HomeMy WebLinkAboutMOUNTAIN VALLEY ESTATES #1 BLK 3 LT 19Onsite File
MOUNTAIN VALLEY
ESTATES #1
BLOCK 3
LOT 19
PID# 050-661-04
Permit Number:OSP261161
Tax Code Number:05066104000
Work Type:SepticTank Upgrade
Effective Date:
Design Engineer:
Site Legal Address:MOUNTAIN VALLEY ESTATES #1 BLK 3 LT 19 G:0758
Owner:TOOYAK ANDREW JR & RACHELUZ R
Site Mailing Address:3600 JOHNNY DR, Eagle River
Lot Size in Sq Ft:133645
Total Bedrooms:3
This permit is for the construction of:
Disposal Field Septic Tank Holding Tank Privy
Non-Public
Water 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. Coodinate with On-Site staff regarding preferred method.
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
6/23/2026
6/23/2027
NORTH RIM ENGINEERING
Expiration Date:
þ ¨¨¨¨
Issued To:
Issued By:
Date:
Date:
6/23/2026
6/23/2026
NORTH RIM ENGINEERING
Isatou B Njie
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
SteveEng.com MTN VALLEY EST #1 B3 L19
SPECIFICATIONS & DESIGN GUIDELINES
Wastewater System Sizing: The current septic tank has failed- the field still functions.
Replace septic tank near same location, decommission old tank per UPC. This lot is very
large in size and on a well. Separation measurements to be made prior to construction. No
adverse impacts are expected from tank replacement. A drainage easement is depicted on
the lot. The slope is flat in the area of the septic tank. No conflicts to neighbor properties.
A previous waiver for well to septic tank was granted @ 93 feet. We request that this
waiver remain in place due to the septic tank being down-gradient of the well; also the
above ground distance between the tank and well, accounting for all the structures
between is 101 feet. Any effluent will flow away from the well and has adequate
separation around the structures. A recent nitrate sample confirms no well contamination.
Specification Requirements: All components and work must comply with the
Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water
Regulations and Wastewater Regulations.
New 1500 gallon minimum, MOA-approved septic tank. Watertight couplings on
inlet & outlet.
5 minimum between the tank and trench. 5 to property lines & 10 to house.
4 of cover or insulation is required for tank; an equivalent of 1 insulation for 1 foot
soil cover. Tank & solid pipe must be set on well compacted, stable soil.
No large rocks for tank bedding. Plastic/fiberglass tanks require special bedding per
MOA- sand or pea gravel.
4 diameter cleanouts with airtight caps are required 1 to 4 from foundation wall,
prior to any 90 degree bend in 4 inch line, in 2nd tank compartment, and two adjacent
opposing cleanouts between the tank and the absorption field, not more than 10 from
the tank positioned to provide cleanout access towards the tank and towards the
absorption field. Manhole Riser required in 1st tank compartment.
All cleanouts must extend to at least ground level.
In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron.
Insulation must be placed over any pipe installed under driveways or parking areas.
Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789,
ABS ASTM D2661,
Sewer Service Line is minimum 2% slope.
Septic Tank to be pumped every two years or when required.
Insulation board to be extruded direct burial polystyrene (Dow Styrofoam HI/equal)
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP261161, Isatou Njie, 06/23/26
J
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Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP261161, Isatou Njie, 06/23/26
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP261161, Isatou Njie, 06/23/26
Municipality of 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#: OSV261023 COSA#: Permit#: OSP261161
PID#: 050-661-04
Legal Description: MOUNTAIN VALLEY ESTATES #1 BLK 3 LT 19
Engineer: NORTHRIM ENGINEERING
Your request for a waiver of the required 100 feet horizontal separation from the septic tank to the
private well has been approved. The approved separation distance is 93 feet.
This waiver approval applies to the existing septic system only. Any future upgrade to the on-site
wastewater disposal system will require all separation distances be met or another approval from
this department.
- ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ -
Waiver is Granted: ----'-X'-----
Date: 6/23/2026
Waiver is not Granted: _____ _
Approved bye �
NameofRe'wer
- ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ •
**** VARIANCE/WAIVER REVIEW****
MUNICIPALITY OF ANCHORAGE .
