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MOUNTAIN VALLEY ESTATES #1 BLK 5 LT 2
trcev uoluzn ut Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP221200 PID Number: 050-651-14 Dwelling: ❑Q Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New F11111 Upgrade Name DIRK & MARNIE STARCK ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench ❑ Bed Mound Site Address 4242 BIRDSONG DR ❑ Other Phone Number of Bedrooms Soil Rating Total de from original grade 3 GPD/SF1 Ft. LEGAL DESCRIPTION Depth to pipe invert from original gr a Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot MOUNTAIN VALLEY ESTATES #1 5 2 Fill added above original ade Ft. Gravel length Ft. Township Range Section width GravelBeds: Ft. Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total sorption area Number of trenches Dist. between trenches From Tank Field Tank Line Ft2 Ft. Well >100'' TANK ❑e Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage Tank Capacity 1500 Gal. Surface Water >100' Material Number of compartments Lot Line >5' NA epoxy steel 2 Foundation> 0' LIFT STATION Manufacturer Capacity Remarks Gal. Alarm location Electrical installed by PIPE MATERIAL House to tank 3034Tank to 3034 drainfield Installer J Rs Drainfield CO/MT 3034 Inspector Curtis Townsend BENCH MARK (Assumed elevation) 100 ft Inspdection 1m 8/24/2023 n 8/25/2023 Location and description 3tl—_ -- 2 --__— 11 41 garage floor at door ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp ti Conditional Approval: Date u -------- — -- `,71' �. J� -- Fi ... ... .... Curtis L_T v .S rd f{ PFFA fir• Date L 2 c , a, Septic Syste,no. 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O Q)w .0 Q% O N O~++ OfC OOt wo pVa CJ•_ LO N •� O •.-+ c e wo 'y d .....0 0 c w • .n V� Caw - N O y 0 d'O O -0 N 67 E N� O O N C C - •O J c•.- N�� VV x.7.1 CL w E_ g6 o H� o c cpi m¢ a •- w E c ..o.. vLNvu>.� O Q Z' U 00—C uN C-- - d uat+o+wvoK o>> o v`dn•E o -v o '~ C14 N N N O U N nT0 Ow Nt C- ¢ N M. N m Lr W— O O V L w N L L�9 ••F 'O 2!.2 U OC C I— Q O L• m -n -.-. ~ c� d � �- c c rnw •.- o; Q JA 'O > O C1 m o+ o 3•- c•_ cvw c v o¢ m rno Q E p C ..0 •_ d •W .«, E CO± y ` Y N O L 0 O X ar vim:«oE c u y aa+L. O Q U Q O N T N C N 3 - N •l a O T O O L- TU .� _ L - .N C •i G d y CL C y�v C O C l O O O ` --- •Tw U T L N N O p •- O w U • w N d Z 0 4L ` (A 0— N.a o cv u N nu v c y•� Q y y ` w > cpc•.- O d O ® o -v �o d C U N Ci C E O t C O O •- 3 d Tw N O U O Z Z: E at a> �. E L L O L w N `o •- d C y p y d > CL m�vcoy � O O O L N w O > rt+ O C O Oi O O .D c0 ••-- o O O o` oy a EL E O -- -.•+ 0vwv�ow Nod v` v c u .� n w u�c�'.�v o w v t.._ •v •o ._ C •_ p._ ` C N U V p O N 0 61 "O Tom+ ov` nEw �'� yN72m -'`ocoi on >.