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MOUNTAIN VALLEY ESTATES #1 BLK 4 LT 3
M ii u ii en c LL rLL 0 (DJ J M C O \\� \ 11 �� o a p dO n 01 a C) N �■ m� �, E ' O a o Y.� c N Q — m c C c N m 'O . N O L O N/ 3 m O m c N A Z N\ A Z L 0 O O N C � N/ �- E Luu _/o*• 4 �� Qi Z 2 °0O� ��c �r 0 W��� m n m mac `J c o c� c� O r ov�zN vN w p p ���5yy4 L: �L� LL LL a) N U O c O 2 Y -O c O T ;v ,�- 1 o O 12 :3m EQ co a)tL ._ w a 0) M Z LJ oE ar W T m mZ Z� = N �^ vJ cn cfl E W O m U) ❑ m c 4— m Z l� U- LL E o m c LL LL J Q O rn _O o a) Z ° Q Z N c u a) a c N Q V W Q m c E O Q. 3 N c u L c F- m cp Q'vW m , �a a ca. N-•O I— ��, fA ZLU O 0 Q)+O 3 m ° V ca--+ o� a 0 0 '5 QcU d3 a > mN ^LO L�. E ZZ ca W0 )Opoi v Y 3 LJJ 0 E z W a ncca T .0 Q. EO mj N n N N LU cl El°° O 70 C/) QO M MCD U =o m _~ \ Z \ Z � Z Z Q U H c Q a) LLIz E o m� o N o a — Lo Lo z z O a) Q J /\ /\ U O LL cn cn (n W O O L Q o O 'a :g N N C) `O .2 Lf� Lf) W a CL CN � w Q UMn a Y , U) c.) O (L >, O O O O � � W VC) O Cn C m cn� In n Ln n r A a a, H L- N Q N a`> cn v cL- c0 '_- U cn Z O Z Q O Z O E F- m W F- Q o X W: .s a Fu c U) 0)i > Z 6) C 06 , a 45 or)E J Q .3 n Q m <° U is O ��— OL N Y Q N N f9 J 7 �(0 N C O 0) Q N 3 E(B z 2 �O � a a W J n O 3 W (/)I o L LL aEi w w U U)Q p in cn �0- I I I N O la O Benjamin Schiller CE 12592 R E G ISTEREDPROFE S S I O N A L E N GINEER 1"=50' 25' LONG x 5' WIDE, 1' EFFECTIVE DEPTH ABSORPTION TRENCH 1500-GAL STEEL TANK w/ AX20 POD w/ PUMP VAULT CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE PV - PUMP VAULT SV - SEPTIC VENT TH - TEST HOLE LEGEND CO PERMIT # OSP241141 PID # 050-651-20 MOUNTAIN VALLEY ESTATES #1 BLOCK 4 LOT 3 A B CO 28.8 MH1 31.9 MH2 35.6 A B PV 32.6 POD 42.9 MT1 52.7 MT2 65.4 20.8 24.2 29.5 32.4 41.2 33.7 52.1 FEET 0 50 100 BI R D S O N G D R I V E 8/26/2024 1740 1730 1720 1710 1700 1690 1680 1670 1660 1650 1640 3-BDRM HOME WELL w/ 50' RADIUS TH#1 TH#2 MT2 MT1 PV FCO PLAN AS-BUILT MH1MH2 POD PROFILE AS-BUILT (NO SCALE) 90.2 85.7 90.7 97.8 FC O MH 1 MH 2 PERMIT # OSP241141 PID # 050-651-20 MOUNTAIN VALLEY ESTATES #1, BLOCK 4 LOT 3 AX-20 POD AND MANHOLES 1500 GAL SEPTIC TANK 104.5 FINISH GRADE 25' DRAINFIELD ROCK MT 1 TH # 2 GROUNDWATER @94.5' 5/28/24 97.0 98.0 89.5 97.0 98.0 104.0 ORIGINAL GRADE MT 2 PV Benjamin Schiller CE 12592 R E GISTEREDPROFES S I O N A L E N GINEER 9/25/2024 PO D MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP241141 Work Type: Septic Upgrade Effective Date Expiration Date: Tax Code Number: 05065120000 Site Legal Address: MOUNTAIN VALLEY ESTATES #1 BLK 4 LT 3 G:0758 Site Mailing Address: 4039 BIRDSONG DR, Eagle River Owner: SCHWARTZ MARK L & Design Engineer: FORGE ENGINEERING This permit is for the construction of: Q Disposal Field RI Septic Tank ❑ Holding Tank ❑ Privy 6/25/2024 6/25/2025 Lot Size in Sq Ft: 60750 Total Bedrooms: 3 ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. O ed and'Closod-on-th . same day, or b.,,.Govered, sealed, and heat p to prevent ee�—`--,,- ecial Provisions: • The tank is to maintain a 5' separation to any deck supports. Received -By: -Z iiuPCA '+ca /" �r� Date: Issued By: ` Date: MUNICIPALITY OF 0, Community Development Department Development Services Division On -Site Water & Wastewater Program ANCHORAGE Phone-. 907-343-7904 Fax: 907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 050-651-20 Property owner(s) Mark and Tracy Schwartz Day phone Mailing address 4039 Birdsong Drive, Eagle River, AK, 99577 Site address �� 4039 Birdsong Drive, Eagle River, AK, 99577 Legal description (Sub'd., Block & Lot) Mountain Valley Estates #1 Block 4 Lot 3 Legal description (Township, Range & Section) Lot Size 60,750 _Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (Z all that apply) Absorption Field FX� Initial El Single Family (SF) r -X1 (w/wo ADU) Septic Tank UN Upgrade RX Duplex (D) D Holding Tank ❑ Renewal Multiple Dwellings ❑ Privy EJ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. . (Signature of property owner or authorized agent) Permit/Rush Fees: 22 Date of Payment: (4) Z' Z-0 Receipt Number: Permit No. 5 L Permit App_'-'- : - I Waiver Fees: Date of Payment: Receipt Number: Waiver No. June 11, 2024 MOA Development Services, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Mountain Valley Estates #1 Block 4 Lot 3 – 4039 Birdsong Drive Septic system design Dear On-Site Services Engineer: The owner of this property would like to replace their septic system, so we are submitting this permit application for the construction of a new one. The attached site plan identifies the location of the home as well as the existing well and proposed septic location. No conflicts exist between this proposed system and any other well or septic system, whether on this lot or adjacent lots. The ground surface on the lot slopes away from the road toward the east. Near the road the lot is flat enough for a house and driveway, but then drops off at an increasing slope, between 30-60%. The proposed septic trench is located along the driveway, near the steep slopes, but there aren ’t slopes greater than 46% within 50’ of the trench. The attached profile shows the trench and the slopes for 50’ on the downhill side, and the design meets the steep slopes criteria. Contours are shown on the site plan showing the grade and direction of flow. Stormwater drainage will not impact this septic system. The new trench will be constructed parallel to the slope as much as possible. Wells on this and adjacent lots are shown. The new system will be a minimum of 50’ from all wells and surface water, and more than 5’ away from the septic tank. Please refer to the attached test hole logs, plan and profile pages