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HomeMy WebLinkAboutMAJESTIC VALLEY ESTATES BLK 4 LT 5Majesti*c Va . I ley Estates Block 4 Lot 5 #050-731-32 Municipality of Anchorage On -Site Water and Wastewater Section ° (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: SW020408 PID Number: 050-731-32 Dwelling: Single Family (SF) with ADU Duplex (D) Two Single Family Project: New Upgrade Name TOM BOLLIN ABSORPTION FIELD - EXISTING Deep Trench Wide Trench Bed Mound Site Address 26130 IMPERIAL DRIVE, EAGLE RIVER Other Phone Number of Bedrooms Soil Rating Total depth from original grade 5 0.6 GPD/SF 3 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 1.5 Ft. Gravel depth beneath pipe 1.5 Ft. Subdivision Block Lot MAJESTIC VALLEY EST. 4 5 Fill added above original grade VARIES +/- 3.06-3.2 +/- Ft. Gravel length (2 @ 98') 196 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 1256 Ft2 2 10 Ft. Well 100'+ 100'+ 25'+ TANK Septic S.T.E.P. Holding Other Manufacturer PREMIER & FAT ALBERT Capacity 1000 & 550 Gal. Surface Water 100'+ 100'+ Material HDPE Number of compartments 1 & 2 Lot Line 10'+ 10'+ NA Foundation 10'+ 10'+ LIFT STATION Manufacturer Capacity Gal. Remarks System not documented at time of construction. See attached letter. Alarm location Electrical installed by PIPE MATERIAL House to tank 3034 Tank to 3034 Installer TWEED EXCAVATING dra afield Drainfield 3034 Co/MT 3034 Inspector S&S — Per MOA DOCS / FWCS-FINAL BENCH MARK (Assumed elevation) 100 ft Inspection ��' 11/01/2002 2�d 1/24/2020 Location and description 3`d 4"' GARAGE SLAB ON-SITE WATER AND WASTEWATER SECTION APPROVAL Conditional Approval: Dated , '' 'a Septic System Curtis Huffman Approved -A°° � Date lQ —2-01��Jr ° ClE71f2Z3o9os ��c` Note: this approval does not include well permit requirements.�� (Kev U5/U1/"I 6) MAJESTIC VALLEY ESTATES BLOCK 4, LOT 5 c� Z A �O zo40 co PAVED cV0 o� " o`" _ D/W LOT `v 1 100' WELL RADIUS PID: 050-731-32 PERMIT: SW020408 e� e 0 T p� C *co Mj D Eo DCO SYST. F DIV LOT 5 CO MT BLOCK 4 G o 0 H T TH#3 CO MT THr- 0 J I \ CO A—C=63,2' B—C=56,6' A—D=66,1' B—D=59.5' A—E=71,8' B—E=64,2' A—F=81,2' B—F=66,3' A—G=97,8' B—G=43.3' A—H=117,2' B—H=62.4' A—I=154,6' B—I=126,3' A—J=144,6' B—J=121,3' FCO Co Co CO CO CO DIV Co R MT CO O n n n FABRIC do INSUL PER OWNER PHOTOS EXISTING UPPER FIELD CA O O n (W Zr) SCALE, i' = 4i MT CO I I I I 76.37 FINAL GRADE 75.22 74.30 FINAL GRADE FABRIC do INSUL RADE PER OWNER PHOTOS 71.90 70.7 70.65 EXISTING LOWER FIELD 68.90 68.90 BOH —14' TH#3 do #4 8/26/2002 SEPTIC SECTION DRY SCALE, NTS PREPARED FOR: SUPPORTSERVICES: I 1k TOM & REBECCA BOLIN ���, OF At,,, 26130 IMPERIAL DRIVE Fwcs ""-,�k EAGLE RIVER, AK 99577 *irtis H �. 0, JiIIiIl FIRST WATER CONSULTING DATE: 1/20/2020 Huffman wx 13030 SUES WAY SURVEY: JLS CE 128991 ��Af ANCHORAGE, AK99516 DRAWN: FWCS 1/20/2020 " = 40 �FEssto��' (907)350-9566 firstwaterAK®gmail.com SCALE: 1 AV INSUL PER- 87.25 PER WNER owNER FD 87'00 500—GAL 71'87 1,000—GALLON HDPE 85.85 HDPE HDPE S.T. SEPTIC TANK FABRIC do INSUL PER OWNER PHOTOS EXISTING UPPER FIELD CA O O n (W Zr) SCALE, i' = 4i MT CO I I I I 76.37 FINAL GRADE 75.22 74.30 FINAL GRADE FABRIC do INSUL RADE PER OWNER PHOTOS 71.90 70.7 70.65 EXISTING LOWER FIELD 68.90 68.90 BOH —14' TH#3 do #4 8/26/2002 SEPTIC SECTION DRY SCALE, NTS PREPARED FOR: SUPPORTSERVICES: I 1k TOM & REBECCA BOLIN ���, OF At,,, 26130 IMPERIAL DRIVE Fwcs ""-,�k EAGLE RIVER, AK 99577 *irtis H �. 0, JiIIiIl FIRST WATER CONSULTING DATE: 1/20/2020 Huffman wx 13030 SUES WAY SURVEY: JLS CE 128991 ��Af ANCHORAGE, AK99516 DRAWN: FWCS 1/20/2020 " = 40 �FEssto��' (907)350-9566 firstwaterAK®gmail.com SCALE: 1 AV FIRST WATER CONSULTING 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com January 24, 2020 Municipalities of Anchorage On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: MAJESTIC VALLEY ESTATES BLOCK 4, LOT 5 During the COSA process it was discovered that inspection report for the septic upgrade that occurred in 2002 under permit number SW020408 was not submitted. Based on visual observations / measurements, photos provided by owner and discussions with the owner — it appears that the system was installed per the permit. MOA documents show inspection was called on 11/1/2002 and the photos provided by the owner are date stamped with 11/2/2002. The inspection report is being submitted with the COSA. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. F�r �s C 11(L11NG SERVICE 1.1 i F, 1/.11451 EVi .1. i SRP PUR I& P I A NN I tIG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES FROM SEPTIC ABSORPTION WELL AddressTO TANK FIELD WELL 03/ 10-31 �U / Phone(s) Per No. No. of Bedrooms S`) 023 0 3 LOT LINE LEGAL DESCRIPTION Lot 5 Block 4 Subdivision `` c i (1•Q 1/Y) �I r- V G L FOUNDATION Township, Range, Section NA I 2 , / 2 / 1 , I �^' 2-3 AS-BUILT DIAGRAM (Show location of well, driveway, water bodies, etc.) N.T.S. septic system, property lines, foundation TANKS SEPTIC ❑ HOLDING Manufacturer Capacity in gallons ANG1,J G ✓!( /000 N`a Material No. of Compartments TYPE OF SYSTEM 3' ❑ TRENCH ❑ BED X W. DRAIN ❑ OTHER r r Depth to pipe bottom from Total depth from original grade b original grade /.S FT QS_" FT {' �� o Fill added above original grade Gravel depth beneath pipe -2 FT FT F; r` � LIJ Gravel length Gravel width Tatem+/ F4?' FT .r FT t'- Total absorption area Distance between lines IY 605z//� SQ FT /O FT E +u >u Number of lines Soil rating Pipe material 13 9 SQ FT L/ITm 3 v 3 y F'fiO Installer C !t C� \, 'q �(A 1 Z� I / Date Installed /I/� GI YntcSS L•✓ /0 � r7 WELLS h ® PRIVATE FYI.ri/-1` ❑ OTHER (Identifv) Classification (A,B,C) Total Depth I Installerna Dale Installed: r r=� REMARKS: ue '2 .2 ' Q GI �G NO f �N,r /7 / G f pPFF� Ili.• C! J�J /WH � . r > Scale: q /J ,/ /Grti Over- %%,-A/�Fl$/� P/nr;^.r Inspections Perrormed by: �. •' IN�F?R6'6EAL '1-. Eagle River Engineering Services .eX 77 2 r l j li) Date. Eagle River, Al( 99577 c.: / yN �V &j rva )jf_c�' / I✓ U/G( �C/,✓�r %'r CNG/ y6gN O/ � f p '�, G. _.. I-G-c -�-'n-• '+tate ov 4S `s-�E^So "c -� l certify that [his inspection was performed according to all a 'F YO C�t� tout: A. •u H2IG �i P4 �q��1 Municipal and State guidelines In ellect on this date: _1 eop Health Department Approval:/0—';Z0 —F5 �) 12-U13 (s/ab) ,r" Municipality of Anchorage Mark Begich, Mayor Building Safety Division P.O. Box 1966550 • 4700 Bragaw Street Anchorage, Alaska 99519.6650 • (907) 343.8301• Fax (907) 343-8200 September 24, 2003 http://ww .mmi.org Tom Bolin 26130 Imperial Drive Eagle River, AK 99577-9628 Subject: On -Site Water and/or Wastewater Permit. Permit Number: SW020408 Legal Description: JMC16stic-Valley'Estates BIock 4 Lot 5" Dear Mr. Bolin: SLD An On -Site Water/WastewaterPermit, number SW020408, issued by this office for a single-family system, will expire on October 11, 2003. This permit was valid for 365 calendar days. If this was a well permit and the well has been drilled, a well log must be sent to this office for documentation of the installation and to close the permit. If this permit was for a wastewater disposal system, an original as -built inspection report must be sent to this office for review, approval and documentation. This as -built inspection report