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HomeMy WebLinkAboutMAJESTIC VALLEY ESTATES BLK 3 LT 3Majesti*c Valley Estates Block 3 Lot 3 #050-731-06 Municipality of Anchorage Page of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 0 Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number. 5W9600z5' PID Number: 0-:50 7,�/L Name: Wastewater System: f New ❑ Upgrade loi e✓ Address: ��" 'd� 105-11 Ak 99577 ABSORPTION FIELD Phone: / (o f No. of Bedrooms: Deep Trench Shallow Trench ❑Bed ❑Mound O Other LEGAL DESCRIPTION Soil Rating: /ry-� /� ,T(otal Depth from/ori al grade: ID.7 �i , V. (Q GPD/S .Ft. (/C Ii,}� p./� Lot: 3 Block: aSubdiv. a r/ / /(/ /J. De th to p pe b lto rom ori al grade: Ft �avel depten �� pipe 15, . Ft Township: Range: Secttiiiton: Fill aadddedd above original grade: Gravel lennglh: r� �✓ U Ft. / r -95 Ft. WELL: New El Upgrade pg Gravel width: II Z Number of lines: ;L Distance between lines: /d Ft. l�n�1( /P rt G{ie Ft. Classification (Private, A,B,C): Via- /-c. Total Depth: (9 00' Ft. Cased To: 131.6' Ft. Total absorption area: 980 SQ.Ft. Pipe material: F Q 0,36-:54 Driller: I / �esi%✓G>t W�%�Cr r�s Date Dr led: r/6e Static Water Level: /33 Ft. Installer: 1141WAN Date installed: S �� Yield: C yS-^Pd Pump Set at: Ft. Casing Height Above Ground: Ft. TANK SEPARATION DISTANCES Xseptic ❑ Holding ❑ S.T.E.P. To Septic Absorption Litt Holding Public/Private Manufacturer: A, At4 Capacity in gallons: O /000 From Tank Field Station Tank sewer Lines , &m r— Well IOOI+ //i�r,G --- _ /(�!4' Material: 57�e6�-- _s Number of Compartments: Surface !+ r '�' `-_ '__" "`_' LIFT ST I O N Water /00 lb0 Lot r !�. e in gallons: Manufacturer: Line to + to on" level at: "Pump off" level at: ligh water alarm at: Foundation /D rF}0 !4Curtain J"Pu]rmp 4 5 0 tk $o r� ake& del Electrical Inspection erformed by: Drain - wo/V& /VVW/V BENCH MARK Remarks: Location and Description: Assumed Elevation: /00 ENGINEER'S SEAL " �a : '•® 8 Inspections performed by: KND etiqAdif 9feflOAQ Dates: 1s O-Z ®®® � :49�Ni°®° 2nd Sz3 °°• °. 0 /Z a O•°w•••••• •.•e• a•w ®®®��;°OKennCEl1�'.}buffos•: Department of Health Huma e�rvices approval \ate by- �� `s�c� Date: �a�6A ov 95'90 Reviewed and approved /L PRO 72-013 (Rev. 9/91) MOA 25 B -D=15.78 C -D=29.79 B -E=13.3 C -E=36.22 B -F=13.07 C -F=45.15 A -G=62.1 B -G=44.15 A -H=59.65 B -H=45.39 A -I=51.15 B -I=45.3 B -J=2812 C -J=51.34 A -K=72.86 B -K=49.95 SCALE: NTS AS—BUILT SYSTEM DETAILS/SITE PLAN LOT 3, BLOCK 3, MAJESTIC VALLEY ESTATES S/D ZZ W o E 0 �LJ INSULATION d Ca C] J OF ALA � * 4 9 TI-I� �* # II{ENNETII M. ll S / 'p CEG -71116 W4' Aar konssloN i 3 BDR SFR Splitter C❑ 98.18 _= ow 98.04 FINAL GRADE nn lill FILTER FABRIC\ well ° coui I H H M G C❑ MTK 0 95,97 SEWER ROCK 03 59' — U 93,81 FINAL GRADE 2 FILTER FABRIC SEWER ROCK 39' — REPARED FOR: WADE & LORI MILLER 10543 OLD EAGLE RIVER ROAD, 44 EAGLE RIVER, AK 99577 SCALE I" = 50' w m o VARIES os� 1 T52, ) 77.90 BOR m K \ VARIES s 89,18 s.,• 83,91 _ I I 77,90 Bull KND ENGINEERING 20441 PTARMIGAN BLVD EAGLE RIVER, AK, 99577 (907)696-6111/Fax (907)696-8111 DATE 10/7/96 DRAWING R SCALE AS NOTED 96005-S1 N �OGAN OF ALA � * 4 9 TI-I� �* # II{ENNETII M. ll S / 'p CEG -71116 W4' Aar konssloN i 3 BDR SFR Splitter C❑ 98.18 _= ow 98.04 FINAL