for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Benjamin Schiller, PE Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241141, Deb Wockenfuss, 06/25/24 Benjamin Schiller CE 12592REGISTEREDPROFESSION A L E N GINEER 1"=50' 18' LONG x 5' WIDE, 2' EFFECTIVE DEPTH ABSORPTION TRENCH 1500-GAL ADVANTEX TANK w/ AX20 POD w/ PUMP VAULT CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE PV - PUMP VAULT SV - SEPTIC VENT TH - TEST HOLE LEGEND MOUNTAIN VALLEY ESTATES #1 BLOCK 4 LOT 3 FEET 0 50 100 NOTE: NO SLOPES >25% WITHIN 50' OR SURFACE WATER WITHIN 100' OF THE PROPOSED SEPTIC SYSTEM ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC SYSTEMS. BI R D S O N G D R I V E June 21, 2024 1740 1730 1720 1710 1700 1690 1680 1670 1660 1650 1640 DECOMMISSION EXISTING TANK PER U.P.C ABANDON EXISTING TRENCH 3-BDRM HOME WELL w/ 50' RADIUS TH#1 TH#2 MT MT PV FCO Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241141, Deb Wockenfuss, 06/25/24 MOUNTAIN VALLEY ESTATES #1 BLOCK 4 LOT 3 TYPICAL TRENCH SECTION (NO SCALE) NOTES: 1. GRADE AREA OVER TRENCH TO DRAIN AWAY 2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2' WITH 2" OF INSULATION 3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY Benjamin Schiller CE 12592REGISTEREDPROFESSION A L E N GINEER DRAINFIELD ROCK 5' 6" 6" 5'-6" 1' DESIGN FACTORS:SYSTEM REQUIREMENTS: 450 GPD PEAK FLOW PERK RATE: 4.2 MIN/IN APPLICATION RATE: 6 GPD/SF 5' WIDE TRENCH SYSTEM ADVANTEX FAP 2.0 SEPTIC SYSTEM BOTTOM OF TRENCH: 7' BELOW GRADE FLOW LINE ELEVATION: 6' BELOW GRADE 450 GPD / 6 GPD/SF / 5' WIDE * 0.88 RED FACTOR [1' DEEP] = 13.1 LF TRENCH REQUIRED (25 LF SPECIFIED) June 11, 2024 GEOTEXTILE FABRIC PROVIDE ADDITIONAL FILL TO ACCOUNT FOR SETTLEMENT 11 4" PVC w/ 10 - 1 8" ORIFICES EVENLY SPACED @ 2.5' OC Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241141, Deb Wockenfuss, 06/25/24 1"=10' SLOPE CROSS SECTION SEPTIC TRENCH Benjamin Schiller CE 12592REGISTEREDPROFESSION A L E N GINEER 46% AN GL E OF EF F L UEN T INF L U EN C E 6/11/24 2010 0 FEET EXISTING GRADE (UNDISTURBED VEGETATION) MOUNTAIN VALLEY ESTATES #1 BLOCK 4 LOT 3 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241141, Deb Wockenfuss, 06/25/24 LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 DEPTH (feet) TEST HOLE 1 DATE READING START TIME NET TIME (minutes) DEPTH to WATER NET DROP PERCOLATION RATE: (MIN/INCH) (inches)(inches) DATE OF MONITORING WAS WATER ENCOUNTERED? DEPTH TO WATER AFTER MONITORING IF YES @ WHAT DEPTH? 120 5/20 1 2 3 GM (SILTY GRAVEL) Professional Engineers Stamp: YES MOUNTAIN VALLEY ESTATES #1 B4 L3 5/15/24 050-651-20 EXTREME CONSTRUCTION 10:331 2 3 1 0 16 11:04 11:35 6' OB 30 Benjamin Schiller CE 12592REGISTEREDPROFESSION A L E N GINEER June 7, 2024 PERC TEST LOCATION TECHNICIAN: J.OPHEIM 1 4 16 7' 7.7' 5/28/2024 COMMENTS: 6" DIAMETER TEST HOLE PRESOAKED PRIOR TO TESTING SITE PLAN 4/16 USCS SOIL CLASSIFICATION WAS VISUALLY DETERMINED CLAYEY GRAVEL 1 0 1630 1 4 16 4/16 1 0 1630 1 4 16 4/16 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241141, Deb Wockenfuss, 06/25/24 LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 DEPTH (feet) TEST HOLE 2 DATE READING START TIME NET TIME (minutes) DEPTH to WATER NET DROP PERCOLATION RATE: (MIN/INCH) (inches)(inches) DATE OF MONITORING WAS WATER ENCOUNTERED? DEPTH TO WATER AFTER MONITORING IF YES @ WHAT DEPTH? 4.2 5/20 1 2 3 4 5 6 GM (SILTY GRAVEL W/ COBBLES) Professional Engineers Stamp: YES MOUNTAIN VALLEY ESTATES #1 B4 L3 5/20/2024 050-651-20 EXTREME CONSTRUCTION 3:171 2 3 4 5 6 1 0 16 3:28 3:39 3:51 4:01 4:13 3' OB 10 Benjamin Schiller CE 12592REGISTEREDPROFESSION A L E N GINEER PERC TEST LOCATION TECHNICIAN: J.OPHEIM 5 8 16 14' 9.5' 5/28/2024 COMMENTS: 6" DIAMETER TEST HOLE PRESOAKED PRIOR TO TESTING SITE PLAN 4 8 16 USCS SOIL CLASSIFICATION WAS VISUALLY DETERMINED June 7, 2024 1 0 1610 3 11 16 2 11 16 1 0 1610 3 11 16 2 11 16 1 0 1610 3 10 16 2 10 16 1 0 1610 3 7 16 2 7 16 1 0 1610 3 6 16 2 6 16 CLAYEY GRAVEL Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241141, Deb Wockenfuss, 06/25/24 x 21.0' DECK 2 STORY �+ RESIDENCEU7 c? N WITH WALHON BALCONY WRH 4.6' x 8.2' PORCH BASEMENT CARPORT BELOW 34.3' 12.0' 1.5' CAM o �f� N .(' 20.0' HOUSE DETAIL Scale: 1" = 30' Tract G-1 PLOT PLAN AS BUILT —2L SCALE 1" —=5L— GRID SW 758 Project No. 22-393/A7 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates, inc. (907) 522-6476 Phone 0000�pO� Professional Land Surveyors (907) 592-46y5 Fax kenOlansurvecom o OF A��oa� jonothanOlongsurvey.com ��P •.• S �0 I hereby certify that I have surveyed the following described property: LOT 3, BLOCK 4, MOUNTAIN VALLEY ESTATES ADDITION No. 1 (Plot No. 74-17) Anchorage Recording District, Alaska, and that the Improvements situated thereon are within the property lines and do not encroach onto the properly adjacent thereto, that no Improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible easements on sold property except as Indicated hereon. {fit Dated this the Day of Tv ZDZ'L- at Anchorage, Alaska It Is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. 49?H*& ................. ........ ?� KE�. .NG :..Q� O"`aA75202.•'o�op4 N 0 AECC963 MUNIMPAILITY(T ANCHObLAGE ADVNNCED NVAI;'rE%�'ATF.R'1'11F,A"I'MFN'I'SN'S'I'EM MAINTENANCE A,.\D REPAIR AGREENIENT THIS ',,'IAINTF.NANCE AND IULTAITZ A6RFT.\1I,_,,N'L herein t1he madc and 24 Day of --June of 20 24 , byaric bet -ween Mark Sdhwartz 1wrehi MOVSKITTU and rlw Munkipality of Anchorage. herein the'MUNICIPALI in Municipal codk� t!".140 1 WAY In condderatim, w.' fl-: In ualul coveruulb �:on: lined hervin. ffic parties to {I ",ti A�I�tc,=,,Cnt a.grCC a -S t`6ll0VVs' I Advanced Wastewater Treatment Svstenis. 