must be signed by the licensed Professional Engineer who inspected the installation of the system. As -built inspection reports are required to be submitted within 30 days of the completion of the system. If no system was installed under this permit, and you are still planning to install a well or wastewater disposal system, a new permit must be obtained from this office. A new permit for a second year may be issued for a fee of $100.00 if the renewal application is received on or before the expiration date of the original permit. When applying for a new permit, the fees are: $400.00 for a wastewater permit and $150.00 for a well permit. If you have any questions, please call this office at 343-7904. Sincere , Jam Cross, P.E. Ma ager On -Site Water and Wastewater Program Enc: Copy of permit G 0 Y .a MUNICIPALITY OF ANCHORAGE tr Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Oct 11, 2002 Expiration Date: Oct 11, 2003 Permit Number: SW020408 Parcel ID: 050-731-32 Legal Description: MAJESTIC VALLEY ESTATES BILK 4 LT 5 Design Engineer: 0003 S & S Engineering Site Address: 026130 IMPERIAL DR Owner Name: Tom Bolin Lot Size: 54556 SQ. FT. Owner Address: 26130 IMPERIAL DRIVE Total Bedrooms: 5 Permit Bedrooms: 5 EAGLE RIVER , AK 99577-9628 This permit is for the construction of: ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 1SAAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Mm Date: /0/, -S -/o 2 - Issued By: 'i" /1 \ Date: Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 0 S'O -1 3 1 - 3 ;t- Permit Number SW Property owner(s) Tom Qo t -t &I Day phone 'F `f/ -7Y a f Mailing address (1) a C 130 1 r' P 64 i h L PR I v 6 Mailing address (2) rt,4(c LC /�r utLft , #K Zip Code Cl 4I5- 77 Legal description (Lot, Block & Sub'd.) L Of Q1DG /114 1 e, 4Ileyr514 Legal description (Section,, Township & Range) Lot Size I , .55_p Acr s/Sq.Ft. Number of Bedrooms THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. S & S ENGINEERING �f 17034 Eagle River Loop Road N0. 204 2 417e , Eaale River, Alaska 99577 (Signature of property owner or authorized agent) Permit Fees: y �i�t�• ° Waiver Fees: Date of Payment: iy / 5, l 0 Z Date of Payment: Receipt Number: d 6 6 5 Receipt Number: (Rev. 12/00) .. ROBERT C. COWAN, P.E. ROBERTA. SHAFER, RE. CIVIL ENGINEERS (907)694-2979 FAX (90i) 604-1211 0C *a bay- 8, 2002 HEALTH AUTHORITY APPROVALS MUNICIPALITY OF ANCHORAGE Development Services Department P.O. Box 196650 SEWER&WATER Anchorage, AK 99519 MAINEXTENSIONS REFERENCE: Lot 5, Block 4, Majestic Valley Estates SEWER&WATER INSPECTION It is requested that you issue a permit to replace the septic tank and install new trenches to serving the existing five bedroom dwelling on the referenced property. ENGINEERING STUDIES Test holes were excavated and percolation tests performed. The approximate locations of AND REPORTS the test holes. are located on the attached site plan. At the time of excavation 8/26/02 no water was found. After monitoring, ground water was not found. WELL INSPECTION We do not anticipate any adverse effects on neighboring wells, septic systems, reserve &FLOWTEST areas or drainage patterns by the installation of the proposed septic tank. The installation of this septic tank will not prevent any future development on any of the adjacent properties. SITE PLANS If you require additional information, please contact us. Sincerely, ROAD DESIGN //�� wjzdvL - Robert C. Cowan, P.E. SOIL TEST RCC/bjj Enclosure PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSAL SYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 1 "S; 40' �0,; NN53m / DESIGN / SITE -PLAN Oti n o m o 0 ;u Ln— W m� y / .Z7 rri D—n�--r o �a / o N mN z AMM /• o L f x r, _ m p O X / / zo ---�-_—_ DDO D no A / m m / 0 O _ r �y0 O ZO m 10 D N DSO �0,; NN53m / DESIGN I SITE -PLAN i n o m o 0 ;u Ln— W m� TI (OT O CIS O .Z7 rri D—n�--r o v i m o 0 0-0 �,w N mN z AMM /• o m x r, _ - ^' m O X ---�-_—_ DDO D O N N D y mm x z D m I i n o m o 0 0 m� p m x .Z7 rri O DC) N mN , /• o m moo > O E mo O X � A m m D D_ _ r �y0 O ZO m 10 D N DSO m O v0 z o0 o ti n O D o m n A � 0 Z O C om > 0 zZ z n N T o C A m c 5 FX/S\ \U FSM r CD r1 O 0 � O � O N p p V O o 71 m� .Z7 rri O n ai /• o � i J� Municipality of Anchorage->:+_ENOIN .. x Development Services Department i Building Safety Division f . y�r On -Site Water and Wastewater Program - 4700 South Bragaw SL ••• '"" - P.O. Box 196650 Anchorage, AK 99519-6650 T i ROBERT C. COWAN i ' www.cLanchoraoe.ak.010�'•.� CE - 8801 ,r ��• � (907) 343-7904 Soils Log - Percolation Test +,hioz6 a� r Performed For: Ll�� Datat�e'Performed: (J qj 0 Legal Description: ice_. I 14- 15- 16- 17- 18- 19 20 - COMMENTS Ni WAS GROUND WATER w' ENCOUNTERED? / V 0 5 IF YES, AT WHAT DEPTH? L Depth to Water After O Monitoring? E Date: Depth o (Feet) 1- G/`i ILL 3- 4- 0 - 5- 6- 6-78-9-12-13-•0 7- 8- 9- 12- 13- -0 14- 15- 16- 17- 18- 19 20 - COMMENTS Ni WAS GROUND WATER w' ENCOUNTERED? / V 0 5 IF YES, AT WHAT DEPTH? L Depth to Water After O Monitoring? E Date: PERCOLATION RATE Z -1,t' {mfnuteunch) PERC HOLE DIAMETER ,Fj r• TEST RUN BETWEEN ,_FT AND 6 FT PERFORMED BY: Vj (C"Oti, 07 C"V•'C I �- PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL "ZOM CERTIFY THAT THIS TEST WAS IN EFFECT ON THIS DATE. DATE: FAM" PERCOLATION RATE Z -1,t' {mfnuteunch) PERC HOLE DIAMETER ,Fj r• TEST RUN BETWEEN ,_FT AND 6 FT PERFORMED BY: Vj (C"Oti, 07 C"V•'C I �- PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL "ZOM CERTIFY THAT THIS TEST WAS IN EFFECT ON THIS DATE. DATE: Municipality of Anchorage NGINE I t Development Services Department Jw Building Safety Division p:. "" . On -Site Water and Wastewater Program �. «1'••`'.`% -••x^'^µ 4700 South Bragaw Sl. P.O. Box 196650 Anchorage, AK 99519-6650 y 't ROBERT C. COWAN l+`� •` www.ci.anchoraoe.ak.usC�lC.-8801 •.`^J�' (907) 343-7904 .pE «,• ��.��, r Soils Log Percolation Test Performed For: ' G�/y n 7•� Dale Performed: 8 2(p 02 Legal Description: %5 , �lG 4 ; _ �%i�y (�S%/(� J� f S Depth .p. (Feet) 1_ 0 •0 2-G'O 3- ° e, 4 5-.0. 6- 7- 8- 12- - 8-12- 'o - 13- 0 14- 15- 17- 18- 19- 20- COMMENTS 0 WAS GROUND WATER Date ENCOUNTERED? A/O Net Time Depth to Water s IF YES, AT WHAT DEPTH? `� L Depth to Water After O P Monitoring? E Dale: Reading Date Gross Time Net Time Depth to Water Net Drop P�))'oWCAle_ C 0 30 0- 30 30 / %2 0 C) �0 '30 3 PERCOLATION RATE (minolesAnch) / PERC HOLE DIAMETER TEST RUN BETWEEN FT AND ;J FT PERFORMED BY:ly{ IGN�'fc7� � (�L/AIL�i _X41W � - �lyr---- CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATEAND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE S& HEALTH AUTHORITY APPROVALS SEWER&WATER MAINEXTENSIONS SEWER&WATER INSPECTION ENGINEERINGSTUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURALS MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSALSYSTEM DESIGN ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS REFERENCE: Lot 5, Block 4, Majestic Valley Estates September 24, 2002 ROBERTC. COWAN, P.E. ROBERTA.SHAFER,PE CIVIL ENGINEERS (907)694-2979 FAX (907) 694-1211 GENERAL: (I r an sn Yw r c{is c r e ) 1. The scope of this project includ/eptic bandonment of the existing septic tank, installation of a 1000 gallotank and a 550 gallon septic tank, extension of the existing trenche,nstallation of new trenches to serve the existing five bedroom residence located on the referenced property. 2. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit or ADEC Authority to Construct with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground utility locates. 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. On all leachfield mound systems, the property owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded area. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department or ADEC if required, for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 Page 2 Lot 5, Block 4, Majestic Valley Estates September 24, 2002 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. 5. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts. These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfreld. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. LEACHFIELD BED INSTALLATION: Excavate the proposed Bed Area to the depth shown on the design. The bottom of the excavation shall be within 2 inches of level. If the bottom of the excavation becomes smeared, it must be raked or scratched (ruffed -up) before gravel or sand placement. 2. If a sand layer is required, place sand over entire excavation to the required depth shown on the design. The top of the sand layer must be within 2 inches of level. 3. Sewer rock shall be placed uniformly throughout the entire bed. Perforated distribution pipe must be installed level with perforations down. Gravel depth below the perforated pipe shall be a minimum of six (6) inches. Gravel depth above the perforated pipe shall be a minimum of two (2) inches. The total gravel depth throughout the entire bed shall be a minimum of twelve (12) inches. 4. The perforated distribution pipes must be no more than six feet apart. The distance between the outermost perforated distribution pipes and the sidewall of the absorption bed must be no more than three feet. Silt barrier material must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. 6. Monitor tubes shall be of four (4) inch diameter, installed at the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel depth shall be perforated six (6) inches below the bottom of the horizontal distribution lines. The monitoring tube should not extend below the bottom of the gravel surface. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finished grade over the bed must be mounded to prevent the formation of a depression after settling. Page 3 Lot 5, Block 4, Majestic Valley Estates September 24, 2002 8. A mound system is to have the upper six inches of top soil and be seeded for vegetation. MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pine Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current MOA or ADEC requirements. INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: 1. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. Page 4 Lot 5, Block 4, Majestic Valley Estates September 24, 2002 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre -construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached MOA permit or ADEC Authority to Construct. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER M U N I C I P A L I T Y O F A N C H O R A G E Department of Health & Human Services y 825 L Street, Anchorage, Alaska 99501 343-4720 ONSlTE SEWER to SEPTlC TANK [ERMIT K������/l Permit Number: G90230 Upgrade �8~x`�o Dat'(,') lssued: 10/05/89 Engineer Designed Owner Name: RODNEY D. MILLS Day Phone: Owner Address: BOX 1721 EAGLE RIVER, AK 99577 Parcel Id: 05O-731~32 Lot Legal: Subdivision: MAJESTIC VALLEY LST, Lot: 5 Block: 4 Section: 23 Yownship: 14N Range: 1W Lot Size 54556 (sq"Ift. or acres) Max Dedrooms: This Permit: 3 ToLal Capacity: 3 SEPTIC TANK: Minimum total septic tank capacity: 11,000 lons, Each septic tank must have at least 2 compartments" Depth to top of septic tank(s) < 4"0 �eet requires insulation over Lank (s). THIS SYSTEM MUST BE INSTALLED IN ACCORDANCE WITH ENGINEER/S DESIGN DATED 10/4/89; AND ANY DEVIATION THEREFROM MUST BE APPROVED 8Y DHHS PRIOR TO CONSTRUCTION" DHHS MUST BE NOTIFIED PRIOR TO ALL INSPECTlONS, THIS PERMIT IS FOR A 3 BEDROOM SINGLE FAMILY RESIDENCE ONLY, AND EXPIRES ON 12/31/B9" THE EXISTING TANK AND TRENCH MUST BE PROPERLY ABANDONED` I CERTIFY THAT: 1, I am Ifamiliar with the requirements Ior on --site sewers and wells as set �orth by the Municipality of Anchorage (MOA) and the State olf Alaska. 2, I will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria (ii this permit, 3. I will adhere to al1 MOA and State o/ Alaska requirements for the seL back distances �rom any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot" 4. I understand that this permit is valid for a maximum of 3 bedrooms. I also understand that the capacity of the total system is 3 bedrooms and any enlargement will require an additional permit. Signed: DATE: �/1 (Owner> RODNE lssued By DATE: EAGLE RIVER ENGINEERING SERVICES P. O. Box 773294 EAGLE RIVER, ALASKA 99577 Phone 694.5195 oD JrStra vs/lc✓ /�>J_irJ SHEET NO _.___ _ —__ _ _.... _. _ OF_ CALCULATED BY---- CHECKED V__CHECKED BY--- SCALE- Y—.SCALE_ !l4 --cJ MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION OCT 51989 RECEIVE® TAN I[ I -L AN w I1XV.1t l'l-, ,, V, G;UI L Nc Ti- LFJ cn er.,. r": Cr'vo .i.w r'rtr 7� O<✓�'JJcce i"/.ENC Jy INSr+LA TG FL o4J LiN� S Chi, MUNICIPALITY OF ANCHORAGE FIGURE 7-23 DEPT. OF HEAUH & ENVIRONMENTAL PROTECTION RELIEF LINE DISTRIBUTION NETWORK ;MT 51989 RECEIVED Distribution Pipe Absorption Trenches Follow Contours Distribution Pipe low From Pretreatment Unit - A Ends Capped Relief Line �A Distribution Pipe and Relief Trench to be Level Line Relief Line 279 SPECIFICATIONS FOR ON—SITE SEPTIC SYSTEM LEGAL.: MAJESTIC VALLEY Ei5'i'.. LOT 5. 11LC)GK /I. A. GEN EwRAL 1 . the well and septic plan are -For a single f arnily r°e-;idencae only. 'rhe drawing and or site: plan shall be a pram: of this spe-cii'icat -1on. Al'I material and workmanship shall mc�et the Anchorage Department of Health and State Department Of Environmental Conservation requil-e- rnents . <1. All r�c)i I tests are adv isory to the des fan cand are -to be ver'if -led CJr modified -in the- field by the= ong"ineer, . 5. All excavations and depths are advisory and are to be vcri-ie>d or, modified in 1: ho field by the contractor, to meet: Municipality or Anchor,agn. Department of Envi i-onmenta l Conservation rectu-frements. 6. The excavation is to be exaci:ly in the area shown on the site p -lar;. any deviation r,c:quires engineer approval. 7. It is always roe, ornmencled that a surveyor locate the noamost 'lor position and the location of any easernents. 0. DRAINFIELD 1. The drainlield - is to follow t:he natural land contour, to mall, nto -I n uniform total depth of the trench bottom_ 2. The bottom of the drainf"ield shall be level, plus or, rninus 3. The total depth CJI thea dr'ainfield excavation "I: not uCo €?xc'eed 2.5' at any point. �. The sewer line is to be connected into the new soptic tank. Ei. Thc; drainfield gravel is to be covered with typar or, fabric: mate=rit:�l 6. Soil car combination of soil and extruded board insulation to a depth of 4' or equivalent is to be place- over, the drainfio'ld. 7. the area over, the drainficld -is to be -finish graded to pr,ovent- pond ina of surface water runnff. 