The URL can be used to link to this page

Home My WebLink AboutMAJESTIC VALLEY ESTATES BLK 3 LT 12Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number OSP231024 PID Number: 050-731-22 Dwelling: 0 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New R Upgrade Name MATTHEW & LAURA COLLINS ABSORPTION FIELD Site Address 26153 IMPERIAL DRIVE, EAGLE RIVER, AK 99577 El Deep Trench Q Wide Trench El Bed El Mound � Other Phone Number of Bedrooms Soil Rating Total depth from original grade 949-943-7847 4 *6.0 GPD/SF SEE DWG. Ft LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot SEE DWG. Ft. 0.55 Ft MAJESTIC VALLEY ESTATES 3 12 Fill added above original grade Gravel length Township Range Section SEE DWG. Ft. 34+ Ft Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES 5+ Ft. - Ft. To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line 170 Ftz 1 _ Ft. Well EXIST. *501+ *50'+ - N/A Septic ❑ S.T.E.P. ❑ Holding []Other Manufacturer Capaci Surface Water EXIST. *50'+ *50'+ -Gal. Material ' Gal. Material ___ f compartments Lot Line EXIST. *5'+ 51+ - NA Foundation EXIST. 10'+ 10'+ - LIFT STATION Manufacturer L Capacity Remarks *AWWTS . *"NEW 24" PUMP VAULT ADDED AFTER **ANCHORAGE TANK/ORENCO Z 4 � Gal. ADVANTEX SYSTEM. ALSO INSTALLED NEW ADVANTEX PANEL Alarm location Electrical installed by INDOOR/REMOTE Spa LnAA PIPEMATERIAL House to tank Tank to D17851 Installer EXIST drainfield D3034 A.C.E.S. - JORDAN ANDERSON Drainfleld D3034 CO/MTD3034 Inspector GEG CONSULTANT, JODY MAUS BENCH MARK (Assumed elevation) 100.00 ft Inspection 1, 5/4/23 2� 5/5/23 Location and description dates: 3b 5/8/23 4"' 5/8/23 TOP OF DECK NEAR PATIO. ON-SITE WATER AND WASTEWATER SECTION APPROVAL I Engineer's Stamp Approval: Septic Syste Approved _ 05/02118) / Date Date is approval does not include well permit requirements. 4 g T ....;........... e A. G rness.. OQo9 / Cr7 3 of ss() #AECC884 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://Www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP231024 Effective Date: Work Type: Septic Upgrade Expiration Date: Tax Code Number: 05073122000 Site Legal Address: MAJESTIC VALLEY ESTATES BLK 3 LT 12 G:0363 Site Mailing Address: 26153 IMPERIAL DR, Eagle River Owner: COLLINS MATTHEW J & LAURA Design Engineer: GARNESS ENGINEERING GROUP LTD This permit is for the construction of: Q Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy �jAiCnr {' si tr. l' fi ]ie paI- tIneIIt 3/6/2023 3/5/2024 Lot Size in Sq Ft: 54936 Total Bedrooms: 4 ❑ Private Well ❑ Water Storaae All construction shall be in accordance with: 1. The attached approved design. L. 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 wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: 1. Confirm groundwater elevation prior to start of construction to verify bottom of sewer rock elevation. Received By: Issued By: Date: Date: =0-Z ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 050-731-22 Property owner(s) MATTHEW COLLINS Day phone 949-943-7847 Mailing address 26153 IMPERIAL DRIVE, EAGLE RIVER, AK 99577 Site address 26153 IMPERIAL DRIVE, EAGLE RIVER, AK 99577 Legal description (Sub'd., Block & Lot) MAJESTIC VALLEY ESTATES; BLOCK 3, LOT 12 Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field E] Initial ❑ Single Family (SF) Septic Tank ❑ Upgrade 0 (w/wo ADU) Holding Tank ❑ Renewal Duplex (D) ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. Signature of property owner or authorized agent) Permit/Rush Fees: 596-- Waiver Fees: Date of Payment:_� 1,� LJ Date of Payment: Receipt Number: 6 � q q _G Receipt Number: Permit No. til 1? 2-1:3 1 Waiver No. GADevelopment ServiceslBuilding Safetyl0n Site Water and WastewaterTorms\Client FormsTermit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231024, Curtis Townsend, 03/06/23 IPERMIT NUMBER: PARCEL 10 ' OSP231024 RECORD DRAWING 050-731-22 NUMBER: R 1"=49 4 zo, LOT 1 BLOCK 3 EXISTING 1500 -GALLON EPDXY COATED STEEL TANK AND ADVANTEX PC EXISTING DOUBLE 1104"Zooif I- I A 1 8 X PV 38.8 43.9 APPROX. 100 -FOOT C01 47.0 57.2 WELL RADIUS --\\/ MTI %6 58A CO2 59.5 64.8 FS 60.2 65.3 CO3 60.9 657 MT2 67,9 70.3 C04 72.0 71.9 NOTE: PIPE LOCATIONS ARE SHOWN PER GEG SHOTS TAKEN WITH LEICA DISTO If S910 LASER DISTANCE METER. SWING -TIES TO HOUSE CORNERS WERE GENERATED IN AUTOCAD. NEW 24" ORENCO PUMP VAULT (PV) WITH PUMP AND FLOATS REQUESTING 2:1 SLOPES OFF DRAINFIELD IN THIS AREA TRANSITION FROM PRESSURE TO GRAVITY /—APPROXIMATE TOE OF SLOPE /—GUARANTEED SERVICES LOT 13 GROUNDWATER MONITORING TUBE INSTALLED FLOW SPLITTER (FS) NEW DRAINFIELD (DRAINFIELD REBUILT), CURTIS TOWNSEND ANDIOR GUARANTEED N TE GROUNDWATER MONITORING ED SE DWA I R NG I STA ED FL SPLITTER R (F T R E 0 C 91 BEN COGGER WITH MOA V W R /RANE SERVICES i t2 TUBE LL TTE 5 NEW E (DRAINFIELD To� BEN COG' ONSITE DEPTARTMENT WERE PRESENT DURING BOTTOM OF TRENCH EXCAVATION. DRAINFIELD IAWWC 1999 BUILT AS SINGLE TRENCH TEST HOLE WITH MOA APPROVAL IN GENERAL AREA OF OLD I L DRAINFIELD. ALL OLD SEWER I D 0 1 RAINROCKtPIPING WERE C REMOVED. APPROXIMATE LOCATION OF 1980 TRENCHES (ABANDONED IN PLACE). FOUND OLD SUMP AT END OF NORTHEAST TRENCH SEGMENT N, ��APPROX' WELL RADIUS ,,e,*lL%IklkvA 10 OF �W lw is T Tp -'ARN'ff7'-' EN' -4 IN"ERIN' '-N R 9 4' ki Iri kx Iff lj U •... rjZ5;5 Md ....... ... .. ........ .............. ENGINEERING -SALES,, CONSULTING 0 3701 E TUDOR ROAD. SUrM 101 ANCHORAGE. ALASKA PHONE (907) 337.8179' WMITE: www gamessongmeamrig.com ......... ............... R!. ;L 0 PREPARED FOR: PHONE NUMBER: PAGE NUMBER # A* #effreyA.Garness -',ZZ7jW # (p MATT COLLINS C49-943-7847 20F3 % c -79 3 ## j 77 PROJECT EGA[ DESCRIPTION: DRAWN BY: C MAJESTIC VALLEY ESTATES SID; BLOCK 3, LOT 12 J.L.M. ... ... p TYPE OF WORK: DATE: 44. LICE RECORD DRAWING OF SEPTIC UPGRADE 5/15/2023 #AEC � VMS It it w ILL CL OOUI<t„ `£ Lu W 0 Liles: t swop zw3T< ♦;LU U�e'; p i Uju 0 10-1 W rz O W mW W O LL r, W W Q ' 7 F W N Q a Z, Z CY ¢ .,., Cr Z!: LC O ' �'✓a4 ¢ PY ap.>O �% Q} f)w? . WE2!" W a g uj O @< F-- uj Er D z a ti Xaprx� N Z LU LU (r MW X Uiu. Zoz0) LL a mm N � M 7 :) K (a. L W f- 5 Z O � f L OD to z�pt)O h+�r' t ZO zJ �G? asa,a>WM a liiLf) w N z In �� z 0 z ¢ ¢ Iso U. oho rn�z �� is a a a W z? Z—ZCCa a a55d —¢W�LL OO om o0X 10. W,Ooa ¢ O W N a0 x ' WO ¢00raw0� �. @i — a7 w {. r O w Z O CL (L 35 1 }'U'¢0 Wwmza D m(r O0¢Ow £ q mC; _J av rw66(x C)a my 5 1 WK'S z co Cy W W Q o SaN .I a —} < - W cn N rS U- S,o j Q UJ m LL O a� z� " t LU - (LyL1�j �q r QO a U co Ix�y i- �t Yri Lu J N .�7 LL� W 4 F. �� Y N �� LU �� ZO W �M U. II ay �Q "" O Zw Q LL O V O4L- Ix � y � � Lll Z W r it Z O O Jt O W d -j O NQ WZ OaZ '7 Z�Q f" W WLL t 1 Z '' p d W a * $, UP J w> u5 a „11' k R, o -j a LL) ti✓ Odea =u 4 �� &Q LLr�ZrO 0 �� LL 0(.)LL LU O� XN� 0OW LU Co LL ` ¢ ��( UQ LLL uj 111 a LU ¢ ¢ W Lu Z Lu r.O=cn} a n O6Za i `�crw°X ¢t rte¢ t t C1r o ti C14 t n.. 1 cn ; 0 i Municipality ®i Anchorage P.O. Box 196650 ® 4700 Elmore Road _Anchorage, Alaska 99519-6650 ® (907) 343-7904 ® Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: OSV231026 COSA#: Permit#:OSP231024 PID#: 050-731-22 Legal Description: MAJESTIC VALLEY ESTATES BLK 3 LT 12 Engineer: Garness Engineerinq Group Your request for a waiver of the requirement for 3:1 slope on the new mound. The mound slope with jute mat are approved to be 2:1. Waiver is Granted: X Waiver is not Granted: Date: Approved by: — &/Z:� Name of Review ............................ ■ ............................. ■ ................. 