'I'lic peurission to thc Owncr to viilizc 4nd opuaw an Ad"nced Wamewawr TreatmentSystern {A WW"I S jescribed zl,,, Advantex System locatedat ijcgal descriptiol) t Mountain Valley Estates #1 Block 4 Lot 3 1 MAintertaxice- Kvvairs and Alterafiows gj!Owner jekjui:ed to rcak.L under�'tand and initiai eLch s"'ection") the term of this AgreanmL he Owner shall en -iter jntoa servxL' agveeriwnf Wth an AWW I S sewice W Ha aintcamc c pro J der approved by the Ivi.imicipality or the Manni-acturcr,Th,,A IN' shall he nmimuMed in a sunkWory condition capabL of per forruing as deAgmd and proMing weald septic Mem in 4.ccordancc wiTh the equipmenCs approval for openmion in the `+1 inicipiilit�_ IsMil bete topay fo-,aJ Costs. and : ispcctioncusts. This Ac / Quxeragree.s that only rnaintenanct. and appruvtd 11?' the. NEInicipality or the manufacturer's represenzative -,vill insp-act and make any necessary mainten.anct. 1Wrt!!)a'*rS O"?,ernlitted ahera',iuns to the System, A/ I/ Owncracknowledges, that regulm mainterwricc of uD AW'WT' S reduces fine ptxential t'aihurcof Lite sstQm. which could inelde sewage bickup,and costiy repair,, (it, drantQdd wplacemen", !rev. UMMUM love I of 3 041,11 Ownw,krul. ledg, that Hie Ndumspurt, lnab rcqu�:Sr r -'Colds of aiw rpaks frow, Ili i,� c or maim1 :tt;3jicc pro� i&r 0�v"-ntr acknowl'-du-f s that the this Cor Rdlirig, to mainti-iin and TCS air ::iii AIN"N'I'S wa,,I lut im accclrdancv with A kIC' '14,60,03�, W-( agrCCS to:'�?rant tile MunicipaUp reasonable access to test nnd inspeez the UVW-1;;, The Mw-',cipalit.,. iii gi-ve at k,-�.st 24-hour notic,,. 01"'.mer it- Cc":.hut ay.' sale or Iranmifer of Ode WIt propertv %vill riot 0Curv'Tithout as nL%� errificate of On-Sitc �, -stems Appro-, A ag:-ccs that the :kVVVVQS insiiII-11-ionatte; rz1 inzenanct! h tj�'C VWW"i's vendociristaTdIler and appowd by the MuiiicipalIWC" nrc tht' gmemby gu;de] mes for the mAntenameemidi t:]mir of the Owners AWVkTS. oCT'V �VT S uircd' Y �hc ;VW - b the A'W'W I'S zp pro v a 1 1 TeML IN mi ordus AgrevrneW. shall Ng7,',n on the daze of approval by the to operarte the instilled spiem, or upon transfer of tiu.. and AM! Com bno, Tlw AWWTS is operational or until Eitic is trawAtr-rtd- 4. Nomwaken The failure oftfiC WheipalRy at arl�� J.-nex, enForce a provission of this in no nay mmmlac a waker of Me pros cion iwr in :alit" "ay akc,, .he vilidi-ky ot tie. !%,,,rccmcnt or any part hertof or the rght, (if tile ;lfliilrcpaiit ihereaft-,r to enforce evei7v provi--Ion ,erzof. 5. okmendjuent. lis A;:,.rcemunt sluill Wy W annen&d by authori7gd rvjprcscF.II6vc,'5 of Au Owwr and hit hcipalit�. Any attempt to ame-nd this 11S;recrpcllt by Citky an iT,-;auIN?rixcd rcprestututi-e or unauthorizcd riwams sha;', voi%- 6. Jurisdiction. Choice of lay; Any Wit action an"sipp, rrom °hi": N"2,re-'mew shall br b rou ht ill the Supebo r Co LITI or I llt' 111 ird J L 'dicia! District of the Si te t:tf A) aska at Anclwm;-c. 1"he lav vsof: be State afAhhu shzH govern !he rights and obEpions okhc- parres under tfti,,� Agrccrrieri'- 7 SeverahlSo Any provislim of thiq.Agrcetrent decrced iiivalid by a court of corlpeten'L j'u-'s(fic!iorl Shall noz Wiclute Me nnnaining provisionsof the AgwomeM I TCV. (S 180018) Page 2 of.1 OWNER: sy: June 24.2024 twou namo STATE OF P&ASIKA T! HRID,fl IN(] A L IA x" ThC H)rCL,'0lM!, M.MS adnwxted,�;cd befoi,c me th,"!;aq-- 6 tA-E-LODY QUESF14BEFRY pow, PwbHr J R kU B L 1 7, (19, A �A ' I/ i Stars & AQW1 'NOTARY MLIC FOR AIMAK My Comrasion ExpWos Apr 20, 2025 Nly Commission M "KIPA "I" t IN L 1 Rv� 1prini mirne) m 00.x:25 1 &2m 9) Paw 3 of I ,~ 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 PHONE ~ UPGRADE lib/ LEGAL DESCRIPTION NO. OF BEDROOMS ~2'~ A~o,'mion.r.~ ~r- D~.,in~ P~R~TNO. (2 ~ DISTANCE TO: ,~/O~. ~ '/ -- ~0~ .~ Y~ ~ Manu,acturer ~ ~.~.~ Material~..2} ~. ~o. of comp,rtmenl~ Liq. capacity in gallons Inside length Width Liquid depth /~O IF HOME.DE: ..... ~ ~ DISTANCE TO: Well Dwelling PERMIT NO. O ~ ~ Manufacturer / Material Liquid capacity in gallons ~ Well Nearest lot Jine~/~ PERMIT NO. ~ Z DISTANCE TO: ~¢~ .~/'/ ~.f Foundation ~ ~Z ~ -- ~ ¢ ~1 Total I en g~ i*}s,__ ~ inches Oistanc~en lines, ~ NO. of lines / Length of each line Trench ~ ~__ ~ /¢ Material beneath tile ~ inches Total Length Width Depth PERMIT NO. ~u ~ ~ Type of crib Crib diameter ~,//~ Crib depth Total effective absorption area ~u Well Building foundation Nearest lot line ~ DISTANCE TO: ~ Class Driller Distance to lot line PERMIT NO, ~ ~O~ ~/~ ~¢~ Depth ~ DISTANCE TO: Building foundation Sewer ]ine Septic tank Absorption area(s) OTHER PIPE MATERIALS ~l C/~g ~t SOIL TEST RATING W/~ / ,/ .// / / I ~P~ ~1~./~ ~' ,// DATE LEGAL -X ~ ~:~::U,~ (Rev, 3/78) 0~/14/1992 ~1:51 89~711~ SGTECHNICAL SULLIVAN PAGE 86 Department 825 264-4720 * * * HANDWRITTEN PERMIT * * * Permit ~ q~(-~ WELL AND~0N-SITE SEWER PERMIT MUNICIPALITY OF ANCHORAGE ~ Health and Environmental rotection _ Street, A/~chorage, AK. >¢501 Applicant: --.JO,~C~. ~-J© ~J3 Location: Legal Description: L ~ ~ Type of Soil Absorption System Is: Trench: Drainfield: Maximum Number of Bedrooms: ~ Mailing Address: Phone Number: Seepage Bed: Holding Tank Soil Rating (sq. ft/br) / The Required Size of the Soil A~sorption System Is: The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimtun depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(H'OLDI~) TANK SIZE = /(3~C> GALLONS * * Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * * * TWO(2) INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 2!5 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 8 2 * * * I certify that: 1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. 2) I will install the system in accordance with codes. 