1A��pROFESS1�N:i�_+ Ground Water Encountered: Yes-- No— If yes, what depth Proposed Installation: Seepage Pit Drain Field Comments: Performed by: o� Date: G MA W J Q ONO Y � i i m r u is I� a 4jr � OBJ Q N � a d .dl J J 7 ® Z Q = U ® w W >cc vFi W 3 ? a x M Lu co o A Ili Q w � m U LL LL ® A 3 A A a i i r u is I� z i �i d , 3 F ® w vFi W 3 ? w z x d A vFi A C�7 i i r u is I� z i �i � t F ® vFi W ® A 3 A A i �i � t ` t t O O O O O o O O O O O O F H F H F F F F H F F H H w O O O O O o o O O O O O O w w w w w w w w w w w q z 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 Parcell.D. 050-731-44 HAA# 6F)M2D Expiration Date: 3 12 10b 1. GENERAL INFORMATION Complete legal description Lot 4, Bk 2 Majestic Valley Estates Location (site address or directions) 26203 Vallihi Circle —Eagle –River. Alaska Current Property owner(s) Bernie Schuyler Day phone(907) 240-5590 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address PO Box 771074 Eagle River, Alaska 99577 Day phone Diana Pinard/Dynamic Prop. Dayphone(907) 232-6346 165 E. Parks Highway Wasilla,-Alaska 99654 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 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 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 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 Pinard Engineering Phone(907) 357-3647 Address PO Box 871347 Wasilla, Alaska 99687 Engineer's Printed Name Paul E. Pinard 5. DSYIGNATURE Approved for bedrooms. Disapproved. Conditional approval for Additional Comments Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Date 11/28/05 Carr 'V• •I• ♦. OOO E 1, PwA E. PInard {'> CE -4703.; S•• �•• < bedrooms, with the following . \N N1 .. *Tr_WATER , Maintenance Agreements Supplemental Engineer's Report Other By; Original Certificate Date: , i 1z l o f (Rev 0IN2) Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lot 4, Bk 2, Majestic Valley Estates ParcellD: 050-731-44 A. WELL DATA Well type Private Date completed JW2/79 Total depth 170 ft. Date of test Static water level Well production If A. B, or C provide PWSID # Sanitary seal (YIN) Yes Cased to _42—+11. FROM WELL LOG WATER SAMPLE RESULTS: Coliform _Q_colonies/100 ml. Arsenic: NA mg./I. B. SEPTIC/HOLDING TANK DATA Tank Type/Material Steel Well Log (Y/N) Yes Wires properly protected (YIN) Yes Casing height (above ground) 18+ in. AT INSPECTION 11/10/05 22.1 n. g.p.m. 5.0 g.p.m. Nitrate <0.5 mg./I. Other bacteria 0 colonies/100 ml. Date of sample: 11 / 10/05 Collected by: Pinard Engineering Date installed 10/3/79 Tank size 1000 gal. Number of Compartments 2 Cleanouts (YIN) Yes Foundation cleanout (YIN) Yes Depression over tank (YIN) No High water alarm (YIN) NA Date of pumping 8/25/05 Pumper Chugach Pumping C. ABSORPTION FIELD DATA Date installed 9/11 -15/O rating (;;ZU or ftp/bdrm) 250 System type 5 Wide Drainfield Length2 ! 53 ea.f<, Width 5 ft. Gravel below pipe 2 ft. Total depth 4.7 ft. Eff. absorption area 530 fe Monitoring tube Yes Depression over field NO Date of adequacy test New SAS Results (Pass/Fait) NA For 3 bedrooms (System unused since installation) Fluid depth in absorption field before test __n in. Water added_XL gal. New depthJU_ in. Elapsed Time: NA min. Final fluid depth n in. Absorption rate >= NA g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) No If yes, give date D. LIFT STATION NA Date installed "Pump on" level at —in. Datum E. SEPARATION DISTANCES Size in gallons "Pump ott" level at _ in. Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 1001+ Absorption field on lot 1001+ Public sewer main NA Sewer /septic service line 251+ Manhole/Access (YIN) High water alarm level at Meets alarm &circuit requirements? On adjacent lots 1001+. On adjacent lots 1001+ Public sewer manholetcleanout NA Holding tank NA in. SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation 51 Property line 5 r + Absorption field 5 r + Water main NA Water service line 101+ Surface water 100 r + Wells on adjacent lots 1001 + SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 51 Building foundation 10 1 + Water main Ne Water Service line 101 + Surface water 1001+ Driveway, parking/vehicle storage 251+ Curtain drain None Known Wells on adjacent lots 100 r + F. COMMENTS ST located beneath G. ENGINEER'S CERTIFICATION ; it was inspected w/ I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name Paul E. Pinard Date 11/28/05 Date of Payment V Receipt Number (Rev. 12101) D5 of pumping &aT—from PL. ,,i 9TH •1'', s, / Prauil E. PN1atd Waiver Fee $ _ Date of Payment Receipt Number ft 05 ,;yj 3 0 Municipality of Anchorage ` )'.O. tktr 1!N'CNS() • Mchoragc, Alaska !Y.)7il9dd4i0 • Telephone (907).UI-Sl01 4700 not aw• Stma • Anchorage, A6%ka 9.W s • ' "' ' w,<a.mu Lorg Mayor Mark Begich Building Snfct}• DiN3sion December 2, 2005 Paul Pinard P.E. Pinard Engineering P.O. Box 871347 Wasilla, Alaska 99687 Subject: Waiver Request for Majestic Valley Estates Block 2 Lot 4 Waiver Request WR#: 050105 Parcel ID # 050-73144 IIA050620 Dear Paul Pinard P.E.: 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 5.0 feet separation to southeast property line. This waiver approval applies to the existing absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, qGoodall vil Engineer On -Site Water & Wastewater Program Community, Security, Prosperity Municipality of Anchorage Development Services Department • +.r Building Safety Division ; On -Site Water and Wastewater Program ' 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchomgc.ak.us (907)343-7904 Waiver Review Worksheet WR#:050105 PID#:050-731-44 HA/Permit# HA050620 Dale Received: December 2, 2005 Legal Description: Majestic Valley Estates Block 2 Lot 4 Engineer. Paul Pinard P.E. Pinard Engineering P.O. Box 871347 Wasilla, Alaska 99687 Applicant: Bernie Schuyler Waiver Requested: 5' lot line waiver from septic field to S.E. Property line Criteria: Geology Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: r.eeeeeee...... e.eeeeeee....... eeeeeeeeeeee..... .eeeeeesee......... seem••• Waiver is Granted: X List Conditions or Reasons for above: Waiver Is not Granted. Date: 12/2/05 By: Joe Goodall Name of Reviewer r................................................eeeeee........ ...eeeeeeee Rec#: 73930 Amount: $M Date Paid: 12/2/2005 PINARD ENGINEERING Paul E. Pinard Registered Engineer/AK 8 ID P.O. Box 871347, Wasilla, Ak 99687 (907) 357-ENGR(3647) TO: Dan Roth Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 Bragaw Street Anchorage, Alaska 996519-6650 December 2, 2005 RE: Lot 4, Block 2, Majestic Valley Estates, Wastewater Disposal System Upgrade Dear Mr. Roth: Reference is made to my earlier letters of August 5 and November 28, 2005 regarding the upgrade of the wastewater disposal system serving the three (3) bedroom, single family residence on the referenced property. If you recall the earlier conversation with me, Jeff Poet of your staff and yourself, you agreed to allow the existing septic tank to remain in place under the garage floor. That tank has been in place for a number of years and a permit, previously issued by the MOA for an upgrade of the absorption field, did not require replacement of the tank or an evaluation of the tank. That upgrade of the absorption field did not occur, apparently due to a foreclosure on the property. When I submitted my plans in August for the recent upgade, your reviewer insisted on adding a stipulation to the permit that required inspection of the septic tank to determine its condition. He would not accept a visual inspection by me, using a light source and a minor after pumping of the tank. Rather, he was adamant about requiring a camera to inspect the tank and verify its integrity, providing the name of a company that could do that work. That company was contacted and the inspection completed with the camera. The inspection confirmed that the tank was sound and, as required by the permit, I provided a statement to this effect under my Professional Engineer's Stamp on the "As -Built inspection Report". I had specifically stated in the comment section of this report that "it was inspected w/camera at the time of pumping and found to be structurally sound.". In a call from