GRADE nn lill FILTER FABRIC\ well ° coui I H H M G C❑ MTK 0 95,97 SEWER ROCK 03 59' — U 93,81 FINAL GRADE 2 FILTER FABRIC SEWER ROCK 39' — REPARED FOR: WADE & LORI MILLER 10543 OLD EAGLE RIVER ROAD, 44 EAGLE RIVER, AK 99577 SCALE I" = 50' w m o VARIES os� 1 T52, ) 77.90 BOR m K \ VARIES s 89,18 s.,• 83,91 _ I I 77,90 Bull KND ENGINEERING 20441 PTARMIGAN BLVD EAGLE RIVER, AK, 99577 (907)696-6111/Fax (907)696-8111 DATE 10/7/96 DRAWING R SCALE AS NOTED 96005-S1 wrti irb ritting lxg by. DOC Co. as SULLIVAN WATER WELL► P.0.BOX 670272.CHUG IAK,ALASKA 99567 • TULEPHONE688.2759 OWNER OF LAND LfAi 1r1/LLM A DEPTH OF WELL ADDRESS S� OLLi Yr4�t.9 QtJ6g- JUI STATIC LEVEL OF WATER F'r. LEGAL DESCRIPTION ,o 1 3 &-.<3 MdCs7-m. 4),4bLtFYDRAW DOWN FT. DATE - Statted Ended ¢ 4' _ GALS. PER HR _ 4 PERMIT NUMBER - KIND OF CASING —11L-11 KIND OF FORMATION: Fr011t—E_Ft. to tL _Ft. (245'1/4X Ei? From .Ft. to Ft. - - I From �' Ft. to�Ft, d 0G'ra.PWAA -k _' From Ft. to___ -^Ft. I From 4 Fc to/ Ft. &6'6SFrom FJ�5�( Ft. to Ft _ . From Ft,to-JT—Ft,�1/;(Y�14 '6 - V -From � Ft.to Ft — _ FromqJ Ft,to Ft.A&/0AM) Froth—Fi. to Ft 0 From/ 3D From Ft. to _. Ft, _ From.&!Ft.to`IFt,ajjL- J Rif Z fFt,to____l_.Fl. _ -- FrOMW Ft, to_ Ft. J�QgFrom Ft, to—Ft. From&;C C Ft. to-w—Ft. �� � From—Ft. to Ft. From.Ft, to �G From Ft. to Ft. **Ft. J ) �' UT"� Q aJFrom—Ft. Frau,��Ft• to�_Ft. ��R,�ss-C+ to --Ft, -- ��,, � � �- From Ft. to 35" Ft. � -/A4Z4 =Q� From -Ft. ro—___.Ft. — Q i D �4 Frum Ft, to 4qJ Ft- C ZFrom Ft, to --Ft. ,�j� Frottt ` FL to Ft. �%Qb 0 From- F ; to 1 t. OCT 1.01996 Ft, QOGL M From From.46Ft. to _ t� _ S Ft, to Coiuniclpallty of r�nctlorErE E Ft, age S Front ,,��,,^^.�,,,,,, Ft. to.l'�u_Ft. AC,k- From—Ft. to --Ft, E, �1 . E. d _ _ Fro FC tofpQ0--Ft. MISCL. INFORMATION: 131 rb 11 .T' 7-19,L (r' c,¢"''(' t og,L k_, y 4e POA g'o 4) 0 W f Froin Ft. to Ft. I t rt `I' MIC U 'r -A"? 'E– 6 0 DRILLER'S NAME Told bbibbbbbt+bb4GSLZ 089 S'1 -13M 2I31CM NHAI1-1r1S WH £5:80 3r11 96-10-180 PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES - lc� pilo P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMITl�-aca PERMIT NUMBER:SW960025 DESIGN ENGINEER:KND ENGINEERING OWNER NAME:MILLER WADE & LORI OWNER ADDRESS:10543 OLD EAGLE RIVER ROAD #4 EAGLE RIVER, ALASKA 99577 PARCEL ID:05073106 LEGAL DESCRIPTION: MAJESTIC VALLEY ESTATES BLK 3 LT 3 LOT SIZE: 54454 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: DATE ISSUED: 2/23/96 EXPIRATION DATE: 2/23/97 .0o < J -"1(o to 1. THE ATTACHED APPROVED DESIGN. 2. ALI, REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED B ISSUED BY: Y: DATE:- DATE: ATE:DATE: -?7 6 v1srrc0 5r,F G2uti.Si OF GNU/,vrfil� %jJ(/USE F�liYv/+i�'R n�/G Unci (J l= (�UUG� SU/[ IhTU 8"4A P&�rpt7/7 iU /�Oj�r3T3 p! J/!�A/ /?La/o FUi/viv 6000 KND ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 11 /FAX (907)696-8111 February 1, 1996 Municipality of Anchorage Dept. of Health & Human Services On -Site Services Section P. O. Box 196650 Anchorage, Alaska 99519-6650 Subject: Lot 3, Block 3, Majestic Valley Estates S/D - Request for Permit Gentlemen: Following a request from the owner regarding the proposed development of the referenced property, we have developed a design based on testholes conducted previously from another engineer