3) I understand that the on-site sewer system may require enlargement if the residence is remodeled to include more that 3 bedrooms. Ap~icant ~ Date: SWP/024 (1/81) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERFORMED FOR: ~... Xf~/)//~(~ ~.~'/b"~.~'~'~.~r".~/v' LEGAL DESCRIPTION: ~/'~¢~)/"~' ~.~ ~/~/ ~ I 2 3 4 5 6 7 9 10 11 12 13 14 15- 16 17 18- 20 COMMENTS SOILS LOG PERFORMED BY: 72-008 (6/79) [] PERCOLATION TEST SLOPE S~TE ENCOUNTERED? O P E IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop Q CD r— I,- co -It It co co r— ti CD � CD � X LLQ o cry o LL N O Q U) N U) U U) C O O Q) N U �I N O N c 0 Q x LU 0 0 0 0 N rLO W 6 LO 0 0 m U (B d c') H J J m U) w F— U) W W J J Q D G C: 0 Q U fn Q) N a) J ti ti LO 0) O7 Q O M W O U) Mme_ W cY) 0 NT a) 0 (CS a) U) U N 2 U) Q W Q 06 J F— >Q U C Q T a) 0 c 7 U c O Q cn E o o L2 m L c`7 L_ 0 o CE O O o 0 Q � Q n3 Q) •� O E > (Lo c0 m � fn C 0 a --r O a) C: H U X CD 0 N m L- 0 0 c m E O N 0 N ti N ai co 0 a) cu U a) U m c Al I O ^0O CL .Y O Q a) Q- 3 N v O O a) � � C N � cn c t H O I— a) U is N C .a O o a) C .N u OFm m cC N O OL Q. Q ca _ o Z O � E U) E 0 N t +' O +' C O 3 a) CL 'y E a) L c E c CL 0 m a) a=i O •CL =v) E a) i O a) -0O V a) Q '> N C _O O O ' > a L O O w O A O A E `o w `o 0t a) t N V L u CL N Q i Q x O D > U -0 C: Q U o a) N Q Z W O U Q I— O 2 U Q H Q I,— C) _O O') ti ti C? C? O O G) CY) A T W, L 0 a) a) C El a) a) U - L m G a) a) LL CO O a) >1 cu a_ 0 a) 0 Q aa)) 0 U_ ) M I` N a o CO m }, O U_ Q Lr) O) n/ ( ti OD O Q (U O N > "= O El O _0 N a) Ua) W+ U) c. - d O C cn Eli N �N W �+ ' C g L Ucn a) m (1) Q E U W N 0) QW C/) -0 m co C-)< U) m a) O CO V f- �,,x W 1 (6 N a) � O a O Q C U O U) O O mCU CO I O N fn",' fn '�'^^ V! � A '/� w � m _ a) ❑ > a ❑ Q. U) H w O w a c a) ❑ v j ❑ O (1)Q m ❑ > a- CO 0 ❑ m O �❑ w Q ?� W LLi- O w a Imo— 0O U ❑ �o O ElU c a`) r LL a) c Ela) U U) Ela) Y Z Q v N cu o c L O >, 0 "O cu � W Z Q (1) ❑ m El C/)L Q J W Z OL F- a O Q N M d ui 6 W, L 0 a) a) C El a) a) U - L m G a) a) LL CO O a) >1 cu a_ 0 a) 0 Q aa)) 0.71 Forge Engineering 8/20/24 N/A N/A N/A N/A Benjamin Schiller, P.E. (907) 522-7773 Advantex ai O ry O N A J 33 i6 � m d Q CLC 4 rax a Y N a E E 0 v V fff A E-� � O ry O N 0+ A� J 33 i6 � m d Q CLC 4 rax J y W J O is C Y N a E E 0 v V fff A E-� Vr� n ry O N 0+ A� J 33 i6 � m d Q CLC 4 rax J y W J O is C Y N a E E 0 v A E-� C 0 N 00 0 5.5' x 12.0' BALCONY 34.3' 12.0' 2 STORY N RESIDENCE WITH WALKOUT BALCONIES WITH 4.6' x 8.2' PORCH-1BASEMENT PARKING BELOW 34.3' 1.5' CANT- / N 20.0' HOUSE DETAIL Scale: 1 " = 30' T Tract G-1 PLOT PLAN ___ AS BUILT _X_ SCALE _ 1_ 50__ GRID _ SW 758Project No. J24-21 11&1 P.O. Box 210005 Lang & Associates, inc. Anchorage, Alaska 99521-0005 0000 (907) 522-6476 0<'=' Professional Land Surveyors jonothan*langsurvey.comQ F ken®langsurvey.com oo'� I hereby certify that I have surveyed the following described property: LOT 3, BLOCK 4, MOUNTAIN VALLEY ESTATES ADDITION NO. 1 (PLAT NO. 74-17) Anchorage Recording District, Alaska, and that the improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated this the __Day of 5 i P( E"M� �al' at Anchorage, Alaska It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. . LS -9944. N � �FfSSIONAL -� State of Alaska AECC963 Parcel I.D, #. 050-551-20 1. GENERAL INFORMATION Complete legal description MUNICIPALITYC F ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Divisionof Environmental Services On-Site Services Section P.O, Box196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING HAA# .... Lot 3, Block 4, Moun~aJ~ valley Estates Location (site address or directions) Michael Drive, South Fork, Eagle River Property owner Mailing address Le,nd[ng agency Mailing address Johanna Ar~ Ponald Tidler M 907-696-7447 Day phone Box 9878 Hiland Pd~ Eaqle River, Ak 99577 Cit~ ~bz~gage Day phone 263-0700 727 w. Ffre.~=ed Lane #120. At. borage, Ak 99503 Agent ~ zamber Day phone 694-5500 Address Jack Ute co., 11823 old Gler~ Hi.way, Eagle P~ver, Ak 99577 Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well Community well Public water ' NOTE: If community well system, provide written confirmation from State ADE.,.~'.attest- ,. . lng to the legality and status of system. . ,, ' ..., .. 4. TYPE OF WASTEWATER DISPOSAL: X '-~ :' ..../" ~' Individual on-site , ;e. ~ -~. -; - -~ - . .~" '"2~ 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 myseal affixed hereto and as of the validation da;[e shown below, I verify that my investigation of th'is Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address PO Engineer's signature Phone ~ T~77~'~'- Date.. DHHS SIGNATURE ~ Approved for ~'[J~---~(~)bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: ~,:,.:;,.,The MunicipalitY of Anchorage Department of Health and HUman Services (DHHS) issues Health Authority Approve Cert flcates based on y upon the re resentabons ~v : "~:"., , " '~ P ' g' en in paragraph 5 above by an independent pro[~s$iOfi~i engineor registered in the State of Alaska The DHHS does this as a cOurtesyto purchasers of homes and th~ r 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~I Legal Description: A. WELL DATA Well type Private Log present (Y/N) Total depth 94 Sanitary, seal (Y/N) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SEp, VF/~.( E IV E I) Environmental services Division 825"L" Street, Room 502 · Anchorage, Alaska 99501. (907) ~,3rq4-f!4 Murlicipality ot Anch.,orage Dept. Health & Human Services Health Authority Approval Checklist 7. r~lcr:k 4, /Cirri. VtAI, q,~,V ~Y~arcel I.D.: Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform 6> Date o£ sample: t'//~/¢} ,? B. SEPTIC/HOLDING TANK DATA Date installed 12/27/82 Foundation cleanout (Y/N) Date of Puniping 1/2/97 C. ABsORpTION FIELD DATA Date. iu~talled 22/27/82 Lengqr 64' Width Effective absorption area 512 ft. ~[. Date of adequacy test _1/3/97 If A, B. or C, attach ADEC letter. ADEC water system oumber Date completed Cased to 94 ' FROM WELL LOG 3/7/83 Casing height (above ground) Wires properly protected (Y/N) AT INSPECTION 1/3/97 40 ~ 39.5 ' 10 g.p.m. 8 24" g.p.m. Nitrate ~) q ~ nn.