your office this morning, I found that this apparently was not sufficient. Even though not specified as such on the Permit, Joe required that I provide a separate structural engineering report on the condition of the tank and its impact on the garage foundation. To me this obviously exceeds the language of the Permit, but rather than argue that issue at this time and jeopardize the pending immediate sale and transfer of my client's property, I am responding to this additional request with this letter. As previously noted, the existing steel septic tank serving this property was pumped of its contents and then inspected with a camera. This was done on August 25, 2005. Based on the images from the camera, the septic tank appeared to be structurally sound and the inlet and outlet baffles were intact. Though the septic tank is beneath the garage floor, it is well in excess of five (5) feet from the concrete footing/foundation, exceeding the MOA separation requirement. Based on the condition of the septic tank, as determined by the recent inspection with the camera, and its proximity to the building foundation, the location of the septic tank under the garage floor does not present any more of a problem or threat to the foundation than if it were located outside the garage, at the minimum separation of five (5) feet from the foundation. In conclusion, the recent inspection did not reveal any problems with the tank's structural integrity, the integrity of the baffles or indicate any potential impact to the building's foundation. If you have any questions, please do not hesitate to call me at 232-1347. cc: Bernie Schuyler Paul E. Pinard, P.E. Of 'ki 4410* 49TH Poul E. Pinard CE -4703 ••Q .o Dec 02 05 05:15p 3WG/IG Municipality of Anchorage; To Whom It May Concern: 552-9995 p.1 dZ^cess We are the potential buyers of Majestic Valley subdivision Block 2, Lot 4. We are aware that the active septic tank at 26203 Vallihi Cir. Eagle River AK 99577 is located within the foundation of the garage at that address. We understand that this is a Grand -Fathered allowance to current code and building practices. Sincerely, Chris & Nicole Mercer Nov 29 2005 5:32PM ENSTnR Engineering 907-502-0053 P.1 7 _ 7 November 29, 2005 Mr. Bernie Schuyler GO Pinard Engineering P.O. Box 871347 Wasilta, Alaska 99687 Re: Letter of Non -Objection Grid: SW363 To whom it may concern: ENWAR Nat arsl GesCompany A DIVISION OF SEMCG ENERGY e0l E. tnki ranch l A" Rnadna rl P n Par 19ams "Aarap. Alaska 995194i2a W 334-7753 FAX (9 i 3620053 ENSTAR Natural Gas Company has no objection to a septic encroachment into the Ten Feet (10 It) wide Utility Easement situated on the southerly boundary of Lot 4, Block 2, Majestic Valley Estates Subdivision, according to Plat No. 77-27, located within the SEI/4, Section 23, Township 14 North, Range 1 West, Seward Meridian, Records of the Anchorage Rewrding District, Third Judicial District, Sate 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: • 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 a no cost to ENSTAR. • Any ousts incurred by ENSTAR for apecisl construction necessitated by this encroachment w:Il be borne by the property owner. • All applicable safety code regulations will be obscrved 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-cf way. Sincerely.�� Andrew Frailer Right Way Assistant ENSTAR Natural Gas Company cc: File MTA OSP ENG 907 761 2646 11/28 105 14:24 NO.919 01/01 CALL OM YOUR COMPANY NON -OBJECTION TO EASEMENT By this document Matanuska Telephone Association, Inc.,(I,1T,R�diares that it has no objection to the encroachment of a septic system within the platted,l,0'. lylflity Easement upon Lot 4, Block 2, Majestic Valley Subdivision, Anchorage Recording DistrictM9liird Judicial District, State of Alaska, situated in Section 23, T 14N, R1 W, S.M. .1. +rr • • r •++•r+r•++++r • r++ar r rr• aadw+a•• a • a rr. ••. • a r+• •++r++r++• • r++rrw u • w+ra rr a ►a • r a r as r Please be advised that MTA through the issuance of this document dow 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, andlor