for the proposed system and replacement field. The results of those tests are attached with original signature. The system will be placed on the southeast portion of the lot. As indicated on the site plan there is sufficient grade to maintain a gravity system. A 1000 gallon tank will be installed in anticipation of a 3 bedroom house being constructed. There is also sufficient area and grade to maintain a replacement gravity fed field. As indicated by the site plan, natural drainage is away from this site and will be maintained after construction. There is no surface water within 100' of the proposed installation. There are no curtain drains within 50' of the proposed installation. No wells exist within 100' of the proposed installation. If you have any questions about this application, please call me at 696-6111/FAX 696-8111. Respectfully submitted, � MUNICIPALI7 Y OF ANCHO tNV1RUNMENTAL SERV/C IrA(,E Kenneth M. Duffus, P. E. I r ES t)IVISIp(y KND Engineering ? 0 1996 attachments: On -Site Well and Sewer Application ECI VED Wastewater Absorption System Details Site Plan Soils Log/Percolation Test -T1TE PLAN WASTLWATER DISPOSAL SYSTEM LEIT 3, BLOCK 3, MAJESTIC VALLEY ESTATES S/D A6Af ; L°f2,B/k2 has unsacumcn1cri C/as5 "G'„ we// X200 /Pon 38 LOT 4 LoT 8 L ri 7� P�'OP� OSE6 URIVEWAY,. �or AL910�s i * 49TH* 9*�0 KENN. 1 W. FFUS 4 CF" -7116 W O fleof-vSSIUNF� ear, ``oma LoT PREPARED FOR: New, /000 C41— TANK . Wi Lo/ 2 sec, of /e oIp L O T 2 ,h �Xi.f �j xYS{IC E„5!, wt//) Zoo' /Q<S.te S/y5/ sF /c`Js/�oU7E/iR6-r� // V13 SF 7-omt. AzvoRG- ----- AREA AVAIL 52 7Z6 SF WADF & LORI 141LLCR 1054"3 ULD EAGLE RIVER ROAD, 114 EAGLE RIVER, AK 99577 KND ENGINEERING 20441 PTARMIGAN BLVD EAGLE RIVER, AK, 99577 907-696-6111 DATO 1/71/94 DRAWHIC a SCALD P . 50' 96005 -SI DESIGN DETAILS WASTEWATER DISPOSAL SYSTEM LOT 3, BLOCK 3, MAJESTIC VALLEY ESTATES S/D Ld o 0 0 00 0 z zz z zz z D w w w ww w O u u u uu u ID 0 �w LL � 'v cal I TANK FILTER 4' SOLID FROM HOUSE @ 2% SLOPE n O OF AZA HENNETH M. DUFIF CE -7116 j P40FESS1011O ORIGINAL GRADE --�INSULATINN SEWER ROCK 37.5' TYPICAL TRENCH SEGMENT T. Zobel Z-200 Splitter DESIGN CRITERIA 37.5' 2.5' OT..5' 5' T.D. = 8.0' 1. 3 BEDROOMS X 150 GAL./DAY/BEDROOM = 450 GPD 2, SOILS RATING: 23 MIN./INCH = APPL. RATE 0.6 GPD/SF 3. 450 GPD/0.6 GPD/SF = 750 SF 4. 750 SF /(5x2)= 75'L 5. MIN. DESIGN SIZE = 2 TRENCHES - 37.5' L x 2' W x 5' D 6. 2" HD INSULATION REQUIRED OVER FIELD <3' OF COVER 7. 2" HD INSULATION REQUIRED OVER TANK <4' OF COVER Water @ 12.5' BOH 14' C. 0, CC�.❑O.�,. �5j M. T. 8, CONTRACTOR TO VERIFY AND INSURE MAX 2% GRADE FROM HOUSE, ABED FOR: WADE & LORI MILLER 10543 OLD EAGLE RIVER ROAD, k4 EAGLE RIVER, AK 99577 KND ENGINEERING 20441 PTARMIGAN BLVD EAGLE RIVER, AK, 99577 (907)696-6111/Fax (907)696-8111 DATE, 1/31/96 DRAWING If NOT TO SCALE 96005-S2 y r no Oq ;1 `: ;• • v Municlpailty of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES a y 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: Y DATE PERFORMED: S-1�?/lg5– I�ajelri � LEGAL DESCRIPTION: LGr -7 !/a//cx Township, Range, Section: /Z 1 w See �3 T - SLOPE SITE PLAN TNI a i� IZ I I IT—�� 1 w► Date Gross Time Net Depth to Time Water Net Drop f - 04 y r no Oq ;1 `: ;• • v Municlpailty of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES a y 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: Y DATE PERFORMED: S-1�?