8. The sept "ic tank and Ieac,hf-ield must not be closer than 100' to anv .. exist-nca pr7vates we I I , 150' to any ("lass "0' we'l l , or 200 "i'taia to any community well RIECOMMENDCD LEA.CI-iF'J:EIA) DIMCN5TOivl5 TOTAL DEPTH =- 2.5' GRAVEL_ DEPTH -- 1 ' DRAINI-'IELO LENGTH � 03' DRAINFICL_D WIDTH Absorption Area = 415 SF. 5oi1 Rat"ina -- 13S average fledr^oorn Capacity =- 3 Septic lank Size, 1000 gal ***NOTE: NEW 1000 GALLON TANK REQUIRED. EXISTING TANK PROPERLY ABANDONED. TO M.O.A. CODE. _ f - 0' IMPERIAL DRIVE 76' 21' Id' W 206.00 -- 100' NE ¢ —,---- GR ,.iii//:•i}' � HSE I I L6 I NEIGHBOR WELL +100'JCIE°NCN TANK ° W � CREEK +1401 � TH i z NEW TANK ABANDON� APPROX. EXIST TRENCH �JSHED LOC. d-TH2 O-5 Hmft1 as. 1 O' 2 — 42' LONG 5' WIDE 1' GRAVEL 2.5' TOTAL DEPTH TRENCHES S S3, 79 ,��/</�y S91,FMENT \ F \ \ oQ \ 19 - TEST HOLE • - MONITOR TUBE o - SEWER CLEANOUT $ - WELL i+m++i H+ - LEACHMELD - - EASEMENT .1lO !I NliNN CNr•in,+/ O/'n/NJ SEPTIC SITE PLAN LEGAL: MAJESTIC VALLEY ESTATES LOT 5 BLK 4 OWNER: N/A _CONTRACTOR: RASMUSSON ENTERPRISES__ JOB # 89_111 DATE: -10/02/89 SCALE 1" 50' EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 EAGLE RIVER, AK. 99577 (907) 694-5195 FAX: (907) 694-3297 T 0 to NEIGHBOR SEPTIC +30' `d WELL +100' 00 SOILS LOG MUNICIPALITY OF ANCHORAGE • +.e DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION V1 PERCOLATION TEST 825 L. Street, Anchorago, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: izm Nyy �-t.._-�l DATE PERFORMED: ci — 25 — Dci LEGAL DESCRIPTION: I KS L��T _L; . U \LLE V 1�eST/yT ISoT 5 13L -0(-K 4 EPT hI SLOPE _ SITE PLAN / /•/ 1 1 .t�\TOP SOL L 2 o. 3 ° 0 4 G' 5 0a- 6rGVc_1 6 O 7 8 0 O 9 Iv 11 12 13 20 COMMENTS PERFORMED BY: 72-008 (6/79) WAS GROUND WATER S ENCOUNTERED? liS OLCJ 'X'J P IF YES, AT WHAT / E DEPTH? 2 S 7dsj, m :r 1 Reading Date Gross Net Depth to Net Time Time Water Drop 50AK �I-2S-wi 12:3 -7 3 0 10 /'1 i n � /b to 3 2 Ib it, Z JZ'.41 ,OD 3 I 00 00 PERCOLATION RATE r (minutes/inch) TEST RUN BETWEEN FT AND FT FT Eagle River Engineering Services P, 0 @el( 77$294 -- Eagle P.iver, AK 99577 633-5195 CERTIFIED BY: � DATE: dl a'/. 1 W SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 204-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: \() C NV� L DATE PERFORMED: /� L J r,I _ LEGAL DESCRIPTION: N\A:��Q)T l(L VA\_LF-J L -Q -T )-RjLO(—I`` 4 -REPT(-� SLOPE SITE PL�AN�j���� 9 10 12 Date Gross Net Depth to Net Time Time Water Drop SOAK 0 13 �o I Z 14, 0o / 14 15 IZ 25 • o0 5 iL 16 17 18- 19- 20- COMMENTS 81920COMMENTS WAS GROUND WATER S ENCOUNTERED? YLs L — 07 0 P IF YES, AT WHAT E DEPTH? 6 • S Reading Date Gross Net Depth to Net Time Time Water Drop SOAK 0 �o I Z 14, 0o / 2 IZ 25 • o0 5 iL WAS GROUND WATER S ENCOUNTERED? YLs L — 07 0 P IF YES, AT WHAT E DEPTH? 6 • S Reading Date Gross Net Depth to Net Time Time Water Drop SOAK I Z 14, 0o / 2 IZ 25 • o0 5 iL 1 /Z. 4L .3a 5g'6, � 4,e , PERCOLATION RATE y (minutes/inch) _ /5Z TEST RUN BETWEEN FT AND 3'5FT Eagle Rivar Englneering Services PERFORMED BY: CERTIFIED BY: vim_ DATE:_ 1 Eagle I?iver, AIC 99577 G9*5195 72-008 (6/79) �. vIUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION I ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264.4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME _ PHONE 10NEW _ C^: /44& 1../5 ? r �, ; •" `:.� �L' ❑UPGRADE MAILING ADDRESS .� -, � .> �= F%F;-t_r. /moi 4>.C=/�_, ��,c�. �% �i-5' 7 7 ,%��>•?C : LEGAL DESCRIPTION l ; f� � K. �/ �.S T/e: Y is c7- •� , ./!,/`%,i j>/igC c c %`. LOCATION NO. OF BEDROOMS TO: Well _ C Absorption area Dwelling t� PERMIT NO. 9DISTANCE Y 1- Z Manufacturer Material No, of compartments Uj N Liq. capacit in gallons 'F CA IF HOMEMADE: Inside length Width Liquid depth OJ DISTANCE TO: Well Dwelling e PERMIT NO. s t7Z Z C S—F Manufacturer Material Liquid capacity in gallons 0 w TO DISTANCE : Well - Foundation i Nearest lot line PER)MIz NO. , j_ = J LL z No, of lines Length of each line Total len th lines Trench h Distance ' of n widd betweg17 les V11 F- z :3 t". j '_7 �) inches Top tile to finish Material beneath F of grade tile 0 v6 absorption area / inches�I�J,/=T'� Length Width Depth PERMIT NO. LU 0 4< 1_ a Type of crib Crib diameter Crib depth Total effective absorption area ru N DISTANCE TO: Well Building foundation Nearest lot line Class Depth Driller Distance to lot line PERMIT NO. J DISTANCE T0: Building foundation Sewer line Septic tank Absorption areas) OTHER PIPEMATERIALS,rz"C-,•j- q SOI L TEST RATING INSTALLER REMARKS 11 2well 4 a Aj l r Gr 6-27-79 5 t —J foA �eo01 X154[ VVUefUi G "l E� u a Ic APPROVED DATE LEGAL // .:.j'`T 72-013 (Rev. 3178) D Y /.L -_- DEPHRTHENT OF -�HLTH HND �HVIRONMENll�L P|~`1�CTI;N 820 /L/ .REET/ HNCHQRGGE/ RK. 9S5- 264-4728 K 03P0 FIRM~—oil A -1051 S: 11 1:y`1ETV: 1071"Hw? A -1 PE�MIT NO ( 7�9212 ) HPPLlCA1T CNIFORLES CA QUMBOX ]2] EHGLE !VR 688 2790 LOCHTION 6. 5 MI UP E. 'F!. YHLLEY RD LEGHL L5 B4 MRJESTIC V8LLEY EST 1 ZE 54800 SQUHRE FEET TYPE OF SOIL 1-1 OV! TRENCH MHXIMUM NUMBER OF B2DROOMS = ] SOIL RHTING (48 FT/80= 191 THE RE8UIRED SIZE OF THE SOIL 8BSORPTION SYSTEM 100: THE LENGTH DIMENSIOH IS THE LENGTH (IN FEET) 0F THE TRENCH OR DRHINFIELD THE DEPTH OF R TRENCH OR PIT lS THE DISTHNCE BETWE2N THE SURFHCE OF THE GROUHD MAD THE BOTTOM OF THE EXCHV�TION (IN FEET) THERE IS NO SET WIDTH FOR TRENCHES THE GRRVEL DEPTH IS THE MINlMUM DEPTH OF GRFIVFTHE OUTFHLL PIPE RND THE BOTTOM OF THE EXCHVHTION (IN FEET). K� P IS "so U :1 Q FT: U; :0 E77 to" - FX 171 -T - 5? 1, 1 v< Ki :1 �7 Fv�-- 4.401SKY, plo Vol A..E~4 71 Fv I 74� PERMIT HPPLICHNT HHS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE lNSTHLLHTI0N IONS OF HNY NELLS HDJHCENT TO THIS P10PERTY HAD THE �UMBER OF ��S}DEN��S THFIT HELL WILL SERVE ��C1, a'! so > 3: 141 IS W H Q W x 470 14140 M FQ KP.-: �: --�: -� 1'. .,i � r l IF -� �i'� �� -.:� !1� B17KFILL1110 OF MW SYSTm QITHOUT FINHL INSFUTTlOT1 F10D HP110VRL BY THIS DEPHRTMENT HILL 8E SUBJECT TO PROSECUTION. MIHIMUM DISTHNCE BETWEEN H WELL HHD HNY ON~SITE SENHGE DISPOSRL SYSTEM I:::i: 100 FEET FOR H PRIYRTE WELL/ OR 1j0 TO 200 FEET FROM H PUBL}C WELL THE TYPE OF PUBLlC WELi, WELL LOGS 80 REQUlRED HND MUST BE RETURNED TU T{1E gEPHRTMENT NITHIN ]0 0HYS OF TIAL �ELL COMPLET��N OTHEk R��U����ENTS MY QPPLY. SPECIFICT11I0445 MAD CONSTRUC[/ON DlHGMMS ME HVOILHBLE TO INSURE PROPE� INSTHLLHTIOH �057 lot vel 711 0- K F70 X RON: TH AS Fly 1wo: Q POK W 0 oil ps: PTO �? it^" 1'�0,G -!i I CERTIFY THAT 1 l HM FRMILIRR WITH THE REQUIREMENTS FOR HS SET FORTH BY THE MUNICIPHL7TY OF RNCHORHGE. 2 I WILL INSTMLL THE SYSTEM IH HCCORDHNCE WITH TUE CODES ]� I UN�ERSTHND EN THAT THE OSITE ER SEWSY�TEM MyREQUIRE LHRGEMENT lF THE N— RESIDENCE IS RE THHN ] BEDROOMS HC.1�LE� & POGHNY DEVB'OPMENT - Lux 90, Davis St., Eagle River, Alaska 99577 694.2774 or 688-2280 Russell Oyster Earl Ellis 694.2774 SOIL LOG 688-2280 Soils Et Foundations Land Development Performed for: Name:c � i1 11,7„ e.,.,,,,,,, Tel. No. 0 Mailing Address: `ox 6'3 ;.,•_ .3 ;.';.� :L.i a-,, a_, ;7 Legal Description:_ Lot -5, __1;< 1!