replace buried or atrial 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 of any 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 arffeement to vacate am portion of the utility easrmcnt and should notes intglpreted as such• Issued for Matanuska Telephone Association, Inc. this 28th day of November, 2005, by, Real Estate & Properties Supervisor THIS IS TO cattTIFY, that on this 28th day of Nocvembcr, 2005, 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 ]mown to be the individual named in and who executed the foregoing instrument and acknowledged to me that be signed and sealed the same as a voluntary act and deed for the uses and purposes therein mentioned. IN WI �r�11 REOF, I have hereunto set my band and official seal the day and year first above written: r(( N S ` No Pub :c)n a6d for, • My commission expires: DS�•.a�•�,xII ( •:�' .,_`yam^ 1� , 'te�i>�. '''•.ti�F•.•!' • GRANTOR htatabmka Telephone Associltion. Inc. -!!,I X550 Paftner,"AK 996.35 _:• =,,,r` t::.r:: t,::`•' rrrir t'. ' Matanuska Talaphano AssOClallon, Inc P.O. Box 3560. Palmer. Alaska 99645.355( 1.500.746.9510 . 007.761.2510 . Fox 007.761.204( MATANUSKA ELECTRIC ASSOCIATION, INC. RIGHT OF WAY ENCROACHMENT EASEMENT THIS AGREEMENT is made and entered into this day of 20 0�, by and between MATANUSKA ELECTRIC ASSOCIATION, INC., an Alaskan non-profit member owned electric cooperative, whose post office address is Box 2929, Palmer, Alaska, 99645, hereinafter called "MEA', and Bernard W. Schuyler and Fredesvenda T. Schuyler whose address is Post Office Box 771074, Eagle River Alaska 99577 hereinafter called "Owner* . WHEREAS, Owner covenants that Owner is the legal owner of the real property described as: Lot 4, Block 2, MAJESTIC VALLEY ESTATES SUBDIVISION, according to Plat #77- 27, Anchorage Recording District, State of Alaska WHEREAS, Owner further covenants that the said property is owned free and clear of encumbrances and liens of whatsoever character that in any way limit Owner's authority to enter into this Agreement with MEA; WHEREAS, Owner and MEA hereby covenant that MEA is lawfully authorized to occupy the 10 foot wide utility easement designated along the south portion of the above-described property and depicted on Plat No. 77-27, Anchorage Recording District, Third Judicial District of Alaska; and WHEREAS, Owner acknowledges that there is an existing encroachment in this utility easement. This encroachment is described as follows: _ Septic monitor tube placed approximately 5 feet into platted 10 foot wide utility easment, located along south property boundary. NOW, THEREFORE, for and in consideration of these mutual agreements: Owner, for Owner's self, plus Owner's successors and assigns, does hereby grant to MEA, and to its successors or.assigns the right to enter upon the property of Owner situated in the Anchorage Recording District, State of Alaska, and more particularly described as follows: Lot 4, Block 2, MAJESTIC VALLEY ESTATES SUBDIVISION, according to Plat #77-27, Anchorage.Recording District, State of Alaska being in Section 14N, Township 1W, Range 23. S.M.; and to construct, reconstruct, rephase, repair, operate and maintain on, over or'under the above described lands and/or in, upon or under all streets, roads or highways abutting said lands, and electric transmission and/or distribution line or system; to inspect and make such repairs, changes, alterations, improvements, removals from, substitutions and additions to its facilities as MEA may from. time to time deem advisable, including by way of example and not by way of limitation: the right to increase or decrease the number of conduits, wires, cables, hand holes, manholes, connection boxes, pedestals, transformer enclosures; to cut, trim and control the growth by machinery or otherwise of trees and shrubbery located within the lands specifically described above, or that may interfere with or threaten to endanger the operation and maintenance of said line or system (including any control of the growth of other vegetation in the right of way which may incidentally