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME -- -q[PFION E ~"~V~
MAILING ADDRESS ~
LEGAL DESCRIPTION "
iLOCATION
DISTANCE TO: Well 6:/ '.~ '
Manufacturer ~ -'*~ -~ ~_
[Liq. capacity in gallons IF HOME~DE:
DISTANCE TO: Well
Manufacturer
DISTANCE TO: Well / / '7 /
No, of ines Length of each line
Top of tile to finish grade ~ ~/
I Length Width ¢
Type of cri~ ~7--
DISTANCE TO:
Class Depth
DISTANCE TO; Building foundation
I Abs~rption area Dwelling
Inside length. Width-
Dwelling
Foundation /...~ ./? *'
Total len,~l ~_~ lines
Material beneath tile
Depth
Nearest lot ling
: Trench w~
BEDROOMS
PERMIT NO.
PERMIT NO,
inches
inches
No. of compartments
Liquid depth
Liquid capacity in gallons
PERMIT NO.
Distance between lines
Total effective absorption area
PERMIT NO,
Crib depth Total effective absorption area
Building foundation Nearest lot line
Driller Distance to lot line
Sewer line Septic tank
PERMIT NO,
Absorption area(s)
OTHER
PIP~/TERIA LS (~
SOIL TEST RATING
INSTALLER
REMARKS
APPROVED
,r ~ _
72-013 (Rev. 3/78)
DATE LEGAL
)" ~ ' R]TEC'rION
[ [~.FHRTr~ENT - HEALTH AND ENVIRONf,IENTFIL
8R5 ",~ STREET., ANCHORAGE, AK. 9~,..01
PERMIT NO. ( Z80~<6:: )
APPL ~ CANT
LOCAT I ON
LEGAL
JOHN L HOPKINS
JOHNNY DRIVE
LtV B 3 MT VALLEY ESTATES
BO>~ ~02d. ANCH
LOT SIZE
t:~645 SQUARE FEET
TYPE OF SOIL, RB$ORBI'ION SYSTEM IS: 'TRENCH
MAXIMUM NUMBER OF BEDROOMS
SOIL RATING (SQ FT?BR)= 125
THE RE6;.UIRE~, SIZE OF THE SOIL ABSORPTION SYSTEM IS:
IC:,E:P ]'H= S-=~ L.F.: f-,tr.:'~ T Ft = :~:2 13 ~'~ Fi",,," E b. [) bT: P ~r Fl:= ¢.~;
THE LENGTH DIMENSION IS THE LENBTW (IN FEET) OF THE TRENCH OF.: [:,RRINFIELD.
THE DEPTH OF R TRENCH OR PIT ~S THE DISTANCE E:ETWEEN THE SURFACE OF THE
GROUND AND ]'HE BOTTOM OF THE E>4CRVRTION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
TWE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GAR'eEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION (IN FEEl').
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING ]'HE
INSTAI.L. ATION INSPECTIONS OF ANY WELLS ADJRC:ENT l'O THIS PROPERTY AND THE
NUMBER OF' RESIDENCES THAT THE WELL WILL SERVE.
........ 'TI4u] ( ~.2~ ) X !"",! ;~'.;F"E ti.': T I 01"-12; tIRE Ii':. EL-;!tJ I; F-':E[:
BACKFILLING OF ANY SYSTEM HITHOUT FINAL INSPECI'ION AND APPROVAL BY THIS
[:'EPARTMENT WIL. L BE SUB.SECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
~.00 FEET FOR A PRIVATE 14ELL; OR
'1.50 TO 200 FEET FROM A PUBL. IC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL.
OTHER RE(~.UIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS FIRE
AVAILABLE 'TO INSURE PROPER INSTALLATION.
I CERTIFY THAT
t: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SEI'
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I PilL[. INSTALL.. THE SYSTEM IN FICCORDRNCE WITH THE CODES.
3:: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE %5 REMODELED TO INCLUDE ~ORE THAN ; BEDROOMS.
SIC~NED:
RPPL ~ CRNT JOHN L HOPK ~ NS
December 29, 1978
John IIopkin s
Star Route 2 Box 9354
~]aqle River, Alaska 99577
,.,u~)j..ct: 80351 Lot 19 Block 3 Mountain Valley Estates
t~7S0971 Lot 13 Block 5 I¢lounta~n Valley Estates
~780936 Lot 12 Block 5 Mounts%in Valley ES'bates ~1
978093'7 Lot 13 Block 5 Mo~u~tain Valley Estates
A permit issue6~ by 'this department for well and/or
sawer system has expirect.
P~rmits are issue¢~, on a ~alend. ar y~ar basis, as stated
on 'the permit, by autherity of ~4unieipal or£1inance.
If yon have drilled the well, a well ~Lo~ should be
sent to this department to document the installation
da~;e.
%f 'the.re are any further q~lestions, please contact
this office a.t 264-4720.
S~lcere].y,
Les N. }~'uchho!z, R.£3.
Senior Environmental Specialist
enc: copy of permit
J~ I .L I NO.
.... t.:~ ~,,.:.~di:.F~i LII ItL;I'IL1H dj"4[.. ENVIrJ. L:II'~r,I[~I'.CFI'~IL. [I,...JILCI ION
c.,.-~,r= ...[ , ....., ::: ...... · . '- ;,~ ; ~',r-
...... = ....- I kJ..E I. "'" t.
[;IJ'~L.J IL]l; .f ILM ......, h,.
FIt:::'f':'L I CFINt
.......... , I I i ON
,.:lOHIq HOPK 11'4'2;
JOHr.,tN't' DF:: I, ,:.
264-4720
LA_gL:J2.' MOUNTFIlN ',/IqL.LI;'¢ [ZG'FFtTES
",~"Fc- OF: ':'"iii,._ . F:IF2;OF:t3TIOI'4 =,,..;.IEM- '"""'- IS: TRIZNCI'I
2;OIL RFll'ING (2;C.4 F:'T,/BR)=':t~.o
· FIE..:;,,.. s~ ION Gh'STt.~M :[2;:
lt'IE REf:~UIRE[) '.i]z¢.E. fiji:' TI'If£ ..:,..ILL
THI2 LEI'.tGTH DIME:tqSIOIq INS THE LENGTI'I (IIq FEET) OF' "H.IE TREIqC:II OF..' DRFIIIqFILZL, D.
'HI~Z DEPTli OF Ft TRENCH OR PIT :[2; THE DISTFINCE BE'I'IqEEN THIE 2;URFfIC:E 01: TIlE
GROUND FiND THE BOTTOM OF 'FI.'IE EXCIflVflTIOI'.,I (IN FEET).
TI.IERE IS NO SE]' HIDTH FOR TF..'L']'ICI.IES.
TIlE :::if,]P¢,,'[]L DEPTH IS THE 1"I:I'.I'4IMUI'I DEf"'Tll Of: GRf:IVEL BEI'HIEEN THL'-. OtJ]'FFtL!.... r::,Ipli;
FiND THE BOTTOM OF THE E',:.'::CFIVfrITIC~I",I (IN FI:EIZT).
[,Ed;.l'll RFFI ..... N] HFtS TI. lIE RE.::,Ft,.i'&x, IE,;fLIT~ TO II'4F'ORM THIS DEPfIRTMENT [.~U,.,.I.l',lb
I 4_ ~ d..._, ].(..,I'4 IN;'..,[ E'.L. ,IL,,L, OF fIN'.? !4EI..LS FID..If:IC:ENTTO TI
r',,.., ,=m~ FIND TIlE
't. JM[~E[,.. OF I,[;.z.,.[,~.~",~L.[..;. TI,,,T 'H'tE HEL,L,, HILL.