•, Depth (feet) SoJI Characteristics 0 1 ,IL -- Alt tops<dl wil th roots at':a 02'_?3nies. 2 3— It —l4 275 :3q. ft./8r. Parcol�tion Ibite 2.125 :inchas / 60 minutes .Silty Sandy ':naval. = 23 tninutas / irtch Cobbles to f3 inches. = 245 sq. ft./Ba. G':J •- S-andy l:raV9l with •-o'bblos o 12 inn .138. . 'ry al?g,1112' 1,1tol'ials. t.'I sandy GrgVel. 12 --Gd -- S rL33> wi_ti] cao!)I�s Lo 12 iL.c-os, 131 Vory an;;ttl.:Lr , z ;•s: ial s. 14e�, aali •- �.il �.',•j :7FL':i :;1Y.���.i�'y. �• �I•i'� ;�:�.-t./T•. 15 16 o'; tc: n of pit. 100 sq. ft./Br,. 2i{5 ,•:1. f I-, . r.+ rti e+e...a.a+ b+..•+.i.•. ./ ry NO. 1745-E eJ�,• .• ,• `N� v B8$ROFESS10yP�"i Ground Mater Encountered: Yes—_—_ Na_�__�_ If yes, that depth ��®•.��;��.,�� Proposed Installation: Seepage PitDrain Field"A Comments: Performed by: Dater = t Eq .. W a� o� 0 Y Im- w w w w y m O O a O • O O OF ® Q Y N a ♦ O N J a w w w c0� �El _ I c � z Q 2 U W N .-1 m ob co wx N m t`i tLj W U i, LL LL O [-^ O F U. IF O F- uF, b w O W O O w H O m Im- w w w w OCT 19 -iop�t O O O O O O O O OF La O O O w w w c0� �El 43 W Ill 4 O LD a Ql to �1 V) z O H Q a 0 w z a U m ry •r/E ro OCT 19 -iop�t v ri O O O O OF La 0 H _ u c 43 W Ill 4 O LD a Ql to �1 V) z O H Q a 0 w z a U m ry •r/E ro OCT 19 -iop�t v ri RECE-. WED rA La 0 H P u N .-1 m ob co m OCE cj• LD t`i tLj i, r-1 O [-^ O F U. IF O F- uF, b w O W O O w O O O O O w w Cc. (z, Cr.• G. a M « ob w x -i O a U. O x w O w O X w O w w O O ce w w w O O O O O x a M a x w w w w w 43 W Ill 4 O LD a Ql to �1 V) z O H Q a 0 w z a U m ry •r/E ro Q � Q 00 Y � Q W 0 0 Y .i Y J Q M Y Q00 E5 M z U ti 0 I r:( rR U Yi Eo rb ri 04 m cb N m U) n w a a H ¢ Z j E= w 3 p ci O N 0 0 m 0 0 o c F F F- F F v> W W F F w w D .... Q w W iCC I N M W LFc kF. W c/' X 'm Q LU U LL LL ® s O F- O a .i Y J Q M Y Q00 E5 M z U ti 0 I r:( rR U Yi Eo rb ri 04 m cb N m U) n w a a H ¢ Z j E= w 3 p ci 0 Q a 0 w 0 0 z O a W 0 0 0 0 0 0 0 0 0 I� w 0 0 0 0 0 0a 0 s 0� e°,, 0�� 0 0 �. w w ua. ftNI( 4PALIRf OfAN(MO"�,.; E w w G 4% DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION 10 ah - = OCT 19 ECEIVE 0 o O o 0 0 0 0 0 o c F F F- F F ' W W F F w w w FF w FE LT. r W LFc kF. cr, 4J.. ix ti kF. 0 0 0 0 0 0 0 0 0 0 2 a x x a a x a a a a e w W W W Cc. W W L O O o O O o O o O O O o vJ :\h 1 nd 0 Q a 0 w 0 0 z O a W 0 0 0 0 0 0 0 0 0 I� w 0 0 0 0 0 0a 0 s 0� e°,, 0�� 0 0 �. w w ua. ftNI( 4PALIRf OfAN(MO"�,.; E w w G 4% DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION 10 ah - = OCT 19 ECEIVE 0 o O o 0 0 0 0 0 o c F F F- F F H H F F E w w FF w FE LT. r W uF cr, ix u 6Fr. [ 0 0 0 0 0 0 0 0 0 0 2 a x x a a x a a a a e w W W W Cc. W W L MUNICIPALITY F ANCHORAGE o� s 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. 050-731-32 Expiration Date: - a`�C r 20 20 1. GENERAL INFORMATION Complete legal description MAJESTIC VALLEY ESTATES BLOCK 4, LOT 5 Location (site address) 26130 IMPERIAL DRIVE, EAGLE RIVER, AK 99577 Current property owner(s) THOMAS & REBECCA BOLIN Day phone Mailing address 26130 IMPERIAL DRIVE, EAGLE RIVER, AK 99577 Real estate agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 5 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ® Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $� Waiver Fee $ Date of Payment t 23Z- Date of Payment Receipt Number i�3 2. S_S�- Receipt Number COSA # S 2(D( 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY, ANCHORAGE, AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 1/22/2020 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & FWFS 6. DSD SIGNATURE System #1 Approved for System #2 Approved for Disapproved Conditional approval for bedrooms bedrooms •4�i,t et TH IJ Curtis Huffman C E 128991 . • c���/ 1/22/202,0.R t1� PROFESS O •: bedrooms, with the following\``\\\6OF l���f �� OIC—SITE v ,� WATER ANEW -11),a))ww))I,. y. a Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. r AUIFATS]:lLVil:1►I&J COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other Legal Description: MAJESTIC VALLEY ESTATES BLOCK 4 LOT 5 Parcel ID: 050-731-32 If more than 1 septic system on lot: COSA Checklist # _of _ Structure served by this system A. WELL DATA ® Well log is filed with Onsite (or attached) Water storage tank volume 900 gallons Date drilled 3/3/1983 (Red!jM Well disinfected for coliform test? ® Yes ❑ No Total depth 195 ft ® Coliform bacteria is Negative Cased to 40+ ft Nitrate 0.4 mg/L ❑ Nitrate less than MRL (ND) ® Sanitary seal is functioning correctly Arsenic ug/L ® Arsenic less than MRL (ND) ® Wires are properly protected FWCS Casing height (above ground) 12+ in. Collected by « & Sullivan Date of flow test for COSA 12/30/2019 & *1/24/2020 Static water level at beginning of test 175 ft. Date of Sample 12/30/22019 & 1/27/20 Well production at time of test *0.12-.15 gpm Comments *Sullivan well production test / calculation at time of chlorination. May consider hydrofracking well deepening, .... to increase low water production. B. TANK DATA Age of tank(s) 17 years Tank type/material SEPTIC / HDPE Measured operating fluid level in septic tank 47" ® Standpipes/foundation cleanout per record drawing Date of pumping 1/23/2020 D. ABSORPTION FIELD DATA Which system tested (date installed) 2002 ® ALL standpipes present per record drawing Total measured depth from grade 5.4 ft (max) Measured depth to pipe invert from grade 3_6 ft (min) ❑ N/A — pressurized field ® Monitor tubes go to bottom of effective. If not, state depth into effective C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 12/30/2019 Results N Pass For 5 bedrooms Fluid depth prior to test 7 in Water added 750 gal New depth 13 in Elapsed time 1440 min ® Code -required soil cover over field Final fluid depth 4 in ® System presoaked Absorption rate 750 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N date of test) If yes, enter date Gallons introduced 1200 gallons Comments/Deficiencies: TestedoES nly half the system — the lower trench presoaked and tested. FW Presoak Minimum Volume: 98'xl.5'xl.5' x 0.4 = 735 gallons. 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' ® Yes if No Community Sewer Manhole/Cleanout > 100' ® Yes if No ft ® Yes if No Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No Neighboring Absorption Fields > 100' Water Service Line > 10' ® Yes Animal Containment > 50' ® Yes if No ® Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No ft ® Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water > 100' ® Yes if No Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No _ Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No _ Water Service Line > 10' ® Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ® Yes if No ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No _ ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' ® Yes if No —ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I certify that / 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. At TH .. ...........:.. 