and necessarily result from the means of control employed): to keep the easement clear of all buildings, structures or other obstructions, other than the existing encroachment specifically noted above, and to allow MEA the right of ingress and egress over the remainder of said parcel as reasonably necessary to conduct the above activities within the utility easement. Encroachment Easement Page 2 2. MEA, for itself, its successors and assigns, hereby waives its objections to Owner's existing encroachment as described above on the following conditions which Owner, for Owner's self, plus Owner's successors and assigns, hereby accepts as covenants that run with the property described above: A. Owner, Owner's successors and Owner's assigns, shall indemnify and hold MFA, its successors and assigns, harmless from liability for any injury or damage to any person or property that may result from said encroachment. B. Owner, for Owner's self, plus Owner's successors and assigns, hereby ..agrees that the continued existence of the encroachment described above shall not restrict or limit the current or future ability of MI=A to fully enjoy the benefits of this easement for any and all utility purposes consistent with paragraph 2 above. C. Owner, for Owner's self, plus Owner's successors and assigns, hereby stipulates and agrees that they shall each hold MFA, its successors and assigns, harmless from liability for any and all damages to the encroachment that may result from the existing and future utility use of said easement by MEA, its contractors, successors, agents, licensees, or assigns. D. Any facilities or property of MEA, its successors and assigns, located with the easement granted herein that are damaged or destroyed as a result of actions undertaken by Owner, or Owner's successors and assigns, shall be repaired or replaced at MEA's discretion and such repairs or replacement -shall be paid for by Owner, or Owner's successors and assigns. E. Any facilities or property of MEA, its successors and assigns, located within the easement granted herein that must be relocated or modified to accommodate actions undertaken by Owner, or Owner's successors and assigns, in order to remain in compliance with applicable codes and prudent utility practice shall be relocated or modified at the sole expense of Owner, or Owner's successors and assigns. F. Owner, Owner's successors and assigns, and their contractors or agents, will not perform work on the encroachment described above with equipment capable of violating any State or Federal law or regulation governing the operation of equipment near energized electric utility infrastructure. By execution of this Agreement, Owner further agrees for Owner's self, plus Owner's successors and assigns: (a) that any septic monitoring tubes placed within the said encroachment easement be visible at all times for a distance of at least ten feet from any direction. Encroachment Easement �.' Page 3 IN WITNESS WHEREOF, the parties executed by their duly authorized representatives first above mentioned. have caused this Agreement to be and agents as of the day and year MATANUSKA ELECTRIC ASSOCIATION, INC. l (MEA) BY:WG��1 • Com- . General Manager or his Rep esentative STATE OF ALASKA SS. • THIRD JUDICIAL DISTRICT The foregoing agreement was acknowledged before me this day of , 20 S�- aOSARY PUB\ -\G STATE OF ALASKA OWNER BY: Bernard W. Schuyl . BY: Fredesvend T. Schuyler SS: THIRD JUDICIAL DISTRICT The foregoing agreement wa d ReDdgbefore k� 2day WyVW of20 05 by 686 Pf1rPCVPAI[�A T• Sclau .lege. =Mani al Alaska lic - Owens s 0W41M Votary 'W "./I�a/ ✓"� P lic for the St of A*4S ka My commission expires: c,G$ RETURN TO: MEA • P.O. BOX 2929 PALMER, ALASKA 99645 Municipality of Anchorage Development Services Department Building Safety Division Onsite Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 9951M650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWERIWELL SUBMITTAL COMMENT SHEET To: PINARD ENGINEERING Legal description: MAJESTIC VALLEY BLOCK 2 LOT 4 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. - 0 Other. 