+: cvoiNw o- •'-sv F- O D O z dv•- �v u vw Awa 3 E � N N N O z O M 0 � �j � t0 n Q 0h N LO v -',0 y rnW LO W y cI ©�NZ WOE mv L Z OWW N V QZJ �j U H 0 N N N O z O MUN ICIPALITY OF ANGHORAGE On€ite Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fa* (907) 343-7997 http://wwumuni.org/onsite Site Legal Address: MOUNTAIN VALLEY ESTATES #1 BLK 5 LT 2 G:0758 Site Mailing Address: 4242 BIRDSONG DR, Eagle River Owner: STARCK DIRK & MARNIE L Design Engineer: EKLUTNA ENGINEERING, LLC* This permit is for the construction of: ! Disposal Field M Septic Tank E Holding Tank E Privy Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: epa I tlrlcn t On-Site Wastewater Disposal System Permit Permit Number: OSP221200 Work Type: SepticTank Upgrade Tax Gode Number: 05065114000 E Private Well E Water Storaoe All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Ghapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (1BAAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notiFT the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (2417r. 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' ',t:';i,'.i;1". I .special Provisions: ., The tank may not be driven over. Protect the tank with bollards or similar.i' . Due to higher groundwater, a steel tank is required. {..:,, ,'j;' l:: .': ii,. ,*. 6t28t2022 612812023 65456 lssued By: MUHMPAUTY OF AHCHORAGIE Development Services Department°�'; ` Phone: 907-343-7904 On -Site Water & Wastewater Section -' Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 050-651-14 Property owner(s) STARCK DIRK & MARNIE L Day phone Mailing address PO BOX 772262 EAGLE RIVER, AK 99577 2262 Site address 4242 BIRDSONG DR Eagle River Legal description (Sub'd., Block & Lot) MOUNTAIN VALLEY ESTATES #1 BLK 5 LT 2 Legal description (Township, Range & Section) Lot Size 65,456 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) [] Septic Tank 0 Upgrade Q (w/wo ADU) Holding Tank ElRenewal ElDuplex (D) ❑ Privy El Multiple Multiple Dwellings ❑ and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municip Codes. t (Signature of p owner or authorized agent) Permit/Rush Fees: # 19 9 5 Waiver Fees: Date of Payment: (0 -(3 '2 -Z- Receipt Receipt Number: —0 z ( 30 l Permit No. ©SPaa 1 a DD Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc Eklutna Engineering, LLC cu rtistownsend @gmail.com June L4,2O22 Subject: Mountain Valley Estates #1 Block 5 Lot 2 Upgrade Septic Tank Permit Request Narrative osP22L200 This is a design narrative for a permit to install a new septic tank on this property. The existing tank is 30 years old. The homeowner is desiring to replace the tank. The proposed system will serve an existing three bedroom house. The existing septic tank will be removed and disposed of and a new septic tank will be installed. The homeowners desire a larger tank size. Double cleanouts will be provided downstream of the tank. Soils. The soil in this area is composed of silty sands and gravel. A test hole had previously been dug during the month of August to a depth of L2' . Groundwater was encountered at 