1 **** VARIAN C E/WAIVER REVIEW **** Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231024, Curtis Townsend, 03/06/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231024, Curtis Townsend, 03/06/23 Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of 1 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP 191306 PID Number: 05073122 Dwelling: X Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ■❑ Upgrade Name PETER AND UTE OLSSON ABSORPTION FIELD ❑ Deep Trench ❑■ Wide Trench ❑ Bed ❑ Mound Site Address 26153 IMPERIAL ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 6 GPD/SF 4 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 3.5 Ft. Gravel depth beneath pipe 0.5 Ft. Subdivision Block Lot MAJESTIC VALLEY ESTATES BLOCK 3 LOT 12 Fill added above original grade 3 Ft. Gravel length (2) 15 Ft. Township Range Section Gravel width 5 Ft. Beds: Number of Lines - Distance between lines - Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 150 Ft2 2 6 Ft. Well +100 +100 - _ +25 TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ❑9 Other Manufacturer ORENCO (ADVANTEX) Capacity 1500 Gal. Surface Water + 100 +1 00 — Material FIBERGLASS Number of compartments 2 Lot Line +10 +10 - - NA Foundation +10 +10 - - LIFT STATION Manufacturer Capacity Remarks NEW ADVANTEX SYSTEM. OLD SEPTIC - _ Gal. WAS DEMOLISHED PER MOA REQUIREMENTS Alarm location Electrical installed by PIPE MATERIAL House to tank 3034Tank to 3034 drainfield Installer GUARANTEED SERVICES Drainfield 3034 cO/MT3034 Inspector CHARLES BALZARINI BENCH MARK (Assumed elevation)100 ft Inspection 151 9/3/19 9/4/196 Location and description 2Mion TOP OF DECK NEAR STAIRS 3rd 9/5/19 4t" ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Sty, \ 4�OF AL�Il` Conditional Approval: Date law 1� %* qg TM *fir r CHARLES G BALZARI91 r��• CE -13854 Septic r— Approved Date ��C 2—� (�TFQFo lll\ PROFESSI�ti�.� Note: this approval does not include well permit requirements. (Rev ab/02/18) LEGEND Q CLEANOUT 19 MONITOR TUBE \ MAJESTIC VALLEY ESTATES BLOCK 3 LOT 12 5 '% 4 BR HOME �! \-I BM, DECK DRIVEWAY I MPERIgL pRI�E NEW 1500 GAL ADVANTEX / TANK W/AX-20 POD ELECTRICAL PANEL m OF A�gsl'�� 49 TH CHARLES G BALZARINI CE -13854 F�PROFESSI6P� (2)5'x15'x0.5' EFFECTIVE DRAINFIELD 50/50 FLOW SPLITTER AONITOR TUBE BLUE BOARD INSULATION - +700.0' DECK FILTER FABRIC /-98'4 FINISHED FILTER FABRIC 100.7 ( GRADE 4.2' jCOVER 97'5 COVER ORIG7 GRADE 3.7' COVER 94.3 INVERT 7 93.7 93.7 I 4`0 DISTRIBUTION PIPE t 93.7 4"0 DISTRIBUTION PIPE J 93.2 1500 GAL ADVANTE.;TANK 0.5' EFFECTIVE SEWER ROCK) 0.5' EFFECTIVE SEWER ROCK - FILTER SAND NOT SHOWN FILTER SAND NOT SHOWN SCHEMATIC PROFILE VIEW SHOWS ELEVATIONS OF INSPECTED ELEMENTS BUT DOES NOT DEPICT SYSTEM IN ITS ENTIRETY. A SWINGTIES B ID C 25.4 21.6 CO D 27.3 23 CO E 32.4 26.2 MH F 42.7 32.8 MH G 50.2 40.1 CO H 55.9 49.3 MT 1 61.6 55.4 CO J 62 55.8 DIV K 63.1 58.6 CO L 67.4 65 MT M 70.4 70.7 CO N 42.2 33.6 CO SCALE: 1" = 30' TUBE GRADE TESTHOLE AWWC 97.7' 7 GROUNDWATE 91.7(10/4/99) 85.7 SOILS INFORMATION BASED HISTORIC TESTHOLE DATA C&M ENGINEERING SERVICES 907-854-5558 LEGAL DESCRIPTION: MAJESTIC VALLEY ESTATES BLOCK 3 LOT 12 OWNER:OLSSON DATE: 9/10/19 1 REV: 0 1 DRAWN: CB I REF: SITE PLAN MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP191306 Work Type: Septic Upgrade Tax Code Number: 05073122000 Effective Date: Expiration Date: Site Legal Address: MAJESTIC VALLEY ESTATES BLK 3 LT 12 G:0363 Site Mailing Address: 26153 IMPERIAL DR, Eagle River Owner: OLSSON PETER Q & UTE R Design Engineer: C & M Engineering This permit is for the construction of: Q Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy �c�11�enY S' Departrnent 8/26/2019 8/25/2020 Lot Size in Sq Ft: 54936 Total Bedrooms: 4 ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: Issued By: Date: Date: U Q l n M MUNICIPALITY OF ANCHORAGE A/S Development Services Department"'' Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTICMELL PERMIT APPLICATION Parcel I.D. ��— 0 50 - 7 31 - a a Property owner(s) Peter Olsson Mailing address Site address 26153 Imperial Drive Day phone Legal description (Sub'd., Block & Lot) Majestic Valley Estates Block 3 Lot 12 Legal description (Township, Range & Section) Lot Size ' 59,93LSq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field 0 Initial ❑ Single Family (SF) 0 (w/wo ADU) Septic Tank ❑ Upgrade Duplex (D) ElHolding Tank ❑ Renewal ElMultiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. C&M ENGINEERING (Signature of property owner or authorized agent) Permit/Rush Fees: ($ q6a/ Date of Payment: 2Ll9-/%q_ Receipt Number: 0j4_&3f_lD Permit No. 05P01364 Waiver Fees: Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc C&M ENGINEERING SERVICES Ph: 907-854-5558 Municipality of Anchorage Onsite Water & Wastewater Program 4700 Elmore Rd Anchorage, Ak 99507 RE: Proposed Septic System replacement for Majestic Valley Estates Block 3 Lot 12 Dear Reviewer, The above referenced property is currently served by an older, failed septic system. The owner would like to replace it with a new septic 4 bedroom system. We are proposing to install a new advantex septic tank and a new drain field. The old tank will be demolished per moa requirements. Our review of available documentation and field investigation show that this project will not adversely impact any nearby wells, wastewater disposal systems, replacement disposal sites, or drainage flowing onto and off of the subject property. A new testhole will not be excavated as there are two existing soils logs for the subject property. The soil log prepared by AWWC includes groundwater monitoring and serves as the basis for our design. The new field is sized based on a 0.5’ effective depth and a sand liner will be required due to the free draining soils. Included with this letter is a permit application and design package, including plans, and calculations. Thank you for your time in reviewing this permit request. Please do not hesitate to contact me at 907-854- 5558 or by email cgbalzarini@gmail.com with any questions or concerns. Sincerely, Charles Balzarini, PE 8/11/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191306, Rebecca Carroll, 08/26/19 Residence: number of bedrooms 4 br Water usage/bedroom 150 gpd/br Water Usage 600 gpd type: SHALLOW TRENCH Application Rate 5 gpd/sqft required absorption area 120 sqft trench width (W) 5 ft minimum effective depth 0.5 ft below distribution pipe see narrative Min Required Length: 24 ft MOA Sand Depth 2 ft MAX Excavation Depth: 6 ft Cover: 3 ft Insulation: 2" blueboard Effluent Pipe: Calc By: CGB Date: 7/25/2019 C&M ENGINEERING SERVICES 907-854-5558 Septic Design Calculations Majestic Valley Estates Block 3 Lot 12 RESIDENCE/LOT INFO DRAINFIELD 4" ASTM 3034 max excavation depth is measured from the high side of the trench CALCULATIONS ARE FOR REFERENCE PURPOSES ONLY USE DIMENSIONS SHOWN ON PLANS CALCULATIONS ARE FOR REFERENCE PURPOSES ONLY USE DIMENSIONS SHOWN ON PLANS Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191306, Rebecca Carroll, 08/26/19 1 00' WE L L RADI U S SEPTIC AREA SEPTIC AREA MAJESTIC VALLEY ESTATES BLOCK 3 LOT 1 MAJESTIC VALLEY ESTATES BLOCK 3 LOT 12 MAJESTIC VALLEY ESTATES BLOCK 3 LOT 13 MAJESTIC VALLEY ESTATES BLOCK 3 LOT 11 IMPERIAL DRIVE 649 6 50 644 655 4 BR HOME DRIVEWAY MOA CONTOURS TOP OF STEEP SLOPE SEPTIC AREA UTILIT Y EASEMEN T WHI T E SPRUC E REPLACE EXISTING STEP TANK WITH NEW 1500 GAL ADVANTEX TANK W/AX-20 POD SET INTO HILL TO CREATE SUFFICIENT DROP FOR GRAVITY FLOW. DO NOT EXCEED MAX BURIAL DEPTH. TH-AWWC (2)5'x15'x0.5' EFFECTIVE DRAINFIELD WITH 2.0' OF MOA SAND. BOTTOM OF SEWER ROCK SHALL BE NO DEEPER THAN 4' FROM ORIGINAL GRADE AT ANY POINT. DEMOLISH OLD TANK PER MOA REQUIREMENTS ABANDON OLD FIELD IN PLACE 10 0 ' WELL R AD IU S 100 ' WELL RADI U S 50/50 FLOW SPLITTER C&M ENGINEERING SERVICES 907-854-5558 AREA PLAN LEGAL DESCRIPTION: MAJESTIC VALLEY ESTATES BLOCK 3 LOT 12 OWNER: OLSSON DATE: 08/11/19 REV: 0 DRAWN: CB REF: SCALE: 1" = 60' CHARLES G BALZARINI CE-13854R EGISTEREDPROFESSIONALE NGINEER 07/25/19 SEE SITEPLAN FOR DETAILS Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191306, Rebecca Carroll, 08/26/19 MAJESTIC VALLEY ESTATES BLOCK 3 LOT 12 IMPERIAL DRIVE 649 650 644 655 4 BR HOME DRIVEWAY MOA CONTOURS TOP OF STEEP SLOPE EASE M E N T REPLACE EXISTING STEP TANK WITH NEW 1500 GAL ADVANTEX TANK W/AX-20 POD SET INTO HILL TO CREATE SUFFICIENT DROP FOR GRAVITY FLOW. DO NOT EXCEED MAX