MINIMUM DIS'I'RNCE BETWEEN FI WELL. FIND fiN','
:1..00 F:EET FOr.". R PRIVRTE HELL.~
WE;.LI.. LOGS FII:,'.E REr.:!UIRtZD FiND I'1LIST DE RETURNIED TO
O'T'IIET.,' IT..'Ef2UIREMENT2; MIT,' I;JJ'"[:'L'i'. ~:F'EOIF'ICFITION~; f'IND CONSTRUC'TION D]t"IGRI-1MS FIRE
.. F Jl'. ;.,E. HE,' ..... F'II',ID HEL. L2;
:!: I Fit'1 }.FIi'lll_I Ilk .LtlTH THE I,.Eg..IIRE.MF. NT.> ON..-.SITE SET
,"FF",'.,...,,, Er,' 'rill.; MUNICIPf:iLIT'.r' (:;if FINE:IIORRGE
I HILL INSTFILL THE .: ~,TE, II IN RCC:ORDRNCE IdV'H.I TIlE CODIES.
'":' ' I ,-,,~'m,":'~' ~*~ '. '" "" UN' 2; I'I"E JE.WER '- "-" -' ~" - 3 ' '
..... ,..,NJ.,,..., ...... ,I,,ID TIIFIT ~. -, ,:,:r =, :.i'EM MFl'r' ,...EL..uIr...E ENLIqF:'.GEMENT IF "rilE;
I,.E.:;,I[.ENL. E. I2; }~EI'Iu.:LE.[. TO INCLUDE MORE THFIN .~. BEDRuOfl.:.
~ h , [. I ... IIqT ,IOFIN I IOI Ix I
t..,=,t., :1[~ ............ DI-1TE . _ V 7:i:.
unicipalitYof
Anchorage
POUCH 6-650
ANCHORAGE, ALASKA 99502
(907) 264-4111
GEORGE M. SULLIVAN,
MAYOR
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
(825 "L" Street)
May 16, 1978
~77379
John Hopkins
4417 San Roberto ~2
Anchorage, Alaska 99504
Subject: Permit Expiration
A permit issued by this department for well and/or on-site
sewer installation on Lot 19 Block 3 Mountain Valley Estates
Subdivision has expired since the issue date exceexs one(l)
year.
In the event you still plan to install the well and/or on-
site sewer system, a new permit is required. The original
soil test may be used to obtain a current permit.
If the well has been drilled, a well log should be sent
to this department to document the installation date.
If you have any questions regarding the above matter, please
contact this office immediately at 264-4720.
Sincerely, ~ ~
Les~lz, R.~.~
Senior Environmental S~cJ. alist
LNB/ljh
GREA.ZR ANCHORAGE AREA BOA dGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-456!
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
'NST."'.LAT,ON LOCA'"',ON
INSTALLATION OF: SEPTIC TANK
TYPE AND SIZE OF FACILITY TO SE SERVED
FINANCED THROUGH
SOIL TEST RESULTS
SEEPAGE PIT ., DRAIN FIELD
NOTE= ~EIRMIT IS NOT VALID WITHOUT E~OIL TE~'
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL 13E SU
MINIMUM DI.~TANCES, REQUIREMENT~
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT . DRAIN FIELD
SEPTIC TANK TO SEEPAGE P~T WALL
SEPTIC TANK SEEPAGE PIT ., RAIN FIELD
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK __ __ __ SEEPAGE Fl~
GEAVEL BACKFILL
A~REA
TEM WITHOUT FINAL INSPECTION BY THE
PROSECUTION.
ZE TYPE '~¢ ,~ C~ ~i
DIAGRAM OF .~Y~TEM
I CERTIFY Tl4AT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS; IN ACCORDANCE WITH SAID CODE.