0 Curtis Huffman f CE 128991 NA IP ft ft ft ft ft M ft ft ANCHORAGE RECORDING DISTRICT, ALASKA ASBUILT OF: MAJESTIC VALLEY ESTATES SURD LOT 5 BLOCK 4 PLAT 77-27 SURVEY CERTIFICATE: 1. John L. Schuller; Have conducted a physical survey of this property as shown on this drawing and drat the improvements situated hereon are within the property lines and no enchroachments exist other than noted. Under no circumstance should any information on this drawing be used for construction offences, structures, improvements, or for establishing boundary lines. EXCLUSION NOTES: It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. WORK ORDER NUMBER:DAZE SC.ItE: E-- JAN 17, 2020 1"=S0' 20-002 ORA A B WECKED BY f CD AVuB£A: BOOK PAGe JLS SWO363 200103 OO = FND REBAR OF.4 * `I9TH '-.JOHN L. SCHULLER, o D LS -10408 s PDL »DR& 4 1831 Talkeetna Street Anchorage, Alaska 99508 (907) 227-1455 office (907) 274-4992 fax DEVELOPMENT SERVICES DEPARTMENT On -Site water and wastewater Section www.muni.org/onsite Well Water Advisory Certificate of On -Site Systems Approval # OSC201017 Subdivision: Majestic Valley Estates, Block: 4, Lot: 5 907-343-7904 Fax: 343-7997 This well's productivity was determined to be .12 gallons per minute. The minimum well productivity required under (AMC 15.55) for a 5 -bedroom residence is .52 gallons per minute or 150 gallons per day per bedroom. Maintain current water storage This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. Ma�hng Address P O Box 196650 *Anchorage, Alaska 9 * w w 9519 6650 w muni org IL ANCHORAGE RECORDING DISTRICT, ALASKA ASBUILT OF: MAJESTIC VALLEY ESTATES SU13D LOT 5 BLOCK 4 PLAT 77-27 SURVEY CERTIFICATE: 1, John L. Schuller, I -lave conducted a physical survey of this property as shomi on this drawing and that die improvements situated hereon are within the property lines and no enchroacbments exist other than noted. Under no circumstance should any information on this drawing be used for construction offences, structures, improvements, or for establishing boundary lines. EXCLUSION NOTES: It is the owners responsibility to detemtine the existence of any casements, covenants, or restrictions which do not appear on the recorded subdivision plat. WORK ORDER NUMBER: onrE SG.tE: a-uNL• JAN 77, 2020 20-002 wuxr er. aiecKm Bycxo H00 : —so VF JLS SW0363 200103 O =FND REBAR **49TH .. ........ I .. 1.".....:... .... /�-�.................. %JOHN L. SCHULLER! c s LS -10408 0, .. f_ r... a5; ®V�Ofessiono� [. LAND 1831 Talkeetna Street Anchorage, Alaska 99508 (907) 227-1455 office (907) 274-4992 fax —_ __ O IL ANCHORAGE RECORDING DISTRICT, ALASKA ASBUILT OF: MAJESTIC VALLEY ESTATES SU13D LOT 5 BLOCK 4 PLAT 77-27 SURVEY CERTIFICATE: 1, John L. Schuller, I -lave conducted a physical survey of this property as shomi on this drawing and that die improvements situated hereon are within the property lines and no enchroacbments exist other than noted. Under no circumstance should any information on this drawing be used for construction offences, structures, improvements, or for establishing boundary lines. EXCLUSION NOTES: It is the owners responsibility to detemtine the existence of any casements, covenants, or restrictions which do not appear on the recorded subdivision plat. WORK ORDER NUMBER: onrE SG.tE: a-uNL• JAN 77, 2020 20-002 wuxr er. aiecKm Bycxo H00 : —so VF JLS SW0363 200103 O =FND REBAR **49TH .. ........ I .. 1.".....:... .... /�-�.................. %JOHN L. SCHULLER! c s LS -10408 0, .. f_ r... a5; ®V�Ofessiono� [. LAND 1831 Talkeetna Street Anchorage, Alaska 99508 (907) 227-1455 office (907) 274-4992 fax MUNICIPALITY OF ANCHORAGE ARL • '- DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services N1 On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # (s o - 3 / 3 HAA # M �) Q I 1. GENERAL INFORMATION Complete legal description rot 5 Block 4; Majestic Valley 1,57arE f Location (site address or directions) NHN Imperial Drive +` Eagle River Property owner Ashley Marquardt Day phone 696-2026 Mailing address —P•0- ,Box 772554 Eagle River, AK 99577 Lending agency _ ° Day phone Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well XXX Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XXX Holding tank Community on-site Public sewer _ NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA e21 5. STATEMENT OF INSPECTION BY ENGINEER. As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I furtherverify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm S & S ENGINEERING Phone 6 cty- xq -7 % 17434 Eagle River Loop Rona PAo. 204 Address y le gimer,,Alaslw 9957 Engineer's signature Date S—b-9 /1 7 �ti�.ROBERT 9�jg`CW,1�� CE 6. DHHS SIGNATURE _ Approved for 2 bedrooms. Disapproved: Conditional approval for bedrooms, with the following stipulations: Additional Comments 1- �- 2 —77 By: Date 0 CAUTION 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-M(Rw.1/91) Back MOAM21 k B. SEPTIC/HOLDING TANK DATA Date installed �� - 15r-5 Tank size 100 O Number of Compartments , Cleanout Foundation cleanou (/) _ Depression (Y4W ri High water alarm (Y/N) l Date of Pumping -ci Pumper 0 M P i ABSOF#P.TION FIELD DATA ( j� \ Date'installed 1 `� - U `j Soil rating (g.p.d./ftz or ftz/bdrm) 43`) g�System type �" g_p'i N Length Width Gravel thickness below pipe _LTotal depth SS Effective absorption area 4 Ill S`� onitoring Tube present &l)Depression over field (Y&_-,�)_ Date of adequacy test 5 Resul Pas ail) _ Pf For _ 3 bedrooms Fluid depth in absorption field before test (in.);i 4? H Immediately afterSDv gal. water added (in.): /6 N Fluid depth (ins) Minutes later: I 40 Absorption rate = W _a g.p.d. Peroxide treatment (past 12 months) (Ya 1J)d 1, If yes, give date _ IJ`/4 72-026 (Rev. 3/96)* Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343Af�WNALIIY OFOCHORAGE ENVIRONMENTAL SERVICES DIVISION Health Authority Approval Checklist MAY 3 Q 199 Legal Description: L -oar 4 -n C_ Parcel I.D.,_0 S A. WELL DATA Well type i If A, B, C, ADEC letter. ADEC or attach water system number Log present &) Date complet�(d 3 �3 -83 Total depth 1 5 Cased to Casing height (above ground) I Z Sanitary seal ON) —Wires properly protected 6%) FROM WELL LOG AT INSPECTION Date of test Static water level1� o FT. �� VkO��4 t0c� Well production 2< <' g.p.m. WATER SAMPLE RESULTS: Coliform U Nitrate Other bacteria _ f� Date of sample: 5 '-,-� / - ! % Collected by: � `� e'�c, Q- • _ B. SEPTIC/HOLDING TANK DATA Date installed �� - 15r-5 Tank size 100 O Number of Compartments , Cleanout Foundation cleanou (/) _ Depression (Y4W ri High water alarm (Y/N) l Date of Pumping -ci Pumper 0 M P i ABSOF#P.TION FIELD DATA ( j� \ Date'installed 1 `� - U `j Soil rating (g.p.d./ftz or ftz/bdrm) 43`) g�System type �" g_p'i N Length Width Gravel thickness below pipe _LTotal depth SS Effective absorption area 4 Ill S`� onitoring Tube present &l)Depression over field (Y&_-,�)_ Date of adequacy test 5 Resul Pas ail) _ Pf For _ 3 bedrooms Fluid depth in absorption field before test (in.);i 4? H Immediately afterSDv gal. water added (in.): /6 N Fluid depth (ins) Minutes later: I 40 Absorption rate = W _a g.p.d. Peroxide treatment (past 12 months) (Ya 1J)d 1, If yes, give date _ IJ`/4 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* E. SEPARATION DISTANCES "Pump on" 'Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot 100 k Absorption field on lot Public sewer main Sewer /septic service line 2S I Size in gallons "Pump off" level at" On adjacent lots 1 nL-.