BURIAL DEPTH. TH-AWWC (2)5'x15'x0.5' EFFECTIVE DRAINFIELD WITH 2.0' OF MOA SAND. BOTTOM OF SEWER ROCK SHALL BE NO DEEPER THAN 4' FROM ORIGINAL GRADE AT ANY POINT. DEMOLISH OLD TANK PER MOA REQUIREMENTS ABANDON OLD FIELD IN PLACE 100' WELL RADI US 50/50 FLOW SPLITTER C&M ENGINEERING SERVICES 907-854-5558 SITE PLAN LEGAL DESCRIPTION: MAJESTIC VALLEY ESTATES BLOCK 3 LOT 12 OWNER:OLSSON DATE: 8/11/19 REV: 0 DRAWN: CB REF: SCALE: 1" = 30' CHARLES G BALZARINI CE-13854R EGISTEREDPROFESSIONALE NGINEER LEGEND CLEANOUT MONITOR TUBE NOTE: THE PROPOSED SEPTIC SYSTEM MUST BE INSTALLED GREATER THAN: 50' FROM ANY PRIVATE WELLS 200' FROM ANY PUBLIC WELLS 50' FROM ANY SURFACE WATER 5' TO ANY PROPERTY LINE OR FOUNDATION 5' TO ANY TEST HOLES 10' TO THE HOUSE FOUNDATION 08/11/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191306, Rebecca Carroll, 08/26/19 Mnuieipality of Anehorage U* Department of Health and Human Services 825 "L" Street Rick Mystrom, P.O. Box 196650 Anchorage, Alaska 99519-6650 Mayor http://www.ci.anchorage.ak.us November 19, 1999 Jeffrey A. Garness, PE 6901 DeBarr Rd., Suite 2B Anchorage, AK 99504 Subject: Waiver Request for Majestic Valley Estates, Lot 12, Block 3 Waiver Request #WR990091 Parcel ID #050-731-22 HA990559, SW990388 Dear Mr. Garness: Your request for a waiver of the required 100 feet horizontal separation from the absorption field to private well has been approved. The approved separation distance is 90.0 feet. The 90 feet separation is from the subject property well to the neighboring Lot 11 absorption trench. This waiver approval applies to the existing absorption field to private well separation only. Any future upgrade to the on-site water well requires 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 343-4744. Sincerely, Daniel J. Roth Civil Engineer On -Site Water Quality Program MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR# 990091 PID# n5n-731-22 HA# RA990559 Date Received: 11-12-99 Permit #SW990388 Legal Description: Majestic Valley Estates, Lot 12, Block 3 Engineer: Alaska Water & Wastewater Consultants 6901 DeBarr Road, Suite 2B, Anchorage, AK 99504 Applicant: Glenna Eldridge FWWWMN3 Waiver Requested: A waiver for a 90 foot separation distance from the well to the neighboring septic system. Criteria: 1. Geology: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Points: 7.4 4.8 Waiver is Granted: X Waiver is NOT Granted: List Conditions or Reasons for above: 5 EE 47T,4CHE/UifES C(j (.( LV NO % 9E i/i�/KEN /�J T/fix CI4A+�RA /S B/?O F Date: _ !_ By: Jpw Name of Reviewer of Rec #: L�S Amount: $ ;�� Date Paid: atia 1N LY 181 181 W LU xx in th vgi 000 Ln O 0 �r cv v �sva N N N N N N W A J V E R R Eq U EST FOR LOT /Z 81-k 3 tfN J E s Tic VALE Y FST/¢T, w,41vER )?F -QUEST #UMBER W1?991M9/ IN19/11ER Rc,?UEST FOR ON -LOT WELL TO TAJF /VF/bN4galemG 1,0- ,6L OT"BL IP 3 Af &.TE S Ti c ✓d i e- E Y 6 5 r,4 7-6 S. - SEPTtc 0i4T,4 - %HF m4Srek,#Tax josolgPnoN TRENCH oAv Lor // w14s /iv oL)gtf {v KEN 7F.cF WEiL Qa L07- 12 w)4S i'VNsrieuLrE 0, TME f}BSOI4PTiov FIELD 390ger IS COMSTRk07,6P /N A (r/M 5`04 1uiTH R PEKfoL,*7?0A1 RATE R/YuGF ol: J - /D M/N1/a. THIS ABSORPTIo�v F/Ecd /S LOwfR IN flfvIltrICAl POT E #v r i AL BY %rig ^ SuKFq{j/VG cFFLA9,vT fKoM THE ORAIAIFIELV wlEt- N07- RE,+(q `UG WELL. THE 198SORI07704- f/6L 0 Is 4L.Sv DOwiv 69,*A/, IN iP=)QMJ of 5uvSwRrws flpees of 50/1- w r F, R aILw>}r6R 7A6LES. WELL 194r)4- 7-NERE RRf NuuERous WELL► L06f /a TIYE 1A4AtF,0i47,f f}!46/¢, T/-f£r /¢LL 1412E (OA/SIStE�/% I�ENT/F}��i✓ T F AC'F rT/?ar�s G K t c��su,ef 7'Fr E !9E b k o tl� No �,► E vG R rA' KE S �1 R u � C - ^f 'PROP p"c' fl4 {v F L L 1-06 oN L07- /3 700 LUT /7, F1P0M //k FEF -7' 7'0 /igo FEj IN 300 FEE T FK am TNF F19 -,s T Mov,A,* l0 T/-{ E ;,? SJ; r r C0/vT/AN%ocF_ s L aT j/ wtr/-f ,�0 B�l�/�oc% ,Ewtvu•�•� r o 2 / S' FEET. 9F vKv CK HAf t Z G % SL 010E 1vuMERo'cS LA-YF—lef OF "S/krr CL.#y 612pv-01- ` Iy�%�lAU1 ") 4?E F-MCauA1)r)PF_O r'RivR Tv B CRIOClf OlrlivG PAlC6,LotA rF_WEO 14T /8Q1tEET, 'rT lPPFRQS TM 4T THE w•ATJE/q CaM/ub pll1M14J2/Lr F4f0,,ot Fle4cT14 rely s / OFii%le0el1 WILL J5j E CUNFI N EQ r -IQ aK r a!e FAtE Cb�vTi4M rev/¢T/ai�•s. w47 -EK fr}MPL4F;F /NditA F N0 $I¢cTFA°Iq PR EsFN7- 9A, 47 Al I TR A r6 S. r F, UA"A~ W W W W W W .Z x x to N N 000 N OO . N N e4 aav N N N N N N P2 i wA 7-Sk Tr+oi P- l8� ' /0 ' S 1�sr6a. PEP7`/ l7a'_x / 9a 70 SOIL SOR6T/ON X70 leu i7o )'e' �f►4,W � AQ/� e T� (T'1.7F --70) W )FTF1Q T,90' -E 6j?,9o/FaT W. c fa.. S. C. R p _ fo D//V TS x=J7 �- 7 7.4 / r z.9 f-lD/?�ZowY/9� 5F_J0i9reA77VAl 10, y 2.9 U,VfLks/Owl Gi?6AIT w►4/�F� G R,9kV ra 7-4L 2-2,2- o4, el L k P Owl 2.2 Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Road, Suite 2B — Anchorage — Alaska 99504 (907) 337-6179 — Fax (907) 338-3246 Consulting Engineers November 11, 1999 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Attention: Dan Roth Ref: Waiver Request For Majestic Valley Estates S/D, Lot 12, Block 3, Attached is the As -built package and Health Authority Approval Request. As can be seen on the As -built drawing the well serving this property encroaches upon the septic system serving the neighboring property (Lot 11, Block 3). We request that your department issue a 90 foot separation distance waiver from the well to the neighboring septic system. Justification for the waiver is as follows: • The ground surface elevation in the area of the septic system is lower than the ground surface elevation by the well (greater than 25 foot elevation difference), so that if any effluent were to surface, it will flow away from the well. • The location of the septic system is in a very visible area so that if any effluent was to surface, it would be noticed and the problem corrected. • Recent water samples indicated that the nitrate levels were 0.605 mg/L and no bacteria was found (see attached results). • Attached are also some neighboring well logs. As can be seen from the well logs, there is hardpan layers and bedrock (boulders) that have served to protect the aquifer from any contamination. Based upon these factors, it is our opinion that there is a minimal risk for the granting of this waiver. With the granting of the waiver, we also request that you issue a Health Authority Approval. If you have any questions, please contacUme at 337-6179, or 244-9612. Thank you for your assistance. Si Jeffre esS- -&, M.S. Presi e t Ari _ � `-- i Z�Q �IF' �] MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On -Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99599-6650 (907) 343-4744 Ey(., f -14i /I -Turf ela-7(c,U ojcut tai 2 m_� JI -3 pr ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT lSP-no Upgrade 11-3 _ C/ Date Issued: Oct 15, 1999 Expiration Date: Oct 14, 2000 1 Ai'SPEC771m1 Permit Number: SW990388 Parcel ID: 050-731-22 I Iq qR pl'� Legal Description: MAJESTIC VALLEY ESTATES BLK 3 LT 12 Design Engineer: 0041 AK Water & Wastewater Consulta Site Address: 026153 IMPERIAL DR Owner Name: Glenna Eldridge Lot Size: 54936 SQ. FT. Owner Address: PO BOX 773352 Total Bedrooms: 4 Permit Bedrooms: 4 EAGLE RIVER, AK 99577-3352 This permit is for the construction of: ❑✓ Disposal Field E✓ 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 DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 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. THIS PERMIT ISSUED FOR THE CONSTRUCTION OF AN INTERMITTENT DOSING SAND FILTER ALTERNATIVE WASTEWATER DISPOSAL SYSTEM. THE ATTACHED PROPERTY OWNER MAINTENANCE AGREEMENT SHALL BECOME A PART OF THIS PERMIT PACKAGE. Received By: Date: 0 / S' - 9cI Issued By: Date: / Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Road, Suite 213 — Anchorage — Alaska 99504 (907) 337-6179 — Fax (907) 338-3246 Consulting Engineers October 7, 1998 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 RECEIVE OCT 11 1939 Muriicipahty of Anchorage Dept. Health & Fluman Services Ref: Septic System Upgrade for Lot 12, Block 3, Majestic Valley Estates S/D To whom it may concern: The existing 4 bedroom house is served by an onsite septic system, and a private well. The existing septic system consists of a 1250 gallon septic tank and a deep trench type drainfield. The existing are surcharged and must be upgraded prior to the sale of the house. Comments regarding the proposed upgrade are summarized as follows: 1. GENERAL: There are a number of site restrictions which limit the available spots to put the new drainfield. These restrictions are summarized as follows: • The location of the existing septic system • Steep topography. Most of the lot slopes to the north (uphill) at greater than 25% • The location of the house. • The location of the 100 well radii • The presence of shallow groundwater Given these restrictions, there is limited space on the lot to put the new drainfield; therefore, we are proposing to install a bottomless, Intermittent Sand Filter (ISF). 