9.5' depth. Wells. This lot and the surrounding lots are served by private water wells. MOA has documentation for these wells. There are no wells within 100' of the proposed septic system. Neighboring Wastewater systems. lmmediate neighboring septic systems are all +10' distant from property lines. Surface Water: There is no surface water within 100' of the tank. The proposed tank upgrade will maintain at least 100' from all surface water and drainage ditches. Topography: The existing topography in the area of the tank is 9% in any direction within 25' of the tank. The proposed installation will not affect the future development of this or the surrounding lots. Sincerely, Curtis L. Townsend, P.E. Attachments 1. 2. 3. 4. 5. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221200, Deb Wockenfuss, 06/28/22 \t\rT]AIUC CNOS CUIBII'I|*'^,ei'I>l'I'ilAtLo 't'IS\|>tIf;\IP.A,-a\-gIIIIr\lrA\I\ ,/'l\l,./t-\JaIllllllllll- --.:t./'.----,/d-/4)oO-/-e;.-::t/(/r,/-II--l -- .. ___\--r-r--T--:a::r',Jf.-r_::7-'--JN!xoi\Iuixi:\a'I?-"' IJ)c*<)Y=cnv!Yz^(J<:MU*LL>O<oo.JZ.EO- L! tLq.)Il-il=N>lrl v=E<L=-!_o\-r\ooNNNTLoF-ol\Nlf)r-Rb$o} H$E:{ r'6'& -a9*: y%frf gflfi3oY>: 7"E=s' Y3i= a=uio<.r-F6zR9sq\hb!f;istLK(JttORNF@llJtu-as56(otoLri=gBkfr6eo oa (lC)JIz.ftlrl--l>-Z?-ra)O)C) dorZ z4@L'-1 ?\<LO-?3Z-o-9F*- >gYl^,{'JidOC\< -?olrIo)*o,-Uv' ^Yr!O\ ,rf "H ?re *=tE z,ri*=+i=Ei=zV*r;'E:;F>ag=E??alAAZEi+EZ;Hg;a*-=8ts-=xl53ip=li..'xa ; gI R E=a F ;=Eiez621vi//exiai=?X9:iq:IeEEaEFF/' 5E317=fib$=zlFi:i;?F*=Lr.lgLC^/\- N-t/$=trl=UN>4kE.="4NOL;t:N L Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221200, Deb Wockenfuss, 06/28/22 Municipality of Anchorage Page I of .-~..---- DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: _-~l~.J~ IO~!~ PID Number: ~~1 Name: '~¢~ ~M~ ~¢M~ I~~ Wastewater System: ~ New ~Upgrade ress:¢, ~ ~~ ABSORPTION FIELD Phone:~.~ Ne. of%ecrus: ~ Deep Trench ~hallowTrench ~Bed ~Mound ~Other LEGAL DESCRIPTION SoilRating: O~ GPD/Sq. Ft, Total Depth from origin~r~e: LO': ~ Blook: ~~¢.Subdivisi°mv~d~ Depth to pipe bottom ~'--Ir°~ origiaall,~,gra~e: Ft. Gravel depth beneath pip~ Township: J Range: Section: Fill added above original grade: Gravel length: WELL: g New ~ Upgrade Gravel~l~ ~/ Number oJ lines: Dista~cebetw~enlines: Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: PiPe mater~l:~l~ R. Ft. ~SO. ~t. ~ Driller: Date Drilled: Static Water Level: ~ller~ Date installed:~ Yield: GPM Pump Set at: Ft. Casing Height Above Ground:Ft. ~~ ~. SEPARATION DISTANCES ~eptic O Holding U S.T.E.P. TO Septic Absorption Lifl Holding ~ublic/Private ManuJaclurer; Capacity in gallons: From Tank Field Station Tank Sewer Lines I Well j~ J ~ / ~_ ¢~ % Material: Number of Compartments: Surface wat~ I~ I¢~ ~ -- ~ ,~ ,n LIFT STATION Lot ~ I~ .