/lg5– I�ajelri � LEGAL DESCRIPTION: LGr -7 !/a//cx Township, Range, Section: /Z 1 w See �3 T - SLOPE SITE PLAN TNI a i� IZ I I IT—�� 1 w► mom MM IMMINE Norio ■E©E 101120 0FANN NA 0 momM MEMO i 10 WAS GROUND WATER NO ENCOUNTERED? S 11 —, IF YES, AT WHAT - r 12 DEPTH? p . O E Depth to Water Alter 13 Monitoring? /P IS, Date: 617 17S- 14 ----- 15 16 17 18 19 Reading Date Gross Time Net Depth to Time Water Net Drop f - 2 _ r 3- v /6 ' 1's S-' -3 %c 4-1 a . 5 `�- . O 6- 7 7 8 l I, - mom MM IMMINE Norio ■E©E 101120 0FANN NA 0 momM MEMO i 10 WAS GROUND WATER NO ENCOUNTERED? S 11 —, IF YES, AT WHAT - r 12 DEPTH? p . O E Depth to Water Alter 13 Monitoring? /P IS, Date: 617 17S- 14 ----- 15 16 17 18 19 Reading Date Gross Time Net Depth to Time Water Net Drop f - _ r i v /6 ' 1's S-' -3 %c zo� G„ PERCOLATION RAPE � (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN s FT AND —6 FT COMMENTS PERFORMED BY: EAG • ss ' CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:.- 72-008(Rev. 4/85) i r• -n: to �� it�� F "a'o oo' �a5oru �y��o 00 n_qa= d, Municipallty of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES i; n �y Louis "c;er❑ P` a 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST I p F,, ,'. Ft PERFORMED FOR: // /i'Ve Y DATE PERFORMED: mel e1 ri'c LEGAL OESCRIPTION: �/,,-.7 U.r11e7 Township, Range, Section: ritiN R t w Sec 3 7H I j� SLOPE SITE PLAN 1 �F5 Cvi / /1Jr54NrC _J M 3 d 4 Gni 5 � S/I/Z, Sa NL+�' GING/ GSA✓G I 7 9- 10- 11 1011 12 U O 13 141 is 16 17 18 19 20 COMMENTS 0 WAS GROUND WATER ENCOUNTERED? i ES S _ IF YES, AT WHAT / OL - ,r DEPTH? P E Depth to Water Atter Monitoring] /D• 6 Date: b /7/9 Reading Date Gross Time Net Time Depth to Water Net Drop So AN f 9� /0 PERCOLATION RATE /5- (minutes/inch) PERC HOLE DIAMETER G_ TEST RUN BETWEEN S FT AND 6 FT PERFORMED BY: I ` l ��� CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: - 72.008 (Rev. 4/85) Municipality of Anchorage �� 1 E On -Site Water and Wastewater Program (907) 343-7904APR1 4 r. CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 050-731-06 1. GENERAL INFORMATION Expiration Date: ? - ,. I —'J Complete legal description Majestic Valley Estates Block 3 Lot 3 Location (site address) 26010 WHITE SPRUCE DR, Eagle River, AK Current Property owner(s) Wade Miller Day phone 632-8715 Mailing address same Real Estate Agent Owner Day phone 632-5518 2. TYPE OF DWELLING: ® 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 C Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Received by: ? �� Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 52& Date of Payment 411lLUlL/ Receipt Number d'T5&1 ,J COSA # DSCI qj y T Date of Receipt Number. Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm NorthRim Engineering Phone 694-7028 Address PO Box 770724, Eagle River Engineer's Printed Name Steve Eng Date 4/14/2014 6. DSD SIGNATURE __1z System #1 Approved for bedrooms. System #2 Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: By: /' [ !