2. SOILS: On July 28, 1998, a test hole was excavated and percolation test performed at the area of the proposed septic upgrade. As can be seen from the attached log, the soil below the organic layer is a GM to GM/ML material to a depth of 12 feet (bottom of hole). Ground water was encountered at the time of excavation at a depth of 9 feet. Ground water monitoring has been performed the last several months and found the groundwater level rose to 6 feet. A percolation test was performed between 3.5 feet and 4.0 feet, and determined to be <1 minute/inch. 3. TRENCH DESIGN: Bottomless Intermittent Sand Filter (ISF) a. Percolation Rate: <1 minutes/inch b. Allowable Application Rate for ISF: 2 gallons/day/ft2 c. Number of Bedrooms: 4 d. Design Flow: 600 gallons per day e. Minimum Absorption Area: 300 ft2 f. Effective Depth below pressure pipes: 2.5+ inches g. Width: 12 feet h. Length: 30 feet. i. Effective absorption area = 360 ft2 (>300 ft2 OK) j. Air Supply: Thomas Industries, Model 5070, "Anchorage Tank". k. Air Supply Line: "Wasteflow" emitterline, 1/2 inch I.D, "Anchorage Tank". 1. Sand Material: Central Paving Products "Winter Road Sand" m. Pea Gravel: 100% passing 3/8" sieve, less than 20% passing the 1/4" sieve, and less than 1% passing the #8 sieve. We are proposing to excavate down to a depth of 3 feet (maximum - removing any organic material), place a minimum of 6 inches of M.O.A. approved sand, install the air supply line, and cover it with 1.5 feet of M.O.A. approved sand. On top of the sand, we will place 6 inches of 3/8 inch pea gravel, with the pressure laterals midway in the layer. We will use a conventional lift station (Anchorage Tank), equipped with a programmable timer so that flow can be intermittently dosed to the ISF. 4. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system. 5. TOPOGRAPHY: As can be seen on the attached design, the area for the proposed I.S.F. system is generally flat. On the opposite side of the driveway from the septic system, the slope increases to over 25 percent. The change in grade is over 35 feet away and it is opinion that this will not be a concern. 6. MATERIALS AND CONSTRUCTION PRACTICES: The materials used, and the construction practices will comply with DHHS' "Intermittent Sand Filter Design, Installation & Maintenance Manual". The contractor should read this document prior to construction. Copies are available at the Municipal Onsite Services office (5th floor, 9th & L St.). 7. CLOSING: Given the site restriction, I think the ISF is the most viable option for this lot, short of install a Recirculating Upflow Filter, which would be more expensive. I am open to any suggestions from your department, which would be an improvement to the proposed design. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact me at 337-6179, or 244-9612. Thank you for your assistance. �/ I Sincerely, Ia Sp - _LL HI cIR - ` CL LOT 1, BLOCK 3,-- i MAJESTIC VALLEY EST. --- /' �% T — LOT 11, BLOCK 2, MAJESTIC VALLEY EST. i I ' LOT 11, BLOCK 3, — 100' WELL RADIUS ♦ / - MATES IIC VALLEY EST./" \ EXISTING x 4 BEDROOM HOUSE 1 / \ PROP SED SEPTIC UPGRADE ♦\�� (SEE DESIGN, PAGE 2 OF 3)SO- WELL / � I RADIUS PTI � \ � — � ♦ / TH#1 AR� LOT 13, BLOCK 3, MAJESTIC VALLEY EST. -- R E EXISTING \ SYSTIC �-— — / _ _ — — — f 100' WELL RADIUS LOT 5, BLOCK 4, MAJESTIC VALLEY EST. 100' WE LLI RADIUS 1 [SEPTIC AR � LOT 6, BLOCK 4, / MAJESTIC VALLEY EST. ` LOT 7, BLOCK 4, MAJESTIC VALLEY EST. `. �PTIC AREA '-[SEPTIC LOT 8, BLOCK 4, ` / \ / ARE�D MAJESTIC VALLEY EST. ALASKA WATER AND WASTEWATER CONSULTANTS, INC. 6901 DEBARR ROAD SUITE 2B, ANCHORAGE, AK 99504 0 c 440 PHONE: (907) 337-6179/FAX: (907) 338-3246 00 V LEGAL DESCRIPTION: MAJESTIC VALLEY ESTATES S/D; LOT 12, BLOCK 3, - Q p ..... TYPE OF WORK: pl SITE PLAN FOR SEPTIC SYSTEM UPGRADE ... .......rn.. ....� Je A. GaQ PREPARED FOR: PHONE NUMBER: O GLENNA ELDRGIDGE 694-7857/694-7858 �04� 7953 .,•'.c�Q DATE: J.L.M. 1 = 100 DRAWN BY: SCALE: ' 1 OF 3 PAGE: 44QQolp fesslon�v�v 10/7/99 Opn,�� o NOTE: THE CONTRACTOR SHALL HAVE THE 100' WELL RADIUS FLAGGED BY A REGISTERED LAND SURVEYOR PRIOR TO ANY CONSTRUCTION. 0FAIIIII11 NOTES, / 1 THE AIR COMPRESSOR SHALL BE LOCATED WITHIN THE BASEMENT OR THE GARAGE. THE CONTRACTOR SHALL PROVIDE/ A 0-10 PSI PRESSURE GAUGE AT A LOCATION WHICH IS READILY ACCESSIBLE FROM WITHIN THE HOUSE. NOTEi A 30 I PSI GAUGE WILL NOT WORK. THE AIR COMPRESSOR SHALL BE A THOMAS INDUSTRIES MOD7L 5070, AS SUPPLIED BY ANCHORAGE TANK. THE AIR LINE SHALL BE 1/2 INCH DIA. HDPE (1 PIECE), INSULATED WITH 1/2 INCH FOAM PIPE WRAP (R3 VALUE). INSIDE A 2 INCH SCHA PVC JACKET. THE LINE SHALL BE BURIED TO A MINIMUM \ DEPTH OF 3 FEET. \ I \ THE CONTROL PANEL FOR THE STEP TANK SHALL HE INSTALLED WITH A AUDIBLE/VISUAL INDICATOR WITHIN THEI \ BASEMENT OR GARAGE. AIR COMPRES OR 1 (SEE NOTE \ \ \ IN AIIR LINED EXISTING 1250 GALLON \ (SEE NOTE) SEPTIC TANK LOCATION TO \ \ BE ABANDONED COMPLETELY \ AND REPLACED WITH A NEW \ \ 1500 GALLON S.T.E.P. TANK \ y�e TOE OF SLOPE \ (APPROX. LOCATION) PROPOSETTOMLESS \ \ SAND FILTER EXCAVATE IATBED THANT �� FCO \ IS 3 FOOT DEEP MAXIMUM BY 12 FEET WIDE BY 30 FEET LONG. SEE ATTACHED G �1 DETAIL AND PROFILE (PAGE 3 OF 3) FOR /-/0 00A4 \ COSTRUCTION DETAILS AND REQUIREMENTS. \" LAT± 0 0 0 oMT \ k off° I MTS MT`s H#1 \ CFLAT+ ER�gL DRQ / / EXISTING TRENCHES ARE TO BE ABANDONED COMPLETELY / ALASKA WATER AND WASTEWATER CONSULTANTS, INC. 4=71 6901 DEBARR ROAD, SUITE 2B. ANCHORAGE, AK. 99504 1=7 0 �F Q PHONE: (907) 337-6179/FAX: (907) 338-3246 400 GAL DESCRIPTION: /Q MAJESTIC VALLEY ESTATES S/D; LOT 12, BLOCK 3, o........ ._., ........ .•••. ... . PE OF WORK: DESIGN OF SEPTIC SYTEM UPGRADE (BOTTOMLESS I.S.F.) �... ................ ZEPARED FOR: PHONE NUMBER: VO f r A. G ss;' GLENNA ELDRIDGE (907) 694-7857/694-7658E-7953el �� pO.s •. ti��G kTE: DRAWN BY: SCALE: PAGE: 44e�ey P • ....... • o\ 10/7/99 J.L.M. 1 = 30' 2 OF 3 O�O��f�s��ao� AIP LINE C0L WaP AT 3/ 4" PIA. 5CH, 40 PVC LATEM5 APPPDX, 2 PEEf. MNCO C NOI E5, SNIELPS, ANP FI. IW � "WASTEPI,OW11 TYPE PPOVIPEP VALVES PER MNCO PE51GN)_ PY ANCHOMA TANK. --A 11/ 4" PIA. 5CH 40 NPPE P15CHAU LINE WM STEP TANK ANP MANIPOI.P h" PIA, MONIfRING TWAf EACH COIUE . PERFOPATEP C3ETWEEN fOP OF SAND ANP 1915Tf;IPWON PIPE INVEPf, C Ptll l 1/ 4 INCH PIA HOLES) 12' x 30' POr'110MIWE55 ISP. NO UNEP; ON I30fI`OM. PI?E550 PIPING PE5I60913Y OMNCO ANP SUPPI.IEP PY ANCHOPAGE TANK, FLUSHING VALVES—' (WITH FWTECTNE COVWS) C EXtNP A30VE 61WP ) PLAN VIEW 2" OF INSULATION 3/ q" PVC LATI;M5 (ffA) I'ILtE PAXIC Mf Mf OVEP PEA GPAVEL FINAL Gf?At7E 2' MIN, OF COVW Of;IGINAL GPAPE 6" LAYEk OP 3/ 8' 1 PEA GPAVWL WITH THE PVC LATEt?ALS t3UpIEP MIDWAY IN THE 5fPATUM, rt7' ;-,n - _ 4 <<:. �,: ;,- :,,',- •,>: }': (MAX.) t :y•` d ,.1-� :t.�^� :='r::t'`°''`::.r,-:=:. •`,��.a "ice` -N :' N (GPAVEL BELOW PIPE 311+) -:i, ;�,.: ' -�. _ ..� �::,•_, rz, ',;.`::.. " _ ��`. r=•C'� 1.5•�ti-i`.� .ti:ti .:x•r; .1. . >5.�-�, _.a. i",.