11.1 NEED LETTERS OF NON -OBJECTION FOR EASEMENT. 12.1 SURVEY MISSING SEPTIC TANK STANDPIPES. t3.1 NEED BUYER LETTER OF ACKNOWLEGDEMENT AND ACCEPTANCE OF SEPTIC TANK UNDER GARAGE. Name of reviewer: JOE GOODALL Date: 12/2/2005 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK PINARD ENGINEERING Paul E. Pinard Registered Engineer/AK & ID P.O. Box 871347, Wasilla, Ak 99687 (907) 357-ENGR(3647) TO: Dan Roth November 28, 2005 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 Bragaw Street Anchorage, Alaska 996519-6650 RE: Lot 4, Block 2, Majestic Valley Estates, Wastewater Disposal System Upgrade Dear Mr. Roth: The installation of the new soil absorption field on the referenced property was completed. in September and the home has been vacant since that time. The inspection report/Record Drawings for this upgrade are enclosed. I have also enclosed a completed application and supporting documents for a "Health Authority Approval' since the owner has recently accepted an offer and is selling this property. Included with these documents is a copy of the As -Built Survey that was recently completed. The As -Built shows that the southern leg of the "5 Wide Shallow Trench" extends into the utility easement and is only five (5) feet from the property boundary. The owner believed that the property boundary was further to the south, but obviously the As -Built shows otherwise. I am requesting a waiver for this separation, to allow the end of this trench to remain in place. The closer proximity to the property line will not cause a problem with impacts to adjacent lots, since this property line borders a dedicated road with a sixty (60) foot ROW. The issue with the encroachment into the utility easement is being addressed concurrently with the utility companies. It appears that utilities are being routed along the other side of the road. Letters of "non objection' are being requested from them. If you have any questions, please do not hesitate to call me at 232-1347. rel � ^ Paul E. Pinard, P.E. cc: Bernie Schuyler s- MUNICIPALITY OF ANCHORAGE u DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date q -9 — 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) l�� 4 �ulL• i Ni/.�-r�a-nc. �i��..�-•y/ C�-ri�`s"--� , Location (address or directions) (b) ,Applicant NameTelephone: Home mss'`I Business ' S"Z-2-6 Applicant Address �� o 1�a_ �� t' — /��c ._S�t 5 Ito (c) Applicant is (chedk ono)'. Lending Institution[]; Owner/kadfde;E3'—, Buyer ❑ ; Other ❑ (explain); (d) Lending Institution Telephone Address r 1-4 ca 2 /�G, K, - (e) Real Estate Company and Agent Address — - Telephone (_b'L_r> (f) A91#the HAA to the following address: 2. TYPE OF RESIDENCE Single-FamilyR-- 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 CI 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 (11/&4) 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 l Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adeq for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtainea 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 Addre Date Telephone p.e.a 0-a.. �a Robert A. Shufor e� ��ir' oa No. 1457•FE �1 � �F °1• sO°" i�tt ,a Pilo rE0,v`Y�' m� 6. DHEP APPR AL Approved for "L bedroomg Date Approved _Disapproved4--* nal _ Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending. institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections ar- 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 (11/84) MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & MUNICIPALITY OF ANCHORAGE (MOA) ENVIRONMENTAL PROTECTION HEALTH AUTHORITY APPROVAL (HAA) 9 1965 CHECKLIST - FEBRUARY 1984 �O 284-4720 R C C - I V S D Legal pDescription: �-*s/n 4 ��� A. WELL DATA Well Classification If A, B. C, D.E.C. Approved (Y/N) I� Well Log Present(�VN) Date Completed tom- - "t Yield • 5��0� 1 Total Depth k 1 D Cased to Depth of Grouting Static Water Level — ( oo Pump Set Aty z - Casing Height Above Ground — �o� Sanitary Seal on Casingo?N) Electrical Wiring in ConduitON) Depression Around Wellhead (YW Separation Distances from Well