/, Original Certificate Date:— r The Municipality of Anchorage Devlopment 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 Septic System Advisory Well Flow Advisory COSA blue sheet 9-1-12.doc X Nitrate Advisory Arsenic Advisory Other If more than I septic system is on the lot: . COSA Checklist # _of _ Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: C ec _V4 (4'1fc I lT?L YParcel ID:050- 7.3/- U6" A. WELL DATA Well type P If A, B, or C provide PWSID # Date completed __VL6 Sanitary seal (YIN) Total depth 6 ok)ft. Cased to L&_5 ft. FROM WELL LOG Date of test .511C Static water level 123 ft, Well production o.75 g,p,m, WATER SAMPLE RESULTS: Coliform --CLcolonies/100 mL Nitrate Arsenic D, 3// ug/L Date of sample: B. SEPTIC/HOLDING TANK DATA Well Log (YIN) Wires properly protected (YIN) v Casing height (above ground) Af in. AT INSPECTION S� 2 /30 ft. I/. S g.p.m. Collectedby: 12�� Tank Type/Material map fig-/ S f-,( Date installed 546 Tank size Oao. gal. Number of Compartments 2 Cleanouts (YIN) Foundation cleanout (YIN) __�L Depression over tank (YIN) 1!�__ High water alarm (YIN) A/ Date of pumping /d/Z (3 Pumper Tp S C. ABSORPTION FIELD DATA Date installed 5./q6" Soil rating (g.p.d.W or ftz/bdrm) (3, � System type %! „ Length �/ e ft. -fo-+Width 2 ft. Gravel below pipe _ -5 ft. /a. S A Total depth _ ft. Eff. absorption area ��ft2 Monitoring tube V Depression over field _v' Date of adequacy test 2 / Results (Pass/Fail) T J, f For _� bedrooms Fluid depth in absorption field before test <� in. Water added 4(56 gal. New depth.30 in. Elapsed Time: .70 min. Final fluid depth Or in. Absorption rate >= SS6 g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type)y/JA If yes, give date D. LIFT STATION n/R Date installed Size in gallons Manhole/Access (YIN) "Pump one level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot /0 4 r?' Absorption field on lot 106 --4- Meets alarm & circuit requirements? On adjacent lots /0 0 ",t - On adjacent lots 4r, Q 't Public sewer main A(4 Public sewer manhole/cleanout W-4 Sewer /septic service line os,* Holding tank A/A Animal containment areas JSG �� Manure/animal excrete storage areas /00 �f SEPTIC/HOLDING TANK ON LOT TO: Building foundation . Property line to `f Absorption field S o` Water main Water service line /Q ��. Surface water l v o f e Wells on adjacent lots Q O r ABSORPTION FIELD ON LOT TO: Property line / f Building foundation /O 'f Water main Water Service line Q f Surfacewater /,00 /y� Driveway, parking/vehicle storage S Curtain drain !talk- Wells on adjacent lots /p 6'f F. COMMENTS G. ENGINEER'S CERTIFICATION t certify that t 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 Sr e /F (FA)6' Date COSA brown sheet_10-10-12.doc • t•: SxN= V1. (:;!J Yfi� cF. PIAT PLAN AS BUILT X SCALE 1" = 50° GRID NW363 Project No. 13-059 Lang & Associates, Inc. 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 (907) 522-6476 Phone Registered Land Surveyors (907) 522-4625 fax o-000 ken@langsurvey.com / jonathanHtangsurvay.cam OF A 4 QO I hereby certify that i have surveyed the following described property: LOT 3, BLOCK 3, MAJESTIC VALLEY ESTATES SUB. (PLAT/76—$4) '(f Anchorage Recording District, Alaska, and that the Improvements situated thereon are 9� within the property lines and do not encroach onto the roe �. p p adjacent thereto, that no Improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible • _ • • • • • • • . easements on sold property except as indicated hereon. m KENNETH G. G LS 5202 Doted this the A'06 Day of, oaf u "UL4 , at Anchorage, Alaska gyp.