>k � On adjacent lots 1 0 0 1 Public sewer manhole/cleanout I l� Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation S� l� Property line 1 Absorption field t o Water main/service line Surface water/drainage X00 t� Wells on adjacent lots I,00 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: k Property line (� 1 Building foundation 10 1 Water main/service line 1 a Surface water L D o Driveway, parking/vehicle storage area Curtain drain `��y-pbt"Jr-) Wells on adjacent lots 1,L-,0 F. ENGINEER'S CERTIFICATION g � I certify that t have determined thru field inspections and review of Municipal records jj�^tems are in conformance wit A7714 nes in effect on this date. ��P.�.N•^»••.., '�s. 4 Signature Engineer's Name6'Z7 C- �'e�✓y✓ / Date 5 ROBERT C. COWAN�@ Z yCE - 8801 rw f HAA Fee $ ? Date of Payment 5�d Receipt Number 72-026 (Rev. 3/96)` Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE M E M O R A N D U M WATER WELL ADVISORY HEALTH AUTHORITY APPROVAL NO. 11,49y02/a During a recent Health Authority Approval on-site inspection and test of the potable water supply well on Lot S Block 4 of NYUTIc Muir ESTATES Subdivision, the well's productivity was determined to be .3s gallons per minute. The minimum well productivity required by this Department (AbIC 15.55) for a -3 bedroom residence is .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 garder_s may be required. This advisory mint be attached to all copies of the subject Health Authority Approval. HEALTH AUTIIORITY APPROVALS SEINER & WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES ANDREPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSAL SYSTEM DESIGN S&S\ ,ine-enrnq ROBERT C. COWAN, P.E. ROBERTA. SHAFER, P.E. CIVIL ENGINEERS WELL RECOVERY TEST DATA FAX(907)694i211 CLIENT: L� I' 1 A4-6 WELL LOCATION (legal): TEST DATE: 6 - 21 -0[7 WELL DEPTH: C1 CASING DEPTH: o + "A A F-"-F-J vE Il.f4' TESTED BY: jr-Aq m=,,3 WELL DRILLER: 5 ,RATE DRILLED: TEST PROCEDURE: MISC DATA: OFF 1) Draw water down to pump. Casing Height: 17, 2) Shut pump off 15-60 min. Sanitary Seal? _ ES D -record time Wires in Conduit? e5 -record meter reading Grading O.K.? qr S 3) Turn pump on. Drawdown. Pump Depth: 4) Shut pump off. Samples Taken? �� 5 ,S; z -record time Date: S'ZI OFF -record meter reading 4 5) Calculate gal./min. recovery. TEST DATA: START TIME: I, I . °2 STATIC WATER LEVEL: ` I TRIAL PUMP TIME METER GAL./MIN. 1 OFF l ON OFF os D 2 OFF Q o �J ON OFF 7 ' 62 3 OFF ,S; z ON OFF 4 OFF P ON OFF 5 OFF ON OFF RESULTS: WELL CURRENTLY PRODUCES: 2� (� oT�j �E� V�Oog__ FLOW RATE NOT GUARANTEED --SUBSEQUENT VARIATIONS CAN OCCUR. 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 MAY -29-1997 07:54 ME ESI ANCHORAGE 9075515301 P.02iO3 CT&E Environmental.Services Inc. 'ZOIL Laboratory Division rsir.►�i�si�ir�r�rri�rs �re�P,trror orrri� Drinking Nater Analysis Report for Total Colifor READ IIYSTR UCTIOXS OX REVERSE SIDE BEFORE COL L ECTIrti'C SAMPL, NIUST BE COMPLETED BY WATER SUPPLIER a PUBLIC WATER SYSTELNi l.0. # PRIVATE WATER SYSTEM Semi ,RE ultce r� O Send to ums �L[f JYnl�m Vy�y mpinr ��vrte luniyi.ymr .%14 iwCAVU—N1 {, vm rr .�y inq Ae,Ittf, .p .v, i LZ Q Srrul Rrfu(tJ O Sendinvoice SAMPLE DATE: luniyi.ymr .%14 iwCAVU—N1 SAMPLE TYPE: .p .v, Q Srrul Rrfu(tJ O Sendinvoice SAMPLE DATE: Month Day Year SAMPLE TYPE: <L Routine O Treated Witter ❑ Repeat Sample (for routine sample 0 Untreated Witter with 1:115 ref. no._ ) o Special Purpose Time Collected SAMPLE LOCATION Collected By r _ rn Bacteria 200 W. Power Drive Anchorage, AK 99518-1605 Tel: (907) 562.2343 Fax: (907) 501-5301 TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to bc: Satisfactory 0 Unsatisfactory 0 $ample over 30 hours old, results may be unreliable Q Sample too Jong in transit; sample should not be over 43 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. Date Received Time Received (neO Analysis Began -Z D r S Analytical Method: 12( Membrane Filter 1) NINIO-,NIUG • Numberofcolonte5/100ml. Lab Ref. No. Result, Analyst e ' 0.1 d O _ Izy 9725434' Sent to Anch Fbk% don ❑ Fu..ed Time: _ Client notified of unsntisfnctory results: Phoned Spoke with Faxed Dile: Time: _ BACTERIO&;ICAL NATER ANALYSIS RECORD Mi/117-MUG Result: Tot31 Coliform E. col; ?tembrnno F'iltpr; Direct Count (/ /� Colonies/100 nil Veriticatian: LTB 8(;B C0LIF1Rdl` r,vrc'• r—.v.Mm'NY r/C"Val Fecal Caliform Confirmation un -rxn<,xuarriv Final ,.Ntembrane Fi w• Results - Cvlirurm/too ml Reported By ! Dme !r,ZAPI Time / hrPAR 1OFs '&r Microbio109Y Drinking Water 09ram oert::Uication 5tatus is ovisional as of 4/8/97, = -- ---___ _ _ ... Member of the SGs Drovp 1506616 GAndra[eve Survelllanco) ENVIRONMENTAL FACILITIES IN AL45KA, CALIFORNIA. FLORIDA, ILLINOIS, MARYLAND, MICHIGAN. MISSOURI NAW iegtt;v nuin t.,eer .nor,.u• MAY -29-1997 07:55 ME ESI ANCHORAGE CT&E ReFJ Client Mame Project Name/# Client Sample IA Matrix Ordered By PWSID CME Environmental Services Inc. 972543001 S & S Engineering L 5 B4 Majestic Valley L5 B4 Majcstit: Valley Drinking Watez C 9075615301 P.03iO3 Client ]POI/ Printed Date/mime 05/29/97 07:47 Collected Date/Time 05/21/97 13,15 Received Date/Time 05/22/97 10:00 Technical Director: Stephen C. Ede Released By allowable Prep perametcr Results PoL Units Mmthod LimitS Date Nitrate -N 0.659 0.100 mg/L SM18 6500-NO3F 10 max Tota( Coliform 0 col/100mL SM18 92228 Analysis Date Init 05/27/97 GCP 05/22/97 A14V TOTAL P.03 MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES M r Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # MC) -11)) - ?)Q MAA # 1 Q5Qk_)1-F1 1. GENERAL INFORMATION Complete legal description Lot 5; Stock 4; Majestic VaZtey Estate Location (site address or directions) NHN ImpeAiat D4,ive Property owner Rodney U. & Ban.baaa J. M.i.P. 4 Day phone Mailing address HC 1 Box 132A So.Cdotna, A2a6k.a 99669 Lending agency Mailing address Day phone Agent Geonge Penkims PERKINS REALTY Day phone 694-3594 Address FagPo Rivoh�APtthFtn 99577 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: -7 \,4 3. TYPE OF WATER SUPPLY: XX Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XX Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72�025(Rev. 1/91) Front MOA#21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I furtherverify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm S & 5 ENGINEERING Phone Address 17034 Eagle River Loop Road No. 204 Eagle River, Alaska Engineer's signature 6. DHHS SIGNATURE Approved for bedrooms. Disapproved. AN Date -1 — �2 Conditional approval for bedrooms, with the following stipulations: Additional Comments wTic Date l7 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 Q1 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LoN ' Parcel I.D. Jcn,L"g-..i F 5`f. A. WELL DATA Well type P(2-l.l kll­ If A, B, or C, attach ADEC letter. ADEC water system number r Log present ®/N) Date completed �'� g3 _/k Driller . - W 1u tlkms Total depth ) `t S f Cased to 14 01,1 A - Casing height 12 _ Sanitary seal&N) Date of test Static water level Well flow Pump level Wires properly protected cq/N) FROM WELL LOG 2.0 E5r g.p.m. SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot 1yCt Absorption field on lot t L -,>f> k Public sewer main ' �I 1 a' Sewer service line AT INSPECTION n ll� T'r7 r n En 0 r -n L m fv V, G v On adjacent lots _ b ca � _ On adjacent lots — 1 b D t Public sewer manhole/cleanout Petroleum tank /a S'kk WATER SAMPLE RESULTS: Coliform 'U Lo�ti goo +� A Nitrate �' t "1 m om! Q Other bacteria Date