DATE f~ /'~/'-- APPLICANT'S SIGNATURE "~ -
EQ-016(3-75)
':i "::"i::'i~ii:'i::'ilil~ i:' E:d:::?Ft!il (ilft:: ilili!i;'.!i;I..I!iiil
HFiR:!:I'"tI.JI"1 I'.,!t...ll"i!iii:liii:!:;i: EJI:':' lii:li::t)l:ilX::*Efi'"l:iii; :::i:
't'l'llli: I..liiZi",tG TH E:, :1: I','IE:I'.,I:i::; ]: ON 1 :ii:; "i'I.-IIF !..!i~:l'.,l(:!iTt. I
'iFil!ii: Dli!i:l:::'"l'H Oi::: t:i:1 "I'I:;i:IiiZNE:I.I QI:;;: I:::':[T ]::iii; "l'l'llii:
Gi;;i:EE.tI'.,iI::, FIND 'i'l-"lli: lii',~9'l'TOH ~:::~1::' "I'I'IE:
't'hlii!!:l:;i:l!:!: :1: :ii; I",]~:J :ii;li'::'l' H :1: D'I't'I I:::T I:;i: 'Tl:;i:llii:l'.,1Cl-Iliii::ii;. '"N
'l'l..ltiii: Gl:;iff::l',,,'tliJ. E:fli:F'TI.i :1: :ii; "i"l.l!i: H :[ I",1 :[ HI.IH t:::,111:1:::'"1'I..I
I:;:I['-,ID "i'I.IE: I!i',O'I"'IEIH Eli::: I I-~I t:,..,.,. I ION
'I'I.IE: 'i.l:;i:hd'.,IE::ll I:::IF'.
'l.,.Ihi:l!ii:H 't'l..!lii: liii;I. Jl:;i:l:::'l:::lI::::lli!: OF' 'Fl.iii!:
lii!:li!il T I,.ilii2 li51 I"~1 "I'1 '1 Ii[il Iiill I I 'i' I:::' I:::li. !... !:::' i!i ?
!:::11",11) I:::!l:::'l:::'!:;i:l:)'v'l:::ll. I!!:"," TI'i :11 :ili;
O 8- E GEOT CHNICAL F:~ DEVELC MENT CO.
Russell Oyster
694-2774
Soils 8 Foundations
Performed for:
Legal Description:
o
2
6
7~
Box 90, Davis St., Eagle River, Alaska 99577
694-2774 or 688-2280
Name:
MMling Address:
Earl Ellis
_SOIL LOG 688-2280 ,
Land Development
~,,~', ,_"5~.,a \\,,~,,_,~., ,el. ,o. %~7-
S~ll Characteristic~
Ground Water Encountered: Yes No If yes, whet depth
Proposed Installation: Seepage Pit Drain Field
Comments: ~-[~,~ ~,._~-'~.,,.~-:, t-'r~>~, :',~'-,.
Performed
Date:
I::IF::'F'L. i£ CI::~N*T*
L 0 C FI *'1" ,'11CI N
I.. E:~:~i FI I
t"1 :l:t'q :1.' I"t1...11'"1 I:::,:[ :5"1~1:;:t1'.,IC1~:: E:E"I"I.,.IIEEI'-,I R t.,.Ili~:L.L. FIN[::, FIN'.? O1'.,I...-'.15
:'I..~;!'.~O t::'E:lii:T I:::'Oi';i: I::1 I::'l;i::l.",,,'l:::lTl!i: I.,.IIELI... CII~: ;;~6~12) F'IEET' I::'()1:;i: I::t F:'IjE:I._.:I:C F.fl!!~:l....I .....
l,.ll~ii:l....I..., t....OG:i~; I:::II:;;:E F~:IE~:.:.!U):I;.:'.EI)FIN[::, I','ll..l~i:;']' BE ¢'.IiL'TLII:;;:I'.4E:t)'T'C~
('.'Il:::' 'l"Hl!i!: I.,.IIi~:L.I.... (::OI"'IF'L.ET .'1: O1'.,I.
':'~;I:::'I'_:::C 'l: F: T ::: I:::IT :1: OI'.,t:E; 1::11'.41:::, i'": '" t'-I':::;"FF'.I;:: ~1" :1: OH [::, :1: I::ll:~il:;,':l:::ll','lli:~; I::11:;i:[~
:1: I'.,l:i~; "t" F:I L.. I,,,, I:::1 'T' ]: ON.
by
A & L DRILLING COMPANY
BOX 97, EAGLE RIVER, ALASKA 99577 · TELEPHONE 694-2588
OWNER OF LAND j ::..'."~"
LEGAL DESCRIPTION
DATE - Started ~ ,,'
PERMIT NUMBER
DEPTH OF WELL / ,%:
STATIC LEVEL OF WATER FT.