• 4' MIN, 2 PEEP MIN. OF PILTEI; SAND 2' TO GC;OUNPWATEf; AIZTrOF5mi? `' PROFILE VIEW ALASKA WATER AND WASTEWATER CONSULTANTS, INC. 7320 E. CHESTER HEIGHTS CIRCLE, ANCHORAGE, AK 99504 PHONE: (907) 337-6179/FAX: (907) 338-3246 LEGAL DESCRIPTION: MAJESTIC VALLEY ESTATES S/D; LOT 12, BLOCK 3, TYPE OF WORK: BOTTOMLESS INTERMITTENT SAND FILTER (ISF) DETAIL PREPARED FOR: PHONE NUMBER: GLENNA ELDRIDGE (907)694-7857/694-7658 DATE: DRAWN BY: SCALE: PAGE: 10/7/99 1 J.L.M. N.T.S. 1 3 OF 3 .J� ffr •A.• GO ....s' —7953 '°ro f es sio�°000 ALASKA WATER & WASTEWATER CONSULTANTS, INC. 6901 DEBARR ROAD, SUITE 2B * ANCHORAGE, AK. 99504 PHONE (907) 337-6179 * FAX (907) 338-3246 SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION: MAJESTIC VALLEY SUBDIVISION; LOT 12, BLOCK 3, PERFORMED FOR: GLENNA ELDRIDGE DATE PERFORMED: 7/28/99 DEPTH _ TEST HOLE # 1 feet 1 ORGANICS 2 11-��I SOIL CLASSIFICATIONS IJP 3- GW 9.0' ' ORG 4- 456 GP 9/28/99 11 11 I ML 5- GM CL 70-7GC!I�1� GM TO 6— S�"100 I I I I I I I I GM/ML �NP��Et PS SORg�o DENSER W/ 7 DEPTH 8 PERG ' 9 10 11 12 B.O.H. 13 14- 15 16 17 18 J�::o GW 9.0' ' ORG 8/9/99 GP 9/28/99 11 11 I ML - I GM CL 70-7GC!I�1� OL o°a°�°h [ S�"100 I I I I I I I I MH °@ o SP CH SM ��,�, OH SC DEPTH TO GROUNDWATER DATE 9.0' 7/28/99 7.0' 8/9/99 6.5' 9/28/99 6.0' 10/4/99 SITE PLAN I" = 100' J 1 �y \� EXISTING \� 4 BEDROOM \ HOUSE EXISTING SEPTIC SYSTEM �. I � SEPTIC +TH#1 ARE�D �MPERIq� pRIVE DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) �NP��Et PS SORg�o PERG ' �IZI99 19 PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6" (INCHES) 20 TEST RUN BETWEEN 3.5 FT. AND 4.5 FT. COMMENTS: INSITU SOILS SHOULD ACT AS A SAND FILT PERFORMED BY ALASKA WATER & WASTEWATER 1,f4 v J CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STAT r�/MUNC�UIDELINES IN EFFECT ON THIS DATE. DATE: /o/2,95 i ,9 NAME MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchora§e, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT PHONE :~N-~'~' MAILING ADDRESS LEGAL DESCRIPTION DISTANCE TO', Well Manufacturer ~ ~ ~. Liq. capacity in gallons DISTANCE TO' jWell Well DISTANCE TO: J No of nes Length of each ne ~ I ~'~ s7 Top of tile to finish ~rade I Length Width Type of crib Crib diameter DISTANCE TO: Well Depth Building foundation DISTANCE TO: OTHER PIPE MATERIALS "'SOl L TEST RATING ~-~ ~/~. ~. INSTALLER REMARKS 72-013 (R~v. 3~78) Absorption/ ¢ !area ] Dwelling ,2~ ! Material Inside length / Width Dwelling Foundation ~..~ ! Total length of lines¢ Material beneath tile Depth Crib depth Building foundation Material Nearest Ioi line z Trench width ~___ inche_s_ inches NO, OF BEDROOMS PERM,T NOg ¢)0 2 7/ No. of compartments 2-- Liquid depth PERMIT NO. Liquid capacity in gallons PERMIT NO. Distance between lines / Total effective absorption area t£2_,~ ~. ,~'7', PERMIT NO. Total effective absorption area Nearest lot line Driller Distance to lot line Sewer line Septic tank PERMIT NO. Absorpt on area(s) DATE LEGAL ~P~:'t.,. ~ LOCRT :[ ON L, EGFII.~, C,';'.:F:' [:q~]","EL. OPHENT F'O E,"?, 323: EF:.' ER L.T :L2 BLt.:.'. 3: I"'IFI.]'E:Ei;TIC ',,,'f:lL.l_E"r' LOT SIZE 694-;?.}"::5E1 .54946 SI]'g...IFIRE FEET T"r'i::'E OF' :E';;E)IL R[~:E;ORF'TION S¥S'TE]"I IE;: TRENCFI HFi::-::II'"I[JM I'.,IIJMBER OF BEDF::OOHE; = 4 '_=,OIL RRTING ,::SI'..".., F]"?E¥;.:)= 250 THE P. EQUIREf) E;IZE OF:' ]'HE SOIL RBE;ORF:'TIOIq S~'r'S"FIEI'"I E::" EE F~ If- ~-H ..... :.L ;~ L.E.' li'-,l u:3 '!1"" H .== :E: n~: C"i F;: R "',-" E] L- £:" EE F" -i- ~"t == 7'FIE LENGTH I}IMEN.'].:,ION IS THE L. ENGTH ,:;IN FEET) OF' THE TF;:ENCH OR E:,RRINFIEL. D. THE; [:,EPTH OF Ft ]"RENCH OR PIT IS THE [:,IET['FINCE BETI4EEN THE SURFRCE (:iF' TFIE EiRO[Jh][:, RN[:, THE BOTTOM OF THE E:,4CR',,,'FITION (IN FEET). 'THERE: I:E; NO SET 1.4I[:,TH FOR TRENCHES. THE GRR',,,'EL [:,EF'TFI IS "['FIE I',-IINIMUM [:,EPTH OF GRFI',,,'EL 8ETI4EEN THE OUTFFIL. L.. PIF'E FIN[:, THE BOTTOM OF TFIE EXCFI'v'FtTION (IN FEET i:,. PERM :[ T RF'F'L. I CANT HFIS THE RESPON:F., I E: I L I'l"'-r' TO I NFOF.:M "['H I S DEPFIRTMENT D[JR I N(.'.:i "I'HE: .T.i'.,I:~71"FILLFITZON :I:.NSF'ECTION'B OF FIN"r' HELLS R[:,JFICENT 1''0 TH:[.'.=, PROPEF.':T"r' RI",ID 1"HE NUHE',E:R OF:' RE:E;II}ENCES THF'I]' '['HE HELL NIL[ "Z, ERYE. ............. -IF ~..-Jt (:) '::: ;;="i: ::" 1; t'--~ "'<=; F" E: C "1~ ][ C" f,t :E; FIt F-:: E] F:: E- ~;-" ILJI ]: R E: [: E,'FICI<FIL..LING OF FIN'[ '=.';'¢E;TEM HITHOUT F:[NRL IN',BF'EC"['ION FIND FtPPF.':O°¢R[. E?T' THIS E:,EF'FI[;'~THENT HILL BE: SUE:..TEC:T TO PR[]'."gECUTION. h'i:[Nit'iUH DISTANCE BE'f'HEEN Fl HELL FIND RNY OI"~-SZTE SE[,-IRt3E DISPOE;RL '.E;Y%"I"EM IS :J..I~EI [::[ET F'OR Fl PRZVR'TE HELL OR .';L50 TO 200 FEET FROM R F'LIBLIC 1.4ELL DEF'ENE~TNG UPON TI'E: T"r'F'E OF' F'UBLI'C 14ELJ .... MiN:[MUH [:,ISTFINCE FROM FI I='F.:IVATE NE[J. "['0 A F'RIVRTE: SEHEF-.' LINE IS 25 FEET RND 'f'O FI [:;:OMMLII"4IT"? SEHEF;: L. INE :['.5 75 FEET. HELL LOCiS FIRE: REC!U:[RED Fli".l[> I"1U2;]" E:E RETURNED TO 'THE DEPRRTHENT NITHIN 3:El [:'R"r'S OF TFIE HELL [::[:)I'IF'I...ET 101",1. OTHEF-: F..'EC!UIREI'IENTEi HFI"r' FIPF'L"r'. E-';PECIFICRTIONS FIN[:' CONSTRUC"I":[ON DIFIGRRMS RRE F:IVFI:[L[::IE:LE TO :[I'4:.E;URE PROPER INS"['FILLRT :[ ON. I CERTIFY THF¥[' /.: I FtM FFIMIL. IFIR t.,.IITH THE REQUIREMENT'-=' FOR ON-SITE: E;EHERS FIND HELLE; RS SET FIFJI~:r'['H E~'T' 'I"I'"IE I"llJI",!ICIF'FILIT¥ OF FINCHORRGE. 2: :[ I.,.I:[I_L. INS"['I"::ILI-TFIE S"r'2;'['EM IN RCCORDRNCE NTTFI THE C:ODES. '];: I LIt",IC'IER:~;TFIND '['t4FiT THE ON-S:[TE SEHER $'¢E;TEM MR"¢' RE£:~.U):F..'E: ENL. RRGEI"tENT IF "['FIE: [;;'.E:E;ZE:'EI"~CE IS REMO[:'EL. EE) TO INCLUE:'E MORE TFIRN 4 BE[)ROOMS. V4. 0 0 & E GEO _ _CHNI CAL & DEVEL PMENT 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 Er Foundations Land Development Performed for: Name: Tel. No. Mailing Address: Legal Description: Depth (feet) Soil Characteristics 0 1 2 3 4 5 6 7 8 9. 10 11 12 '"" OF A, X11 13 ��;• •;9 1 * 49TH 1LL-- . •.i.... •.•.••....•.••.••e.:.• . 15Earl P. Ellis % c� % NO. 1745-E ��d AV so 16 pAOFESSIONP �► Ground Water Encountered: Yes® No-- If yes, what depth Proposed Installation: Seepage Pit Drain Field Comments: Performed by: Date: :ui :z Q co O �O U r Y :Z O Qco t u: 4z w u4 wO 0 0 0 0 0 0 0 O O 0 0 O~ F F F F F F F F F F F F WA 3 n a z to OO O O O O o O O O O O • w w w w w w w w w w w v V _I a A A V ZJ DLLI a MA CMA CC Lu a N LUm LL LU LL O N •F p E+ F+ w w w w w w w w w w w hf r C\i 0 0 0 0 0 0 0 0 0 0 O 0 cf, Ll C: w w w w w w w w w W w Y � C,O O Az Q M a A 0 Q co w O O O O O o O o o o O O z a w I I I O w w w w w A ww www w w J U z w oG a w w MUNICIPALITY OF ANCHORAGE Development Services Department r Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 050-731-22-000 Expiration Date: 9/2/2023 Legal description MAJESTIC VALLEY ESTATES BLK 3 LT 12 Site address 26153 IMPERIAL DR Eagle River AK 99577 Current property owner(s) COLLINS MATTHEW J & LAURA The On-site system(s) is/are approved for bedrooms X Conditional approval for 4 bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: 6/2/2023 'This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory X Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approval_June 2022 Legal Description: MAJESTIC VALLEY ESTATES; BLOCK 3, LOT 12 Parcel ID: 050-731-22 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 9/23/80 Total depth 300 ft Cased to UNK ft OR Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 5/11/2023 Static water level at beginning of test 186.3 ft. Comments B. TANK DATA Measured operating fluid level in septic tank Date of pumping L]'Required maintenance competed, if AWWTS Comments: \-C-(k e s� D. ABSORPTION FIELD DATA Which system tested (date installed) 5/4-8/23 ❑ ALL standpipes present per record drawing Total measured depth from grade 3.8 ft (max) Measured depth to pipe invert from grade 2.9 ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced `gallons date Any rejuvenation treatment (past 12 months) If yes, enter date Comments/Deficiencies: COSA Checklist June 2022 Well production at time of test 0.9+ gpm Water