~ Line /~ ~ ~ ~ "ump on" leve~at:J"~ leve~ ;t: ~h ~alarm Foundation ~1~ ~t~ ~ __ ~ P j~,,~ CurtainDrain ~/~ ~1~ ~ / ~ Pump Mak~lectrical Inspections performed by: Remarks: ~¢~ ~ ~~ BENCH MARK Location and Description: ENGINEER'S SEAL o. ~4 Inspections performed by: 17034 Eagle River_. . L~ ~oed, ~3ates: lst~~ ~,,,~,~,,~=,~,~o~~¢' ~%""~ Department of Hea~ and Human Services approval ~ ~'0~ Reviewed and approved by: ~~ ¢/~ Date: ]-~_ 72-013 (1/91) MOA 25 Permit.o. ~------'~V~I ~;~---" Page ~--- of '?~ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report / / 72-013A(2/91) MOA 25 PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW910282 DESIGN ENGINEER:S & S ENGINEERS OWNER NAME:STARCK DIRK & MARNIE L OWNER ADDRESS:P.O. BOX 772262 EAGLE RIVER, AK. 99577 PARCEL ID:05065114 LEGAL DESCRIPTION: MT VALLEY ESTATES #1 BLK T 2 LOT SIZE: 65456 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 5 L DATE ISSUED: 9/11/91 EXPIRATION DATE: 9/11/92 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. THERE MUST BE A MINIMUM OF 24 INCHES OF COVER PLACED OVER THE INSULATION. '-- / ' ISSUED BY: ~O~ ~'('77~ DATE: August 5, 1991 ROBERT SHAFER, P.E. ROGER SHAFER, P.E. CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street Anchorage, Alaska 99501 REFERENCE: Lot 2; Block 5; Mountain Valley Estates We request you issue a permit to upgrade the septic system located on the referenced property. An adequacy test was performed on the existing system on December 12, 1990 and found to have an absorption capacity of approximately 200 GPD which is adequate for a one bedroom capacity. On December 21, 1990, a conditional Health Certificate was issued. We propose two small 5' wide drainfield trenches to be terraced down the slight slope on the property and tied into the existing bed. We do not foresee any adverse effects on neighboring properties by the installation of the proposed upgrade. Sincerely ROGRR G. SHA~ER RJS/ztc 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 SCALE Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PF-RFORMED FOR: LEGAL DESCRIPTION: b~. 1~'~ 9 10 11 12 13 14 15 16 17 18 19 2O DATE PERFORMED: Township, Range, Section: ~j~.,.~ SLOPE ENCOUNTERED? SITE PLAN DEPTH? pO E Deplht0 Water Alter~ I/ t i'flonltoring? ."z... Dale: 'e~-c:!'[ Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE ~'""'~ TEST RUN BETWEEN __ (minutes/inch} PERC HOLE DIAMETER ._ FT AND ,-,z~ FT COMMENTS PERFORMED ..._ ~ ,. ,,.,~_. CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON~ITHIS DATE. DATE: 72-008 (Rev. 4/85) MUNICIPALITY OF ANCHORAGE DE. RTMENT OF HEALTH AND HUMAN SER ES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Richar~ Legg x P-~one(s) [BIockz~'' LEGAL DESCRIPTION 1Subdivision TANKS L¥ SEPTIC [] HOLDING Ma,,ula?.?er [Gapac,ty ,n g¢1~(3 . TYPE OF SYSTEM ~ TRENCH ~ BED ~ W, DRAIN [~ OTHER Peplh to pipe bottom from ~ ]olal deplh Item ongmal grade or:glnal grade ~, I FT ~ t ET DISTANCES WELL SEPTIC ABSORPTION TANK FIELD l Zo' ~'Zo WELL -- LOT LINE FOUNDATION I--! AS-BUILT