DRAW DOWN FT.
GALS. PER HR
KIND OF CASING C
KIND OF FORMATION:
From ': ' Ft. to ~ Ft.
From ,~ Ft. to ' ' Ft
From i :~ Ft. to F'5 ' Ft.
From" Ft. to "i' Ft..
From Ft. to : ~ Ft.
From '
From
, Ft. to ' :: Ft
Frmn · , Ft. to r":' Ft.
From__Ft. to__Ft
From Ft. to__Ft.
From Ft. to.__Ft.
Fl'om Ft. to__Ft.
From Ft. to__Ft
From Ft. to Ft,
From Ft. to Ft.
From____Ft. to.__Ft
Front
From
From
From
~n r .Z From __
From
From
From
From
From
From
From
From
From
From
Ft. to__Ft.
__Ft. to.___Ft
Ft. to Ft.
Ft. to Ft
Ft. to___FL
Ft. to Ft.
Ft, to Ft
Ft. to Ft,
Ft, to Ft
Ft. to Ft,
Ft. to Ft.
Ft. to_ Ft.
Ft. to_ Ft.
Ft. to _Ft.
Ft. to Ft.
Ft. to Ft.
Ft. to Ft
MISCL. INFORMATION:
:,:: ,,. ? ~ ,:,.
DRILLER'S NAME '
1.
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEAl_TH AUTF{ORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date
GENERAL INFORMATION
(a) Legal Descriptien (include lot, block, subdivision, section, township, range)
Lot 19 Block 3~ Mountain Valley Estates T14N
Location (address or directions)
J o h n_n~y_ Drive
RiW SEc. ,~3
(b) Applicant Name Jim --York Telephone: Home694-_4_309 __ Business N/A
Applicant Address Star Route 9253 Eagle River AK._~_~_7_
(c) Applicant is (check one): Lending Institution []; Owner/builder~_"~-; Buyer []; Other ~ (explain);
(d) Lending Institution __N/A _ . Telephone
Address
(e) Real Estate Company and Agent
Address
(f)
Telephone
Mail the HAA to the following address:
___.P_~,_ck_u_p b~_ eng~in_eer
TYPE OF RESIDENCE
Single-Family L~ Multi-Family
Nurnber of Bedrooms
Other
WATER SIJPPLY
Individual Well ~ Community E] Public ['"J
Note:'lf community well system, must have written confirmation from the State Department of Environmental Conservation
attestin9 to the legality and status,
SEWAGE DISPOSAL
Onsite [] Public [3 Community [] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2 /2 025n1,84)
ENGINEERING FIRM PROVIDING INSPECTIONS, "rESTS, FILE SEARCH, DATA AND INFORMATION
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Flealth
Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained
from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is in compliancP~ with all Municipal and State codes, ordinances, and regulations in effect on
the date of this inspection. ~-';'f~' ~-"":"~¢'~ ° ~'~-~'~ ~-/~'/''~' ~- ~ ~,~,~ Y~,-/-~ ~ ..... ~' .
Name of Firm ~6LE Rt-VE~ ENC:rlNEER~RVf~ES Telephone
Address EAGLE RIVER, Al( 99577
Date
P, 0. BOX 773294
694=51'g5
Engineer's Seal
DHEP APPROVAL ~
Approved for ~"~(.-~-~bedrooms by
Approved ___ _'~ Disapproved
Terms of Conditional Approval
l
Conditional
Date
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 requiroments. Employees of DHEP 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.