~//_. Other bacteria Collected by: Trunk size 1,000 Number of Compartmeuts 2 Cleanouts (Y/N)__ Y Depression (Y/N) N High water alarm (Y/N) N/A Pumper J-R, Eagle River Soil rating (g.p.d./fl2 or fl2Podrm) 150 . Systmn type _deep trench 24" Gravel thiclmess below pipe d ' Total depth 114" Fluid depth in absorptiou field before test (in.); Fluid depth (ins.) Mioutes later: Peroxide treatment (past 12 months) (Y/N) Monitoring Tube present(Y/N) Y Depression over field (Y/N) N Results (Pass/Fail) __pass For 3,~R bedrooms hmnediately after gal. water added (in.): Absorptiou rate = g.p.d. If yes, give date 4- D. LIFT STATION Date installed r'~rm Manhole/Access (Y/N) High water alarm level at* Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot 6T 100' Absorption field oll lot 97 ~ Pablic sewer inain nono Sewer/septic service line aT 100 ' Size in gallons "Pump on" level at* *Datunl : On adjacent lots aT 200 ' ; Oil adjacent lots aT 100 ' Public sewer manhole/cleanout Lift station norm "Pump ofF' level at* I certify that I have determined thrufield inspections and review of Municipal recor~[~a~e q~iv"e~i~,etns are in conformance with Ma4 [f~ guidelines in effect on this date. ~5~,~*~,~_ ................................................................................................. ...... F, ENGINEER'S CERTIFICATION HAAFee * ~C~,~ Date of Payment Receipt Number Rev. 8/95 OSS: baa.wk.doc Waiver Fee $ (~c~.~7~ Date of Payment Receipt Number SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 10 ' Properly line 6T50 ' Absorption field 24 ' Water main/service line 10 ' Surface water/drainage aT 100 ' Wells on adjacent lots aT 100 ' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation 10 ' Water main/service line aT 25 ' Surface water aT 100 ' Driveway, parking/vehicle storage area 50 ' Curtain drain ~ Wells on adjacent lots 6~ 100 ' Property line 50' none MUNICIPALITY OF ANCHORAGE MEMORANDUM SEPTIC SYSTEM ADVISORY HEALTH AUTHORITY APPROVAL NO. ~V~00{~ Prior to a recent adequacy test on the septic system for this lot, ~ inches of standing water was observed in the absorption field. This indicates that approximately ~0 % of the absorption area is inundated. Although this system passed the adequacy test, the remaining life expectancy may be limited. This advisory must be attached to all copies of the subject Health Authority Approval. 1/5/97 Mike Anderson, P.E. Regarding: Lot 3, Block 4, Mountain Valley Estates; (050-651-20) Michael Drive, South Fork, Eagle River A test was conducted on the above 3 BR septic system on 1/3/97. System data: sink faucet leaking for 1-2years 4'sewer rock distribution Line invert = 51" above bottom trench action level = 43" above bottom of trench tank pumped = 1/3/97 prior to test trench backs up into tank @ 53" above bottom action level -- 44" TEST PROCEEDURE: Water was added to the monitor tube at the north end of the trench at a flow rate of 8GPM. Level in the trench was 43" AB. The addition of 275 gallons caused the level to rise to 51". Trench capacity was insufficient to hold the required 450 gallons. 5 readings were taken as the level rose to avoid backup into the tank. After a 1 hr recovery the level had dropped from 51" to 49", and the trench had absorbed approximately 75 gallons. Water was added again to bring the level back up to 51". 75 gallons was added. After a 1 hour recovery the level had dropped again to 49". Water was added again to bring the level back up to 51". 65 gallons were added. This process was repeated until a total of 470 gallons were added to the trench. A total of 195 gallons were absorbed during the repeated one hour recovery periods. Level was checked 24 hours after the test was begun and a LLAB of 43" was recorded. CONCLUSIONS: During the test the trench absorbed in excess of 65 gallons per hour, which would project to 1,560 GPD, exceeding the MOA requirement by 1,110 gallons. Most of the absorption took place in the upper 2" of the trench, indicating that the trench is close to the end of its useful life. The effect of the leaking kitchen faucet on the life expectancy of the trench is unknown. ADDITIONAL PROBLEMS TO BE CONSIDERED; 1. The well is 97' from the north end of the trench. 2. The cleanout at the south end of the trench is bent at a 45 degree angle to the trench preventing verification of depth of gravel. 3. The trench is located on a slope greater than current MOA req. Closing is scheduled for the end of January. I have assured the clients that we could be submitted and hopefully approved by that date. I can be available anytime to accompany you on a tour of this South Fork property, Sincerely, Stuart Gilbert Technician Rick Mystrom, Mayor Municipality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 February 3, 1997 Michael E. Anderson, P. E. Anderson Engineering PO Box 240773 Anchorage, Alaska 99524 Subject: Waiver Request for Lot 3 Block 4 Mountain Valley Estates Subdivision Waiver Request #WR970002, PID #050-651-20, HA970019 Dear Mr. Anderson: Your request for a waiver of the required 100 foot horizontal separation of an on-site wastewater disposal system to a private well has been approved. The approved separation distance is 96.7 feet from the private well to the absorption trench (west end). This waiver approval applies to the existing on-site wastewater disposal system to well separation only. Any future upgrade to either will require all separation distances be met or another approval from this department. If there are any questions or further concerns regarding this waiver, please call our office at 343-4744. Sincerely, [J ~l~;SEPng~l;iram' On-site Services JPW/ljm:Tidler WR9 WR970002 Date Received: MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site.Services Section Waiver Review Worksheet PID# 050-651-20 January 16, 1997 HA# HA970019 Permit Applicant: Legal Description: Lot 3 Block 4 Mountain Valley Estates Subdivision Engineer: Michael E. Anderson, P.E.