storage tank volume 300 gallons Well di ected for coliform test? E] Yes Yes No oliform' bacteria is Negative Nitrate mg/L itrate less than MRL (ND) Arsenic ug/L i Arsenic less than MRL (ND) Collected by GEG, LTD. Date 5/11/2023 V IFTSTATIONequired maintenance completec Age of lift station N years Lift station material G. Comments: pvmp VP -U' --r) Adequacy test date NEW Results ❑ Pass Fluid depth prior to test NEW in Water added NEW gal New fluid depth NEW in Elapsed time NEW min Final fluid depth NEW in Absorption rate 600+ gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 6.6 in Effective depth used 0 in Effective depth remaining 6.6 in E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100'Community Sewer Manhole/Cleanout > 100' Yes if No *50+ ft 0 Yes if No ft Neighboring Tank > 100' [■ Yes if No ** ft Private Sewer/Septic Line > 25' 0 Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No *501+ ft Holding Tank > 100' M Yes if No ft Neighboring Absorption Fields > 100' ** Animal Containment > 50' 0 Yes if No ft Qi Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' MN Yes if No ft■❑ Yes if No ft ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Fields) on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water > 100' ❑ Yes if No *50'+ ft Tank to Property Line > 5' M Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' IAN Yes if No ft Private Wells > 100' ❑ Yes if No *50'+ ft Water Main > 10' 0 Yes if No ft Community Wells > 200'❑ Yes if No ft Water Service Line > 10' R Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS *THIS IS AN AWWTS **50'+ TO NEIGHBORING AWWTS G. CERTIFICATION & 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, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Gamess Engineering Group, LTD. (GEG) Phone 907-337-6179 Engineer's Printed Name Jeffrey A. Garness Date In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including (but not limited to) soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. COSA Checklist June 2022 o OF rE7 ........ Je LICENSE4k4a,,r ° f e 5 sjOiiin°Qo #AECC8U �0��00 1Z LOT 13 LOT 11 LOT 1 BLOCK 3 N2 5 ° 0 5 ' 0 9 " E 2 7 0 . 8 2 N 4 2 ° 3 5 ' 2 0 " W 1 1 4 . 0 0 S47 ° 2 4 ' 4 0 " W 1 5 0 . 0 0 N76° 3 2 ' 0 7 " W 5 7 . 0 6 EDGE O F P A V E M E N T 30 . 0 R. O . W . S1 3 ° 4 7 ' 2 7 " W 2 0 3 . 9 2 20' UTI L . E S M T . OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU W IMPE R I A L D R I V E G R A V E L D R I V E W A Y OH U OH U OH U OH U OH U 14.8 58 . 9 106 . 2 72.2 26 . 3 26 . 3 23.9 24.124.28.7 8.8 1 0 0 ' W E L L R A D I U S G E CULV E R T W H I T E S P R U C E D R I V E 30. 0 R.O . W . Lot 12, Block 3 Majestic Valley Estates Subdivision 54,936 Sq. Ft. +/- 26153 Imperial Drive 2 Story Wood Frame House With Attached 2 Car Garage S76° 2 1 ' 1 0 " E 1 8 2 . 0 0 S S S S E M.H. M.H. S S SSS S S M . H . S SHED 4.5 8 . 5 9.1 36 . 8 PROFESSIONAL SEAL Date:Frontier Surveys, LLC Project No: 650 W. 58th Ave. Suite E Anchorage, Alaska 99518 As-Built Survey of: www.frontiersurveys.com Frontier Surveys, LLC I, Pierre Stragier, hereby certify that this Mortgage Inspection Survey was performed by me, or under my direct supervision on Plat:Grid:Ordered By: 907.460.1686 - info@frontiersurveys.com This survey complies with the ASPLS Mortgage Location Standards. The survey represents visible improvements and conditions at the time of the survey. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may reveal. It is the responsibility of the Owner to determine the existence of any easements, covenants, or restriction which do no appear on the record plat. Under no circumstances should this document be used for construction or for establishing a boundary or fence line. May 12th, 2023. Legend: Scale 1" = 50' Gas Meter Electric Meter/Outside Power Deck Septic Septic Cover Telephone Pole Fence Overhead Utility S G E Lot 12, Block 3 Majestic Valley Estates Subdivision General Notes: 1. This document is created for the purpose of a single property transaction and is subject to Federal Copyright Laws. 2. Excepting for gross negligence, the liability for this survey shall not exceed the cost of preparing this survey. 3. All measurements/setbacks are to the visual/apparent building footprint. 4. All dimensions to property lines are plus/minus 0.1ft. Matthew Collins 23-181 05/15/2023 77-27 SW363 W Water Well ConcreteM.H. May 15, 2023 R E GISTEREDPROFESSIO N A L L A N D S URVEYORPierre M. Stragier No. L.S. - 9812 May -29.2023 04:46 PM A+ as news via I �1111IT"o Field, Maintm Ann al Inspection '4015h PAY WWG U1 Laura Matthew & Laura Collins Matthew 7 ra 26153 Imperial [Drive, Eagle RlVer AK 99577 AX 0. 'P101306 AX-14��Iil OSPI91306 RetrIOV I O&M Into Dally t Tank will be pumped when new owner occupiesl home. Pumped tanks create low level alai ms. Best to pump when occupants can refill the tank. Perform Field SamPling/Observations NTU (16 NTUO) PH (o -q) 7 13 j (2-6) Odor 4t Sample y Typical 'NJ M 1 Eanhy n uStY f Decay Non-t+cal F-]Suffldo LJ Cabbage _71 OilYfflinfirIPW nyes &W Foam In tank ye. Check 4riltrol Panel Reolro, kmps DIschaWAmpa W. 1 11 . I Audible anvisual alarms I d NQK Dlal.10AO {telemetryonW Dyes IQ No I Inspect/Clean Pump System Inspect Clean .................... � SL Splice �x .... I ................ 1&� Float Cards ................... Floato 810tu "Filter ................. 1310tu Pump Vault ............ Rect lating Splitter Valve....... N, ww') Fox 9078686770 P 1/ 3 0 Anch geTank' go f V2-3543 Date, A-/ N'Llds bolted 01 �G ntrol panel N'Th"k mods pi n Other? - ftum ft I 'Urm t Current Cu:nt Previau® 2nd Corn mft( ,'urror t Pix Current Current Previous Ito 018811 A LC I an x F iter OU or: N rrnaj put! t Laterals/IoNrl Inspect Clean I X B orne! ome r Irma [D Ext i lt� lve Pod,Uttorn � rs� 8 ldglr g/Poni n g: ne/MinOr 11 Ex Intel, Vent 'p, MP 4 It act Inspect Clean R fL ::::d ploato 6 S co 3ox Pump Float c )r%;N servil or Sirs aim, Camp 1 f elift ns t clean i Inspect clean D in 'tion E pi i mt —S-1 �IsParsal LatsraWOr k 9 -PQ SON alIons LW i Id flon &I S"o V 11 I R ndo d Clot nett e a I eets, 1❑Replaced UV 01 ns? L I rtop, I **�swa od c her em I W 7 1 ad., iA 1 lilt: rran�, i�" [Mlable rLr flate selectJon) 1 e n N I Date, A-/ N'Llds bolted 01 �G ntrol panel N'Th"k mods pi n Other? - IUMCIPALITY OF Development Services Department On -Site Water- & Wastewater Section ANCHORAGE Phone: 907-343-7904 Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 050-731-22 Complete legal description MAJESTIC VALLEY ESTATES; BLOCK 3, LOT 12 Location (site address) 26153 IMPERIAL DRIVE, EAGLE RIVER, AK 99577 Current property owner(s) MATTHEW AND LAURA COLLINS Day phone 949-943-7847 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: N Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: 0 Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: 01 Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 4 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: 0 AWWTS ❑ Bed ❑ Deep Trench RE Wide Trench ❑ Seepage Pit Waiver request for: REQUSTING 2:1 SLOPE WAIVER ON WEST END OF DRAINFIELD N/A Distance: Expedited review requested: ❑ By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee Waiver Fee $ Date of Payment 5/ Z 5 /z3 Date of Payment S�z 5�2 3 COSA # SC 2 3 / / �.