• �Igll� ,.•Q It Is the responsibility of the owner to determine the existence of any easements, ��1�aa%FSSt IONfJ� covenants, or restrictions which do not appear on the recorded subdivision plat. Engineer: _egal Description: ,ermit: Report Type: Municipality of Anchorage P.0 Box 196550 4700 Elmore Road Anchorage, Alaska 99519-6650 (907) 343-7904 Fax (907) 343-7997 http://www.muni.org/onsite Planning and Development Services Department On -Site Water and Wastewater Program On -Site SewerNVell Submittal Comment Sheet NORTH RIM ENGINEERING MAJESTIC VALLEY ESTATES B3 L3 OSC141127 WellSeptic COSA Completed By: fhe attached paperwork has been reviewed and is being returned for the following reasons: Is well flow reported the actual well production. 4/17/2014 J. Poet t11clit ` h1L//yt�Llt • '� DEPARTMENT OF HEALTH & HUMAN SERVICES iiVO9 MUNICIPALITY OF ANCHORAGEtgLERVC3DIV;rDivision of Environmental Services DNOn-Site Services Section lyy6 P.O. Box 196650 Anchorage, Alaska 99519-6650 CEI 343-4744 V f 4 CERTIFICATE OF HEALTH AUTHORITY l� APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D.# 5()%3AU0 HAA# , O�kr,������1 1. GENERAL INFORMATION Complete legal description LuT l3/� es iC� V Ci. I• Location (site address or directions) Property owner 04ele 4Cd/I `Lf /�% Day phone 6Y& Mailing address /�Sy'3 d���Czerda✓ Z lG✓k 2%5 Lending agency Mailing address Agent Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water Day phone Day phone NOTE: If community well system, provide written confirmation from State ADEM attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: 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 )Roy. 1/01) Front MOA X21 5. STATEMENT OF INSPECTION BY ENGINEER. As certifie:� by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage 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 p9lne�Phone 20"! lal Address Eagle River, AK 995778736 Engineer's signature Date zo�,4^ �} or C9 X '. eeOV l' a f� a0d:S .L... 10 1 z ~ : ,r m.i. a..a . ..iii •• Lcnnei 1 M Uullu . c PQ . CE 7116 Q �F9 '0leso./5/�( ••''���d 6. DHH SIGNATURE ����pROFESSIONP'� Approved for �� bedrooms. D sipproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: ' e'j�L• }�L </ .�°%Z'� (ti— _ Date i c. 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 #21 MUNICIPALITY OF ANCHORAGE M E M O R A N D U M WATER WELL ADVISORY HEALTH AUTHORITY APPROVAL N0. N14 9ZoIIOW 1 During a recent Health Authority Approval on-site inspection and test of the potable water supply well on Lot 7 Block .3 of /Y%q�lEs7Gyi�ZL&,1 67s7- Subdivision, the well's productivity was determined to be ©P'7� gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a J bedroom residence is 6•,3/ gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Health Authority Approval. Municipality of Anchorage � ,� p Y 9 DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division y� 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343- ic��jD Q* Health Authority Approval Checklist Legal Description: / & LZ�p ,� Parcel I.D.: A. WELL DATA / Well type G� • If A, B, or C, attach ADEC letter, ADEC water system number Log present (Y/N) Date completed `JAI ly I Total depth