~ Anderson Engineering PO Box 240773, Anchorage, Alaska 99524 Johanna & Ronald Ttdler Waiver Requested: Private well to absorption trench (west end) of 96,7'~ Criteria: 1. Geology: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: Special Conditions: Points: 0,% 3. Other: Waiver is Granted: ~ Waiver is NOT Granted: List Conditions or Reasons for above: Date: *[/~/~ By: /i~ 1 ******~/~ of RevieWer 02583 295.00 1-16-97 Rec #: 02584 Amount: $ 6@5.00 ~ Date Paid: 1-16-97 January 16, 1997 Municipality of Anchorage Department of Heath & Human Services 825 "L" Street Anchorage, AK 99502-0650 RECEIVED dAN 1 6 1997 Mu.ir;~pality of Anchorage Oept. Health & Human Serviae8 Subject: Lot 3, Block 4, Mountain Valley Estates Subdivision Separation Distance Waiver Absorption Trench to Well Dear On Site Services Engineer: The well on the subject lot is located 96.7' from the west end of the absorption trench. A separation distance waiver is therefore required from the 100' separation distance mandated by Municipal Oridinance. We are hereby requesting a waiver be issued allowing the absorption trench to continue to function within the 100' protective radius of the well. The septic system was constructed in December of 1982 and the well was installed in March of 1983. An apparent mismeasurement resulted in the well to be placed too close to the absorption trench. In 1991, a Health Authority .Approval Checklist notes the well is 104' from the absorption trench. This also appears to be a mismeasurement. The actual distance was recently measured using survey equipment. The results of that survey are attached. Water quality tests performed at that time of the 1991 certification revealed no coliform or other bacteria and only minute amounts of nitrates. Well water was not affected by the location of the absorption trench. The well is located approximately 15' upslope from the absorption field. The total depth of the well is 93.5' with casing the entire depth of the well. The well Icg indicates soils at the site include hardpan and boulders to a depth of 89'. Hardpan normally indicates a very tight silty soil which would prevent effluent from the absorption field to migrate to the aquifer serving the well. Contamination appears highly unlikely. Lot 3, Block 4, Mountain Valley Estates January 16, 1997 Page Two A recent water sample taken from the well again indicated the absence of coliform and other bacteria. A minor amount of nitrate (.4.4 mg/L) was found, but well below the acceptable amount for human consumption. Obviously the effluent from the absorption trench is not causing any contamination to the water produced in the well. The overwhelming argument to grant the separation waiver to 96.7' is the fact the well water is not showing any significant sign of nitrate content. The tightness of the soil surrounding the well and the current separation distance of 96.7' is adequate to prevent any contamination from the absorption trench. I therefore recommend the waiver of the separation distance to 96.7' be granted in this instance. Sincerely, Michael E. Anderson, P.E. Attachment 01/09/1997 15:06 9076941211 S /~ND S ENGINEERING PAGE 02 CT&E ESI RNCHORRGE w 5635389 CT&E Environmental Services Inc, NO. 899 ~02 CT&E Ref,# Client Name Project Name/# Client Sample B} Matrix Ordered By PWSID Sample Remarries: Smnple collected by: Stuart 970033001 SO Technical L3 B4 Mt~l. Valley Est. gl Do~p Sink Dowl~staits Drinkit~g Water Client POI/ Printed Date/Ti,ne 01/09/97 '12:238 Collected Date/Time 01/06/97 14:00 ReceivedDate/Time 01/06/97 I5:45 Technical Director: Stephen C. Ede ParQmater ~itreto-N Total Cotfform Resu[tu PQL Unitg 0.460 o 0,100 mg/L 0 col/lO0mL Altownble Prep Analysis Method Limits Date Date Init sH18 4500-NOZF 10 n~x 01/07/97 WEP $H1D 92~ZB 01/06797 TAV DATE: TO: FROM: MEMORANDUM January 29, 1997 Jim Williams Mike Anderson, P.E. RECFIVED JArl .2. 997 Municipality of Anchorage Dept. Health & Human 8er~;ices SUBJECT: Lot 3, Block 4, Mountain Valley Estates Subdivision Separation Distance Waiver Well to Drainfield Attached is a site plan of Lot 3, Block 4, Mountain Valley Estates Subdivision which illustrates the location of the well in relation to the absorption trench. The plan also identifies surface drainage patterns on the lot. All surface drainage is away from the well and toward the eastern lot line of the property. Also included are logs from several water wells on the lots adjacent to Lot 3. The well fi'om Lot 2 immediately north of the subject property encountered bedrock at a shallow depth. The static water level in this well is noted at 87' which is lower than the 40' found on Lot 3. The ground surface in this area, however, is lower on Lot 2 and may account for the difference in static water level. Please review the attached information along with that previously submitted. We are confident the separation distance waiver can be issued in this case without compromising the quality of the water produced in the well. i=- m m i m 0,% 1o~ 3 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES 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. # ~~\ - ¢-~O NAA# ~ ~ c~ \ (_~ ¢.