Page 2 of 2
WELL DATA
Well Classification
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORrrY APPROVAL (HAA)
CHECKLIST- FEBRUARY 1984
264-4720
Legal Description: ,~- o
If A, B, C, D.E.C. Approved (Y/N)
Well Log Present (Y/N) / Date Completed ,.~"-///4~//~? Yield
Total Depth /~b ¢ Casedto Mc w Depth of Grouting ~ ]~
Static Water Level ~'/ / Pump Set At / ~5--
Casing Height Above Ground ~ ~ Sanitary Seal on Casing (Y/N)
Electrical Wiring in Conduit (Y/N) ~ D~pression Around Wellhead (Y/N)
Separation Distances from Well: ~) ~'¢ 0 ¢
To Septic/Holding Tank on Lot ~ ~ ~ .~ gf~ On Adjoining Lots
To Nearest Edge of Absorption Field on Lot /O~ ~ ; On Adjoining Lots
To Nearest Public Sewer Line ~ To, Nearest Public Sewer
Cleanout/Manhole ~ To Nearest Sewer Service Line on Lot
Water Sample Collected by _ ~2 '~e~ ; Date ¢//
Water Sample Test Results ~ ~ ~ ~ ~
Comments ~Y~= ~c
SEPTIC/HOLDING TANK DATA
)
Date Installed //¢' / ~._~j~.,:~ize /.2-
Standpipes (Y/N) _ .,~ Air-tight Caps (Y/N)
Depression over Tank (Y/N)
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
~.
No. of Compartments
. ,Y Foundation Cleanout (Y/N)
Date Last Pumped .S.~
; for
Temporary Holding Tank Permit (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Supply Well
To Property Line ~
To Water Main/Service Line .... ~/¢'~
Co m me~lts -.~
To Building Foundation
To Disposal Field ~'
Page 1 of 2
To Stream, Pond, Lake, or Major Drainage
72-026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed /¢ '"~'Y'
Width of Field ~v¢
Square Feet of Absorption Area
Depression over Field (Y/N)
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well
To Building Foundation /'~'¢ ·
Lot
To Water Main/Service Line /'~ c-
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Type of System Design
Length of Field
Depth of Field
Gravel Bed Thickness '~' /
Standpipes Present (Y/N)
Date of Last Adequacy Test
To Property Line ~-"'/¢
To Existing or Abandoned System on
; On Adjoining Lots
To Cutbank (if present)
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.
Signed
Company '~'¢'/~
Receipt No.
Date of Payment
Amount: $ ~'
Page ~ of 2
Date ~,~'- / ~//f~"3"
MOA NO. ~-¢7'" ~ ,,,%-~' ,J-
72-026 (11/84)
Susan Oswalt
Municipality of Anchorage
Health Department
825 L Street
Anchorage, Alaska 99501
Ref:Lot 19, Block 3, Mountain Valley Estates
Dear Susan;
ii/ /85
On behalf of my client, Mr. Jim York, I have inspected the
drainage on the above referenced lot on 11/11/85. The inspection
shows that the drainage path was dry and nonexistant at time
of inspection. Enclosed is photo for your inspection. There
is no definitive drainage basin associated with this area and
the major drainage path exists 100' to the north of the septic
system. At the time of my adequacy test it had been raining
heavily. Enclosed is a statement from the owner regarding the
status of the drainage as he has observed over 4 years time.
Based on current evidence and the absence of any current drainage
I would concure that no health hazard exists. It must be realized
that the engineer cannot observe drainage channels or ground
water levels through every season of the year and therefore cannot
be responsible for anything other than current observation.
It is evident that in some areas of Alaska 'the surface and ground
water patterns may change based on the severity or combinations
of weather patterns and manmade alterations of surface/ground
water flows.
If there are any questions or concerns please call me at
my office 694-5195.
Sincerely,
Lou Butera P.E.
STATEMENT REGARDING HEALTH AUTHORITY APPROVAL
LOT 19, BLOCK 3, MOUNTAIN V~kLLEY ESTATES # 1
MUNICIPALITY OF ANCliORAGE, STATE OF ALASKA
A~ owner of the above mentioned real estate, I have observed
for over four years the small drainage located approximately sixty
feet to the south of the well. I declare that this drainage is
ephe~-~'al, that is, water flows in it for only short periods of time
during and inm~ediately following rainfall and snowmelt events.