To Septic/HefeliRg Tank on Lot 1 oc2 ; On Adjoining Lots (+ To Nearest Edge of Absorption Field on Lot I a ; On Adjoining Lots To Nearest Public Sewer Line /� To Nearest Public Sewer Cleanout/Manhole A To Nearest Sewer Service Line on Lot Lt - Water Sample Collected by `�S �'�'G�1^5"'G` Date-��''�s' Water Sample Test Results Comments _T7 P2�c�UcE ( V.s�Ce�ls B. SEPTIC/HeLtH*G TANK DATA Date Installed t(>- 3-r79 Size k � " No. of Compartments 2 -- StandpipesON) Air -tight CapsON) Foundation Cleanout (YW Depression over Tank (YQ Date Last Pumped Pumping/Maintenance Contract on File (Y/N); for _ Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/"ddifigTank: To Water -Supply Well To Building Foundation S FR dw� i h�us� To Property Line t k To Disposal Field To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course rJ /P Comments S�P•r`c- V-- is 171 PPi �X STS R'y+�' w w�- h i V,-�G I •-- - Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata -e.2— Type of System Design "T—{z�r-I Date Installed ( rte— 3 - �� Length of Field 4-S L Width of Field S1.0- Square to" Square Feet of Absorption Area Depression over Field (Y/Op Depth of Field t o Gravel Bed Thickness r7 z Sr C> 5 q" Stand i es PresentC(�/N Results of Last Adequacy Test S /�-nsF Separation Distance from Absorption Field: Date of Last Adequacy Test 9 — 1c'—<E!5 To Water -Supply Well 1 coo To Property Line to To Building Foundation)I t t To Existing or Abandoned System on Lot ``�/A ; On Adjoining Lots 1'{ To Water Main/Service Line 1 e� r t To C/utbank (if present) NIl, To Stream/Pond/Lake/or Major Drainage Course NJ" To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed Dimensions Size in Gallons I Manhole/Access (Y/N) "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments "Pump Off" Level at ** Check Permitted Bedroom Rating Against HAA Request ** Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA I certify that I have checked, verified, or conformed to all MOA and�.HAAA guidelines in effect on the date of this inspection. SignedDate i -/O- cZ) Company, MOA No. i�s�'y OF of t , {' O Q is f� rat)�� e�7�1 '� y, Receipt No. h�� "r c� Ca� 9 tl'e9Qs� / 07}as,,., Date of Payment - 1 / l 1 N < J 0980 O ® yypQn9t9.•f i i Amount: $ L4 �`� ° in al X G� RoberteA. Shu{ar i4s+ ^e No. 1457•E a 1 �A c �r oQeaQQ»r t,P�'F.�.zr Page 2 of 2 A �� p®a.��� 131 72-026 (11/84) T 5. LEGA ESCRIPTI UABI DATE ECEIVED INSPECTION APPOINTMENTS e! i C t'Jr TIME TIME TIME SINGLE FAMILY — y ❑ MULTIPLE FAMILY DATE I ` l DATE / DATE — -a l ❑ PUBLIC UTILITY INSPECTO INSPEMTOR4A - INSPECTOR MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIOpp�I� DEPT. OF HEALTH & 825 L Street - Anchorage, Alaska 99501 tNVIRONMENTAL PROTECTION • ENVIRONMENTAL SANITATION DIVISION OCT 2 2 1979 Telephone 264-4720 RRFF (('' ��jj REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER`PaACZO/ DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER 3 �cno PHONE PLAY >'� 2 MAILING ADDRESS �3 �a fi`f� 1" .&-')k tv�rr lv PROPERTY RESIDENT (If di f rent from bove) �a(4e PHONE Lot -z. �IICy 2. BUYER �A 0", YAC1'— l PHONE MAILING ADDRESS / p� 3. LENDING INSTIT IONPHONE hC -q5 r� MAILING ADDRE 4. REALTOR/AGENT PHONE MAILING ADDRESS 5. LEGA ESCRIPTI UABI ST�RJEET LOCATION VCS C_ 0-c 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS SINGLE FAMILY El One ❑ Four ❑ Other ❑ Two ❑ Five ❑ MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SUPPLY INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior t� that elate, give well ❑ PUBLIC UTILITY depth (attach log if available.) S. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE** 1a_19 _YEAR ON-SITE SYSTEM WAS INSTALLED. PUBLIC UTILITY tTHE NOTINSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE O FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED tp r 1 INSTALLER {� 1i ❑Septic Tank or ❑ Holding Tank Size: 1000 If Tank is homemade give dimensions: SOILS RATING l 1 TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area j POO Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. 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