~_~_~_~_~_~_~_~_~.~ GENERAL INFORMATION Complete legal description Lot 3; Block 4; Mountain Valley Est~es Location (site address or directions) NHN Micha~E Property owner Mailing address Lending agency Mailing address B&n G~asso Bn:~ q,~78 Hd.gh~and Re, ad Day phone 257-1324 Eagt& Rive% Ak. 99577 Day phone Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 3 ~ TYPE OF WATER SUPPLY: Individual well Xx Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: ×X If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. ?2-025(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 typeofstructureindicated herein. I furtherverifythat 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 Address '~7034 ~.agle River Loop Road No. 20_4 Eagle River, AlaSk~ Engineer's signature DHHS SIGNATURE ~.~.._ Approved for Disapproved. ~'~/~ (/~,~ ,) bedrooms. Phone ¢~'~'~ ? ? ~' Date ~/~-~/~ / Conditional approval for bedrooms, with the following stipulations: Additional Comments The Munioipality of Anchorage Department of ~eahh and Human Services (DH~$/ issues Flealth 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 DH HS does th is 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) 8ack MOA #21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: I.D. A. WELL DATA Well type <i~¢'t'J~"CF~ Log present ~'/N) Total depth c~ 9' ~ '~ Cased to Sanitary seal(~N) ~// ...... If A, B, or C, attach ADEC letter. ADEC water system number Date completed ~/t~,'~~'' '?~¢~' Driller cl ~' I¢," Casing height Wires properly protected (~N) Septic/holding tank on lot Absorption field on lot Public sewer main Public sewer service line FROM WELL LOG AT INSPECTION Date of test Static water level WolI flow Pump level SEPARATION DISTANCES FROM WELL TO: ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform ~ c.~/i¢~..q., __ Nitrate Date of sample: SEPTIC/HOLDING TANK DATA Cleanouts ~)/N) High water alarm (Y~'~ Date of pumping /-.¢' ~,5,~ ~'~/ Collected by: Tank size ~,O00 Foundation cleanout (~/N) Other bacteria )*J ~ ~'J~-- $ & S ENGINEERING 17034 EagJe Kivar Loop Road No, 264 Eagle River, Alaska 99577 Compartments ~ ~--'¢ Depression Alarm tested (Y/N) ~'J/~' SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot ~. ~, "/.~ To property line ~ C, Surface water/drainage On adjacent lots Absorption field Foundation Water main/service line 72-026 (Rev. 3/91) Front MOA 21 CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level Meets MOA~ · S~N DISTANCE FROM LIFT STATION TO: NVell on lot On adjacent lots Manufacturer Manhole/Access (Y/N) ~ "Pump on" level at .~'~'-~"Pump off" level at ~ Cycles tested Surface water D. ABSORPTION FIELD DATA Date installed \¢.. '~'~ Length I~¢:~' Width Total absorption area Depression over field (Y,(~ Resultsd~/fail) Peroxide treatment (past 12 months) (Y/~ Soil rating I~'-'..-~&/¢,¢-- System type Gravel thickness Total depth Cleanouts present~/N) )/ · Date of adequacy test (.,, - 2. for '7""'~//¢,¢'~- ("'~) bedrooms If yes, give date "U~ SEPARATION DISTANCE FROM ABSORPTION FIELD TO: On adjacent lots Surface water Curtain drain To building foundation E. ENGINEER'S CERTIFICATION On adjacent lots ~ ~ Property line [ c~ To existing or abandoned system on lot Cutbank /"~/,~" Water main/service line Driveway, parking/vehicle storage area I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on Signature :.; & :; ~;[. ;¢ ,*-q:ER 4G 17034- ;?;¢':v [.dv.:.r 1.cop Road Engineer's Nam~agla River, Alask~ ¢9~¢ 2r~' Date .;~¢/ / HAA Fee $ Date of Payment Receipt Number Waiver Fee: $ Date of Payment Receipt Number 72-026 (Rev. 3/91) Back MOA 21 CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 Client Sample 19:L3 B4 MT VAtLg~ EST PWSID Collected 3UN 20 91 ~ 12:40 FAX: (907) 561-5301 Chant Name .S B S iNOINEZ~IHG Client Acer :$NSBNG? ~P0 $ ?0 t NONE EECEIYZD A~ly~]~ Completed JUN 21 91 Send ~epoxts to: ~aboratory $upe~leor,:STEPHEN C. EDE 1)S 8 5 ~NGIXE[R1NG Chemlab Ref ~: 912909 Lab Smpl iD: t Matrix: Allowable Sample ROUTINE $t~PLE COLLECTED BY: g.D.J. ND- None Detected "See Sampl~ Re,'~;k~ Above .y MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CER'rlFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 GENERAL INFORMATION IMUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Property Owner,/~/'~¢/O/',.~' Telephone: Home Business .Mailing Address. (c)", Lending Ipstitution. Telephone ..: Mailing Address i(d) Real Estate Company and Agent . ,,/'~ (e) Mail the HAA'to the followine address: or: Check here,~, if hold for pick up. List contact person and day phone number below. 17034 Eagle River Loop Road No. 204 Eagle River, Alaska 99577 TYPE OF RESIDENCE Single-Family ~.. Number of Bedrooms WATER SUPPLY Individual Well~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite,~[. Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 IRev 8/861 Front ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, J verify that my investigation of this Health 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 flies 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 EHG!NEEP!NG Telephone Address 17034 Eagle River L~p Road Ne. 2~ Date DHHS APPROVAL Approved for ~d/_ .~ bedrooms by Approved ~.../~ Disapproved Terms of Conditional Approval Conditional 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. Page 2 of 2 72-025 fRev 8/86) 8ack WELL DATA MUNICIPALITY OF ANCH~t~[ClPALiTY OF ANCHORAGE (MOA) ENVIRONMENTAL SERVICES iI~f~.E~l AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 AUG t 1988 264-4744 RECEIVED Legal De,~,~,~ ~7~oZ' ~ L~~--. '~ Well Classification Well Log PresentEc~N) Total Depth ~'" Static Water Level -1~\~/~1'-~ If A, B, C, D.E.C. Approved (Y/N) y Date Completed '"~/~.