o Cased to /.5/1 Casing height (above ground) Sanitary seal (Y/N) Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION Date of test 5h Static water level Well production y 9 -P.M. WATER SAMPLE RESULTS: Coliform 6 Nitrate � % rr Other bacteria Date of sample: 9//2 Z /' Collected by: e���� � VB. SEPTIC/HOLDING TANK DATA Date installed —Tank size 1000 Number of Compartments Cleanouts (Y/N)—V_ Foundation cleanout (Y/N) _ Y Depression (Y/N) IV High water alarm (Y/N) N Date of Pumping Nom_— Pumper C. ABSORPTION FIELD DATA / Date installed 9�_-Soil rating g.p.d./f z r ft'xtfm) 04 ' / _ System type 7p ✓ C/� lo.'l z /�v chcs / Length B' a/ Width Z ea- Gravel thickness below pipe J cac�r Total depth TSB 8• �5 Effective absorption area — Monitoring Tube present (Y/N) Y Depression over field (Y/N) i✓ Date of adequacy test A/F1- Results (Pass/Fail) _ �� For _ bedrooms Fluid depth in absorption field befor t (in.); Immediately afte __ gal. water added (in.): Fluid depth _ Minutes later: A rption rate = , f3 P•' Peroxide tr��ent(past 12 months) (Y/N) If yes, give date _ 72-026 (Rev. 3/96)' D. LIFT STATION Date installed Manhole/Access (Y/N) _ High water alarm level at' Cycles tested E. SEPARATION DISTANCES Size in gallons "Pump on" level at' 'Datum SEPARATION DISTANCES FROM WELL ON LOT TO: mp off" level at' Septic/holding tank on lot /00 `+ On adjacent lots /OU '-t- Absorption field on lot On adjacent lots /00 �+ Public sewer main _ /00 ,-�- Public sewer manhole/cleanout /00 Sewer /septic service line /00 / fi Lift station /V ¢- SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation /D Property line _ /0 f Absorption field /O 1¢ Water main/service line /0 `+ Surface water/drainage /00 �+ Wells on adjacent lots /00 `+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line /b + Building foundation /O /-N Water main/service line io 14 - Surface water — zoo f ,(- Driveway, parking/vehicle storage area ZS 14 - Curtain drain` 0 + -* NoNc- .f'No/vN Wells on adjacent lots F. ENGINEER'S CERTIFICATION / certify that l have determined thru field inspections and review of Municipal records in conformance with MOA HAA guidelines in effect on this date. Signature Engineer's Name v� r�yn , k'A o' ° S Date 9 0 A/1 HAA Fee $_ 5n. c 0 Date of Payment l U/9/9 1p Receipt Number -O�(,L��J rf / 72-026 (Rev. 3/96)` Waiver Fee $ Date of Payment Receipt Number )U ` -F �Stesms are �. iaalNai°a�/V [9��V °°a ! 00 IQ ! as ao soli i ioaH! e•l N+il ilii •• Kenneth M. Uuffus c� CCE 77116 ��ESS1j� �— NORTHERN TESTING LABORATORIES, INC. %SIIU ..`;�:I If is it -- � '!�J I�. I;. ;l I� - - -t'�I� "iA. `�IJO • I i . - .. KND Engineering 20441 Ptarmigan Blvd Eagle River AK 99577 Attn: Ken Our Lab #: Location/Project: Your Sample ID: Sample Matrix: Comments: F166447 L3/3 Majestic Valley Water Report Date: 09/17/96 Date Arrived: 09/13/96 Date Sampled: 09/11/96 Time Sampled: 1031 Collected By: SO MDL = Method Detection Limit * Flag Definitions B = Below Regulatory Min. H = Above Regulatory Max. Date Date Lab# Method Parameter Units Results * MDL Prepared Analyzed --------------------------------------------------------------------------------------------- F166447 EPA 300.0 Nitrate -N mg/L 2.77 0.15 09/13/96 Reported By: Patricia A. Wo - Senior Chemist C