Date ~James E. York
P.O. BOX 6650
ANCHORAGE, ALASKA 99502-0650
(907) 264-41 '11
TONY KNOWI_ES.
MA YOR
DEPARTMENT OF HEALTH & HUMAN SERVICES
October 22, 1985
Lou Butera
Eagle River Engineering Services
PO Box 773294
Eagle River, Alaska 99577
Subject: Lot 19 Block 3 Mountain Valley Estates Subdivision
Dear Mr. Butera,
Based on information submitted with your application, this Department
hereby grants a waiver to 93 feet of the separation distance from
the well and septic tank on the subject lot. This waiver is valid
for a four(4) bedroom single family dwelling.
Sincerely,
Susan E. Oswalt
Acting Program Manager
On-site Services
SEO/ljw
DA'~'E RECEIVED
I NSPFCTI ON APPOINTS ENTS (~.~f.~-~_(
TIME TIME TIME
DATE DATE DATE
INSPECTOR INSPECTOR INSPECTOR
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIO~EPT' OF l iEALTH &
825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL PROTECTION
ENVIRONMENTAL SANITATION DIVISION j[.~N 9 t981
Telephone 264-4720
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1, PROPERTY OWNER PHONE
MAILING ADDRESS
PROPERTY RESIDENT (If different from above) PHONE
2. BUYER PHONE
MAILING ADDRESS
3, LB~BI~61~STITUTION [ PHONE
I
MAILING ADDRESS
4, RE~AG~ ¢~ ~ / PHONE
MAI LING ADDRESS
5. LEGAL DESCRIPTION
;TREET LOCATION
5. TYPE OF RESIDENCE NUMBER OF~BEDROOMS
'~ SINGLE FAMILY ~ One [] Four
Two [] Five
[] MULTIPLE FAMILY Three [] Six
[] Other
WATER SUPPLY
7. '~ INDIVIDUAL*
LI COMMUNITY
[] PUBLIC UTILITY
* ATTACH WELL LOG. A well Icg is required for all wells drilled ·
since June 1975. For wells drilled prior to that date, give well
depth (attach Icg if available,)
8. SEWAGE DISPOSAL SYSTEM ~ 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
E~,,-'~GLE FAMILY [] ONE [~ THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
2, WATER SUPPLY PERMIT NUMBER
~"'~-~NDIVI DUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
Connection Verified. LOG RECEIVED
PERMIT NUMBER '7
~. ~DiAGE DISPOSAL SYSTEM
VI DUAL/ON -SITE DATE INSTALLED
Connection Verified INSTALLER
~pticTank or []Holding Tank
Size:give dimensions: ! 2.~ If Tank is homemade SOILS RATING
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line
Absorption Area to nearest Lot Line d~, ~,~/'
5, COMMENTS
APP OVED FOR .EDROOMS
[] CONDITIONAL APPROVAL {letter must accompany certificatel
[] DISAPPROVED
DATE BY ~~,
72-010 (Rev, 6/79)
D[JPAHTMENI OF IIEAITIt AND EItVII~ONMI~NFAI.. PftO1EC[ION
June 11, 1981
John L. Hopkins
431 Mellow Place
~chorage, A].aska
99504
Subject: Lot 19 Block 3 Mountain Va!].ay. East Subdivision #1
Approval for the individual sewer and water facilities
canno~ be granted until the following items have been
completed:
(1) The water ana].ysis report: needs to be submitted to
~ this office from ~he Chem Lab.. 5633 B Street, fo]:
our review. Effective June l, 1981, the ].ab fee is
$2O.OO.
) The septic tank pumped with a receipt submitted -to
this office.
,~/~(~ (3) Exposed electrical wires to the well head are in
violation of the Munic.i. pality of Anchora.le codes and
' C
' must be encased in conduit and buried. ThJ. s will
need to be reinspected when it is completed.
g-/~/ If there are any further questions, please call. this office
at 264-.4720.
Sincerely,
James S. Roberts
E~vironmental c, '
opec~alist
JSR/ljw
cc: Alaska Bank of Con~erce
Post Office Box 1185 99577