� Waiver # V S Vr ZS(K) k J*q /9 COSA Application June 2022 s/�o/3 CM MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this '� Day of A8 a of 20 2 3 , by and between Cu Cherein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as i o &Lc. k 5 e n�--L S u< (, w. Q G l T3, I,n� located at (legal description) PAk. cs),% vckut�,A Cc -4 L- I2 733 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) Throughout the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. C 1 It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). C i Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. C( Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Pagel of 3 C I Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. C I Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. C t Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. C I Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. C f Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. C Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 OWNER: By;Z�9�(signature) Date: -5-/23./13 NJ 1 lit x in (print name) STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this IS day of nn s, 20 Z3, by rAtr,k c FS�d �ti we NOTARY PUBLIC FOR ALASKA MICHALE BADUA My Commission expires: � �„ Zy Zoe 6 Notary —, State of Alaska MyCommission Expires Jun 24, 2026 MUNICIPALITY: By: (signature) (print name) Date: Title: (rev. 05/18/2018) Page 3 of 3 UAKNESS ENGINEERING Ltd Ae C i ENGINEERING SALES CONSULTING GROUP, �.,��_ _•� - � �.�. June 1, 2023 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Request for Conditional COSA Majestic Valley 133 L12 To whom it may concern: The subject lot is serviced by a private well and septic system. Anchorage Tank is waiting to pump the septic until the new owners move in. We are requesting that your department issue the conditional COSA for the subject lot. If you have any questions, please contact us at 337-6179. Thank you for your assistance. 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com Well Water Advisory Certificate of On -Site Systems Approval # OSC231026 Subdivision: Majestic Valley Estates, Block: 3, Lot: 12 This well's productivity was determined to be .9 gallons per minute. The minimum well productivity required under (AMC 15.55) for a 4 -bedroom residence is .42 gallons per, minute or 150 gallons per day per bedroom._ Although_ the, well production does not meet this requirement, water storage has been provided to meet minimum code requirements. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. Mailing Address P Q Sox 196650 * Anchorage, glaska 99519 6650 *www muni org EP"IfiAlS MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section -'� Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 050 731 22 1. GENERAL INFORMATION Expiration Date: _I Z o___C -1 Complete legal description MAJESTIC VALLEY ESTATES BLOCK 3 LOT 12 Location (site address) 26153 IMPERIAL DRIVE Current property owner(s) OLSON Day phone Mailing address Real estate agent Day phone 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic, El Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: NON E Distance: NA Received by: Date: COSA to be released to the engineer, unless othervvise requested by the engineer. COSA Fee $ Litt% Date of Payment 4?/ /& 19 Receipt Number 6 SAaalJ COSA # 01909/uao Waiver Fee $ Date of Payment 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 C&M ENGINEERING Phone 8545558 Address 20182 TULWAR Engineer's Printed Name CHARLES BALZARINI Date 9/5/2019 0 �__9j 111r_0 10 l I� )V I Original Certificate Date: 2 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet 4� of q�gsl� / .49TH — .* 6. DSD SIGNATURE System #1 Approved for ,• ;; , bedrooms CHARLES G BALZARIM �� System #2 Approved for bedrooms `'6 . • • CE -13854 .-49 Disapproved • ,l�iF�PROFESS10NPti�` Conditional approval for bedrooms, with the following stipulations: 0 �__9j 111r_0 10 l I� )V I Original Certificate Date: 2 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet lefelaivelmm Legal Description: MAJESTIC VALLEY ESTATES BLOCK 3 LOT 12 Parcel ID: 050-731-22 If more than 1 septic system on lot: COSA Checklist # 1 of 1 Structure served by this system 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 9/23/80 Total depth 300 ft Cased to +40 ft FOR Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) +12 in Date of flow test for COSA 8/30 Well production at time of test 1.31 gpm Water storage tank volume 300 gallons Well disinfected for coliform test? ❑ Yes ❑ No ON Coliform bacteria is Negative Nitrate .�5, mg/L ❑ Nitrate less than MRL (ND) Arsenic �� ug/L ❑ Arsenic less than MRL (ND) Collected by C&M ENGINEERING Date of Sample 9- 3' 1 "I Static water level at beginning of test 185 ft. Comments HOME HAS WATER STORAGE AND IS CAPABLE OF PROVIDING OVER 600 GALLONS IN 4 HOURS B. TANK DATA Age of tank(s) 0 years Tank type/material FIBER ❑ Standpipes/foundation cleanout per record drawing Date of pumping NA D. ABSORPTION FIELD DATA 2019 Which system tested (date installed) 2019 ❑ ALL standpipes present per record drawing Total measured depth from grade 7 ft (max) Measured depth to pipe invert from grade 6.5 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of drainfield. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced NA gallons Comments/Deficiencies: NEW SYSTEM, NOT TESTED COSA Checklist yellow sheet C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: NEW SYSTEM, FIBERGLASS ADVANTEX TANK Adequacy test date Results ❑ Pass For bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' 0 Yes if No Community Sewer Manhole/Cleanout > 100' ❑✓ Yes if No ft Q✓ Yes if No ft Neighboring Tank > 100' ZYes if No ft Private Sewer/Septic Line > 25' Q✓ Yes if No ft Absorption Field on Lot > 100' Q✓ Yes if No ft Holding Tank > 100' F✓ Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' ❑✓ Yes if No ft F,71 Yes if No ft ft Community Wells > 200' Q✓ Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' 0✓ Yes if No ft r,/] Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water > 100' 0 Yes if No ft Property Line > 5' F71 Yes if No ft Driveway/Parking > 0' Q✓ Yes if No, comment Absorption Field > 5' QYes if No ft Wells on Adjacent Lots: Q Yes if No ft Water Main > 10' 0 Yes if No ft Private Wells > 100' OYes if No ft Water Service Line > 10' F,71 Yes if No ft Community Wells > 200' Q✓ Yes if No ft From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' F71 Yes if No ft Driveway/Parking > 0' F7-1 Yes if No, comment Property Line > 10' 0 Yes if No ft Wells on Adjacent Lots: Water Main > 10' 0 Yes if No ft Private Wells > 100' Q Yes if No ft Water Service Line > 10' Q✓ Yes if No ft Community Wells > 200' Q✓ Yes if No ft Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. 9/5/2019 COSA Checklist yellow sheet a�1d®®\ .� of A4.gk.�� CHARLES G BALZARINt CE -13854 •��0 �t�F�pROFESSI�NP�-� N 0 Scale 1" = 50' Frontier Surveys, LLC Project No: 19-353 Date:09/06/2019 Ordered By: Charles Balzarini I Plat: 77-27 1 Grid: N/A _ o _ 182.00 eEy Electric Meter/Outside Power cO, Telephone Pole Tel. Ped. ,y Gas Meter ® Deck -o- Fence LEElec. Ped. 4) Septic %n Septic Cover rMailboxOverhead Utility W; Water Well 11 Concrete 4 Light Pole General Notes: 1. This document is created for the purpose of a single property transaction and is subject to Federal Copyright Laws. 2. Excepting for gross negligence, the liability for this survey shall not exceed the cost of preparing this survey. 3. All measurementsfsetbacks are to the visual/apparent building footprint. 4. All dimensions to property lines are plusiminus 0.1ft. 1 ie _ OF q4gsrfl', `j • 9 y! 4 9! i n .i i IP • •Fredet!, W. i NO. LS. -9946 9/9/2019 f f r o IO ..... • Pio �r f l t t%FESS ONA` ; �. PROFESSIONAL SEAL 0 25 50 100 Scale in Feet This survey complies with the ASPLS Mortgage Location Standards. The survey represents visible improvements and conditions at the time of the survey. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may reveal. It is the responsibility of the Owner to determine the existence of any easements, covenants, or restriction which do no appear on the record plat. Under no circumstances should this document be used for construction or for establishing a boundary or fence line. As -Built Survey of: Lot 12, Block 3 Majestic Valley Estates Subdivision I, Frederic Wagner, hereby certify that this Mortgage Inspection Survey was performed by me, or under my direct supervision on September 6th, 2019. Frontier Surveys, LLC FRONTIER, 650 W. 58th Ave. Suite E Anchorage, Alaska 99518 Surveys•., 907.460.1686 - info@frontiersurveys.com www.frontiersurveys.com MUNICIPALITY OF .ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this t Day of e � t m)Z c-- of 20�, by and between C 1, KS , herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an, Advanced Wastewater Treatment System (AWWTS), described as ADVANTEX located at (legal description) MAJESTIC VALLEY ESTATES BLOCK 3 LOT 12 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial .each section) 4,1— Throughout the term of this Agreement, the Owner shall enter into. a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. 'The AWWTS shall be maintained in a satisfactory. condition. capable of performing as designed and,producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. 1�r-- It shallbe the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600): Owner agrees that only maintenance and repair personnel approved by theMunicipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. /;-- Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the. system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Page 1 of , w, Owner acknowledges that the Municipality may request records of maintenance and repairs. from the manufacturer's representative or maintenance provider. A- Owner acknowledges that the fine for failing to maintain and repair an. AWVjITS may be assessed in. accordance with AMC 14.60.030. Owner agrees to grant the Municipality reasonable access to test..andinspect the AWWTS. The Municipality will give at least 24-hour notice. Ae__ `Owner agrees that any sale or transfer of title of the .property will not occur without anew Certificate of On -Site Systems Approval. _- Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved, by the Municipality are the governing guidelines for the construction, maintenance and. repair of the Owner's AWWTS. 1�l Owner agrees to maintain remote monitoring of the AWWTS as required by the AVGTWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall. continue_ while the AWWTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of. this, Agreement shall in no way constitute a waiver of the provisions, not in any way affect the validity of the Agreementor any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. .Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative. or unauthorized means shall. be void. 6. Jurisdiction: Choice of La -vv. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The.laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability: Any provisions of this Agreement decreed invalid by a court of competent. jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 OWNER: By: 'f/(signature) Date: ZV-Z ^Y7W,xe .1 ✓- 6//,,o—(Print name) STATE OF ALASKA } ss. THIRD JUDICIAL DISTRICT } The foregoing instrument was acluiowledged before me this 6 day of 20 f q, by �" f a_ 41u W �o l�;ns \ti\\\\�t\lt 0" C e r N0,fARY PUBLIC FOR ALASKA My Commission expires: q— (8— 0022 MUNICIPALITY• By: (signature) Date: (print name) Title: 1'��TDO�TAPkY * rA. ^� V BLIC r - (rev. 05/18/2018) Page 3 of 3 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AU'FHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date _~ ~" GENERAl.. INFORMATION (a) Legal Description (include lot, block, subdivision, section, tow0ship, r.a~pge) Location (address or directions) Applicant Address ~i~O ¢i~!~D ~,4 ~¢~,.~ ~..~, (c) Applicant is (check one): Lending Institution ~; Owner/builder~; Buyer ~; Other ~ (explain); (d) Lending Institution ~ ¢;~ ~ ~'' Telephone Address (e) Real Estate Company and Agent Address ~¢Lephone (f) ',Ma+l the HAA to the following address: TYPE OF RESIDENCE Sin gle-Fa mil,'¢~ Multi-Family Number of Bedrooms ~ Other 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. SEWAGE DISPOSAl. Onsit~ Public El Cornmunity [] Holding Tank El 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 (11/84) 5. ENGINEERING FIRM PROVIDIN,... ,NSPECTIONS, TESTS, FILE SEARCH, DA... AND INFOREqATION As certified by my seal affixed hereto and as of tile validation date shown below, I verify that my investigation et tlm~ Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and ad r for the number of bedrooms and type of structure indicated herein. [ further verify that baaed on the information from the Municipality of Anchorage files and from my investigation and inspectioe, 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. Address ' Date __ Telephone DHEP APPROVAL ~ /~.// , . Approved for /~-~ ~''~ '~edrooms by?~t,,/'-'' '~&~'l,--'~'~.~ Approved /~_?"~'~ ' _ DisapprovE~d Conditional 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 or analyze data before a certificate is issued. The Municipality of Anchorage is riot responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11184) WELL DATA MuNiCipALITY OF ANCHORAGE DEPT. OF HEALTH MUNICIPALITY OF ANCHORAGE (MOA) ENVIRONMENTAL pROTECTION HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 · '! 264-4720 Well Log Present ~N) Total Depth ~'~ / Cased to Static Water Level /~w~''" Casing Height Above Ground ___ Electrical Wiring in Conduit (~N) Separation Distances from Well: If A, B, C, D.E.C. Approved (Y/N) Date Completed c~- 3,. '3 ~,~'O Yield To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line. Cleanout/Manhole A/ /08 Water Sample Collected by Depth of Grouting ~ Pump Set At LC ~..~1( Sanitary Seal on Casing (~N) Depression Around Wellhead (Y/~[~ ; On Adjoining Lots ; On Adjoining Lots To Nearest Pubtic Sewer To Nearest Sewer Service Line on Lot Water Sample Test Results Date Comments B. SEPTIC/H~L-B~NG 'rANK DATA Date installed /~'~(-~ Size I'~. 5-0 ~. No. of Compartments "~ Standpipes (~N) Air-tight Caps (~N) Foundation Cleanout (~N) Depression over Tank (Y~ 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/Holding Tank: To Water-Supply Well To Property Line '"~O .ff-- To Water Main/Service Line ~ (~)" 1"- Course /O O To Building Foundation / To Disposal Field /~'~ To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed / Width of Field Square Feet of Absorption Area Depression over Field (Y,~ Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot /l~f* Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes Present ON) Date of Last Adequacy Test To Property Line )¢ To Existing or Abandoned System on ; On Adjoining Lots ~ It-- To Cutbank (if present) ~ ~J loorg- To Water Main/Service Line ~;,O/- To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Date -/~,///~'/~ -¢- Signed~ & ~* ~.NGINE[~BIN~ Company , · sRr~ Date of Payment Amount: $ Page 2 of 2 72-026 (11/84} DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME , DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR MUN C PAL TY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTI'~'dCIPALITY~''''' OF ANCFIORAG~ 825 L Street - Anchorage, Alaska 99501 DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION ENW RONMENTAL SANn'AT ON D wS ON Telephone 264-4720 0CT~ 8 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND DIRECTIONS= Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1, PROPEr;t~Y OWNER PHONE MAI LING ADDRESS -- f ' ' P.OP RES,DENT ' ' (If different from above) PHONE 2. BUYER PHONE MAILING ADDRESS LENDING INSTITUTION PHONE MAILING'AbDRES~ 4. REALTOR/AGENT PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION STREET LOCATION 6. TYPE O'F RESIDENCE L~.~-~H N G L E FAMILY [] MULTIPLE FAMILY NUMBER OF~BEDROOMS E] One ~'"'~:ou r [] Two [] Five [] Three [] Six [] Other 7. WATER SUPPLY I~'-[N DIVI DUAL* [] COMMUNITY [] PUBLIC UTILITY * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) 8. SEWAGE DISPOSAL SYS'rEM ~ INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [~ ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTENI PERMIT NUMBER [] INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or []HoldingTank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line I WELL TO: Absorption Area to nearest Lot Line 5, COMMENTS I~ APPROVED FOR ~ BEDROOMS [] CONDITIONAL APP/R'OVAL (letter must accompany certificate) [] DISAPPROVED 72-010 (Rev, 6/79)