of sample: �' �� `� Z Collected by:S & S ENGINEERING —f703�Eag a Ever L.Vup KUMVI aw. B. SEPTIC/HOLDING TANK DATA Engle River, Alaska 99577 Date installed \0- Tank size 1bGc> Compartments _ 2 Cleanouts O/N) �_ Foundation cleanout O/N) _y Depression (Y&y4 High water alarm (Y& Alarm tested (Y/N) Date of pumping Pumper -5 �F voaL SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot ��� , On adjacent lots 1 00 To property line l o tk Absorption field ly Surface water/drainage Foundation 4 I ` Water main/service line. lol k- 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent(Y/N) High water alarm level Meets MOA electrical "Pump on" level at Manufacturer Manhole/Access (Y/N) SEPARATtQ-N'61STANCE FROM LIFT STATION TO: on lot D. ABSORPTION FIELD DATA On adjacent lots _. ----"Rump off' level at Cycles tested Surface water _ Date installed lz_� • `e'y`1 Soil rating �3q 0/System type \L06- DF -0-n-1 Length Sg 1 Width S ( Gravel thickness 1 Total depth Total absorption area !11(0 II�oy . Cleanouts present (ON) Depression over field (Y6) 7—` Date of adequacy test ' 2 Z '� Results fail) P � for "I A (�) r bedrooms Peroxide treatment (past 12 months) (Y/9 J° ,6( 6 KAo\,4,� If yes, give date f 1 `l� _ SEPARATION DISTANCE FROM ABSORPTION FIELD TO: v� Well on lot l o U On adjacent lots t('Ot k Property line_ t �— To building foundation To existing or abandoned system on lot k- , On adiacPntlots �p 1Cuthank '_\ Dr Wntarmain/sarvicalina Surface water Ivo I Driveway, parking/vehicle storage area Curtain drain E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in 5 & S ENGINEERING Signature 17034 Eagle River Loop Road No. 204 [.age River, Alaska 99577 Engineer's Name Date HAA Fee $ f y Date of Payment 7/31 1/?2 2 Receipt Number 72-026 (Rev. 3/91) Back MOA 21 Waiver Fee: $ 1 �r moo`'% this inspection. Date of Payment Receipt Number CHEMICAL & GEOLOGICAL LABORATORY c F =`�g� A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. LAOORATORY 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301 ANALYSIS RESULTS for INVOICE # 55870 Chemlab Ref.# 92.3466 Sample # 3 Matrix: WATER Client Sample ID L5 B4 MAJESTIC VALLEY EST PWSID UA Collected JUL 13 92 @ 15:30 his. Received JUL 14 92 @ 15:15 his. Preserved with AS REQUIRED Analysis Completed JUL 15 92 Laboratory Supery s STEPHEN C. EJIE Released By : C - V( Client Name :S & S ENGINEERING Client Acct :SNSENGP BPO# Req# Ordered By :R. SHAFER Send Reports to: 1)S & S ENGINEERING 2) ..., PO# :NONE RECEIVED ................... .............................................................................................................._ Parameter Results Units Method Allowable Limits ------------------------------------------------------------------------------------------------------------------------------------- NITRATE-N 0.19 mg/1 EPA 353.2 10 Sample ROUTINE SAMPLE COLLECTED BY: RAY. Remarks: -Y69O61 'Tests Performed.............. See Special Instructions Above UA -Unavailable ND. None Detected See Sample Remarks Above NA- Not Analyzed LT -Less Than, GT -Greater Than 111#90 SGS Member of the SGS Group (Societe G6n6rale de Surveillance) N M Juty 29, 1922 ROBERT SHAFER. P_E. ROGER SHAFER, P.E. CIVIL ENGINEERS (907)694-2979 FAX 694-1211 HEALTH AUTHORITY APPROVALS Mn. George Perkin.6 PERKINS REALTY 1719 Eagle River Road Eagte River, AQaska 99577 SEWER &WATER MAIN EXTENSIONS REFERENCE: Lot 5; Bkock 4; Majutic va tey E6ta.tes Subdivision Dean Mn. Perkin SEWER &WATER INSPECTION D .F p Atyour request a blow tent was per6ormed on .the we.2.2 wcving .the 4e6ereneed property on July 29, 1992. The static water Levet was measured in the welt at 168 beet below the ENGINEERING STUDIES o6p the weft easing. A meter was connected to the water system and AND REPORTS .top the 6�2ow turned on butt. A6ter 6.c6teen minutes .the water Levet was drawn down to the pump (192 beet). The pump was ,then shut ob6 and the water eeve2 was a22owed to recover bon approximatety 6.i6teen minutes. WELL INSPECTION At that time .the pump was ,turned on again and the water 2.evet. drawn & FLOW TEST back down to ,the pump white ,the water quantity was metered. This process was repeated severat b.ive times with reasonably consistent resutts . SITE PLANS From this test we have bound the weft to currently produce approximately 27 gallons per hour (GPH). This 6iow rate is not guaranteed to remain constant, subsequent va4iations can occur. ROAD DESIGN 16 we may be o6 6urther serv.iee, please contact us. '. I Sincerely, solL TEST ROGER J. SHA ER, P.E. RLS/ss PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 e/1 4 0 A f" -0 (� �At-'(Aql o r,A - l� LP IM VA �(' 1 UP ,O 2 I CT V + 2j 6.,;P� -�,Zq-92�- S & S ENGINEERING 17034 Eaglo River Loop Road No. 204 Eagle River, Alas!kh 49M, WATER WELL ADVISORY HEALTH AUTHORITY APPROVAL NO. �t.L `� % During a recent Health Authority Approval on-site inspection and test of the potable water supply well on Lot Block of �f Subdivision, the well's productivity was determined t(6 be gallons per minute. The minimum well productivity required by this department (AMC 15.55) for a bedroom residence is 6�,)/ 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 noncritical 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 DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION - - - 825L Street- Anchorage, Alaska 99501--- - - - _ - - ENVIRONMENTAL ENGINEERING DIVISION 0* Telephone 264.4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incompleterequests will not be processed. Please allow ten (10) days for processing. 1. PR ERTY OWNER1 PHONE ,} 1 MAIN D RESS \ �/ P6 �k--Z PROPERTY RESIDENT (if different from a o e) ( PHONE 2. BUYE - - - - - - PHONE MAILING ADDRESS — ��^rne�n 3. LENRING INSTITUTION PHONE Lszc:� �Ull�� srk-ULtt41SLeC��e, hA&II INE: Anr)RRRS 5. LEGAL DESCR_ PTION U��5 - -& \ STREET LOCATION UL14:4 - � YU LUL 6. TYPE, F RESIDENCE NUMBER OF BEDR OMS 4her \[� SINGLE FAMILY ❑ ' One Four ❑ ❑ Two ❑ Five ❑ MULTIPLE FAMILY ❑ Three ❑ Six 7. -WATER SUPPLY - —_ \9P. INDIVIDUAL* - *ATTACH WELL LOG. -A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑- PUBLIC UTILITY depth (attach log if available.) 8. SEWGE DISPOSAL SYSTEM p INDIVIDUAL/ON-SITE** `*If individual/on-site, give installation date If system is over two (2) years old an adequacy test is required - ❑ PUBLIC UTILITY - by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLt INSPECTION APPOINTMENTS DATE RECEIVED TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE CJ' SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE IYHREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY P INDIVIDUAL Cl COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER �t DEPTH OF WELL DATE DRILLED- LOG RECEIVED - - - 3. SEWAGE DISPOSAL SYSTEM OP-KIDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED 7? INSTALLER Vptic Tank or ❑ Holding Tank Size: 1000 If Tank is homemade give dimensions: SOILS RATING q TYPE OF TANK MANUFA TUBER TOTAL ABSORPTION AREA co� —r MATERIAL - 4. DISTANCES WELLTO: Septic/Holding Tank 9 a,� Absorption Area O3 Sewer LineNearest Lot Line Absorption Area to nearest Lot Line _ 5. COMMENTS 0;�—APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED 1. DATE BY (Till 1 - - LEGAL DES I ION 72-010 (Rev. 3/78)