~ Yield Cased to q~l~ ~, . Depth of Grouting ~ Casing Height Above Ground Electrical Wiring in Conduit ~N) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field %n~Lot To Nearest Public Sewer Line / /(;:> j'~' Cleanout/Manhole ~ L ,o G?rd --k Pump Set At 6-),~---- Sanitary Seal on Casing(~/N) Depression Around Wellhead I '\ \ "/-'" ; On Adjoining Lots / C::P'¢¢ On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot Lo_c;, I jo Water Sample Collected by ~ ~ '~/p~:;~l/',~(--- ;Date Water Sample Test Results ~/~'~. %~ -- ~ ~~ Comments ~_~ ~¢ ~ ~~~ B. SEPTIC/HOL-BING-TANK DATA Date Installed Standpipes (:~;~'4) y Air-tight Caps ,~-I~N) Depression over Tank (Y(~ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic,q~loM~ Tank: To Water-Supply Well To Property Line I ¢;;' I..~. To Water Main/Service Line Course \ ~O Comments No. of Compartments '7' Foundation Cleanout f4/.~ Date Last Pumped;for Temporary Holding Tank Permit To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Page 1 of 2 72-026 (Rev 8/86t Front C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absorption Area Depression over Field (Y/~¢~ ¢//F¢---- Type of System Design Length of Field Depth of Field ~;~ Gravel Bed Thickness ~' Standpipes Presen~.~N) Date of Last Adequacy Test Results of Last Adequacy Test ~'"""""""""""""""""~/~~/ - Separation Distance from Absorption Field: To Water-Supply Well \ To Building Foundation \ Lot 1,4 To Water Main/Service Line \ ~:~ To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area To Property Line ~, ~ I'¢r- To Existing or Abandoned System on ; On Adjoining Lots ~Dc:~ I Jr--- C/. To Cutbank (if present) Comments Size in Gallons~'------.-.. "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) ~cles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all M. CA/and HAA guidelines in effect on the date of this inspection, Signed ~, & S ENGINEERING D ,~/~/0¢ ~ Rece ¢t o.(.,0,5 Date of Payment Amount: $ Page 2 of 2 72-026 fRev 8/861 Back CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. FEDERAL TAX ID # 92-0040440 ANALYSIS REPORT ~Y SAMPLE for Work Order % 8040 Date Report Printed: JUL 26 88 @ 10:05 Client Sample ID:I,3, B4, MTN VALLEY EST. PWSID :UA Collected 5UL 20 BB ~ 15:50 hrs. Received JUL 21 88 @ 15:00 bro. Preserved with :4 DEG. C Client Name : S & S ENGINEERING Client Acct; SNSENGP P.O.# NONE REC'D Req # Ordered By ; R.J.S. Analysis Completed ;JUL 25 88 Send Reports to: Laboratory Superv~or :$TEPNEN C. EDE f . 1)S & S ENGINEERING Released Ey ';;;;;;;'""'"7 ...... ................................................ Instruct: Chemlab Ref ~: 1896 Lab Smpl ID: 1 ~atrix: Water Allowable Parameter Tested Result/Units ~ethod Limits NITRA~E-N 0.41 mg/1 EPA 353.2 10 Sample ROUTINE SAMPLE. Remarks; SAMPLE COLLECTED BY Tests Performed ' See Special Instructions Above UA-Unavallable None Detected "See Sample Remarks Above Not Analyzed LT-Less Than, GT~Greater Than ROBERT A. SHAFER August 3, 1988 CIVIL ENGINEER 694-2979 HEALTH AUTHORITY APPROVALS SEWER &WATER MAIN EXTENSIONS SEWER &WATER INSPECTION ENGINEERING STUOIES WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST !~ PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN Mr. Dan Bolles Municipality of Anchorage Department of Health and Human Services 825 L Street Anchorage, Alaska 99501 REFERENCE: Lot 3; Block 4; Mountain Valley Estates Subdivision Dear Dan, Pursuant to our telephone conversation this morning, the "turbid" note on the bacterialogical water sample results can be explained. Prior to taking the water sample the house had been winterized and the well not used for a long period of time. It is not unusual for a well under these conditions to produce slightly turbid water. With continued use the water generally clears. On the referenced property there has been some work done on the house and a fair amount of water has been used. There has already been a noticeable clearing of the water from the well and it no longer appears turbid. We feel that this well will continue to clear and be well within any turbidity NTU limits, therefore, further testing of the water for turbidity levels should not be required. If you have~a~ questions, please contact ~S/ss US · MUNIcIPALiTY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION 3 RECEIVED 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 APPLIC' NT FILLS OUT UPPER HAl. Property Owner /~, '~/( .:,i .~ (~¢~ 'q % ), Mailing Addre~ ~ ~, ~. ~ ? /.? d?~) [~ ~,1/,'- .? /4 ,~' ONLY Zip Code '? ~:/~( ~ '/ Phone Address Zip Code Lending Institution /I /'-" ./)/i (, f, ~' /'"-' r' ~ /(~. Phone Address Zip Code Realty Co. & Agent Phone Address Zip Code --Street Location ,,'t-q / (~' ~ t'(,' /~',,"r~ Type of Residence ~.¢ Single Family ~J Multiple Family No, of Bedrooms [] Other Water Supply ~¢ individual Lq Community [] Public Utility Sewer Disposal [~ Individual Public Utility [] Holding Tank ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975. For wells drilled prior to lhat date, give well depth (attach Icg if available). Year Individual Installed: / C; ,~ When Connected to Public Utility: NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Zime Time q, Time Time dO Inspector ~/ Inspector Inspector ~..,~ ' \1 Inspector Field Not ee:)..~]~_ ~ ~--~,~0~'~ "Municipality of Ancharago" (,~ ) APPROVED BEDROOMS 'CONDITIONS OF Protection" ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL* BY: Soils Raling Date ~wer Installed Well To Absorption Area Well Log Received Well to Tank Septic T~k Size 72.023 (318~)