DIAGRAM tShow Iocahon el '.veil. septic system, property lines, loundabon. Gravel depth beneath pipe 7 ~G so FTi t 'Z. ' FT ' WELLS PRIVATE ~ OTHER fldentitv) Total Deplh F'r Cased to Date Installed: FT REMARKS: cedily that Ibis inspeclion was performed according to all Municipal and Stale guidelines ill ellacI on Ihis dale: 72-013 (3/85) DOC Co. dba SULLIVAN WATER .WELLS P,O. BOX 272, CHUGIAK, ALASKA 99567 i TELEPHONE 6813.2759 u4~. £ ~Y I)EI'TI[ OF WELL STATIC LEVEL OF WATER FT, DRAW DOWN FT, GALS, PER tlR KIND OF CASING // ND OF FORMATION: Ft. to__Ft. From . Ft. to__ Frmn.__ Fl, to From__ F to From__Ft. Frmn, Ft. to__ Froln__F lo__ From__Fl, to From__Ft. to Ft. Et,. ,Fl, FI, Ft Ft. A: ~¢ Ft. From ~ From From, From Fronl From From_.. From From __FI. to __Fl .. Ft. lo, __Ft. Fl, to Ft. Ft. to, Ft, ISCL. INFORMATION: · Ih"IlILJI[P4t ]E C~ 1" F:" f:.~L. :'11." '"'FY II]IF-': ,-'-~IbJIL_,.IF'~tt E.] IF~.~dL-qF'Z'~ DE'.'P~RTMFN'I" OF' HEAl_TH AND ENVIROI'.MEI,.FrAL F'F~OTECTI[)N 2 6 4.'--472 () F:'EERM I T N(]: DA'IT ,I SSL ED: 84()5 1'7 06 t27/84 ~. I'T I '~. x'" 4 ..... _.[C, 4t l1: AD:[)RE!r,q S: C.{,)lll AC.,1 PHOI'.IE: RICHARD LEGG F'. [I. B[IX 109 1 E[AGL. E I:(IVE{R,, Al'::: 694"-97 11 995T7 I.,,.E:[,iAL DE:SCR ]: F': I...CIT S I ZI-Z: MAX SLIBDIVIS]:ON: MT. VAL, L}Z~ EST. LOT: 2 .SECT t ON: ~¢:]; TOWN!-]H I F': '14N RANGE: :I,W 65~6 (SQ. FT. C)R ACRES) 4 BLOgI.'.:: ~S I.,,isd:ed below ar'e the. op'Lion~..~ avail, able. 'Lo yOLt ill design J. rlg yOLtP sep~.:i;c ~.iy~t'.sm. []boos6) thB ap'lLJ, orl 'Lha'l:. best f l'Ls DEPTH TO F'IF'E BOTTOH (Fl'.) 4.0 5,,0 fl.,,O GRAVEl_. DEPI'H (F'T.) 3,, 0 (). ~ 2,, 0 TO'rAL. DEI='TH (FT.) 7.0 5,, 5 6,, 0 8RAVEL I4]:D]]-,I (FT'.) 2.5 22.0 GRAVEL. L, ENGTH (F'T.) ].00.0 '~'~ 4 ].. 0 B4.0 '~"~ GRAVIF]... V[]LUHE (CU,, YD[a. ) :;2.4 33.4 38.8 TANK S I ZE (GALS) :I, ~ 250,, 0 '~"~ ~, 25(),, 0 '~'~ :[, 250.0 *~' SOIl... Fd-YTING (SQ. F'I',, /[3R) :tSO :t50 :1.50 · ~'~ BRAVEI~ LE. I lblH :::' '75 FT. RE(,;!UIRES HULTIPI.,E RUNS (NOT EXCli-:]'B)INB 75 F'T,, EACH) · ~' TANI< MUST HAVE AT LEA.BT TWO [',OMPARI"IqE~NI'S I certi£y that: ' 1,, I am familiap w:Lth the r'equit'eme, n'Ls; fop on,--si'Le, seweps and wells as set fm'tl"l by the Municipality oF Anchor'age (MOA) arid the ~'Late of Alaska. 2. I wiI]. :i. nstall the system in accm"dance with all MOA codet~ ancl r'egulations, arid in cempliance with the de~ign c:r'itep:i.a of th:Ls permit,, 3. I will. adher'e.b~ all MOA and State of Alaska r'equipements rcm the set back dis'Larmes fr'om any ex:i. sting we:l.:L, waf~tewatee dissposal s~ys'Lem m" I:)ubtic s(,~werag[e system on this er' amy adjacent of heal-by let., 4,, I Llrld~]PS'Land f. ha'L '}.,J'iJ,~ pel'mJ.{ :i,s valid fm~ ~ maximum Of q. I:)edpooms amJ any er'llal"gemerlt w~],]. P~:~qu~pe an addlt,.iona], l:}~rtml'L. ]:F:' A L. IF:"I~ 8TA"FT. ON 1o INSTAL.LJB) II'.l AN ARF!:A [X]VERI::.D [~Y MCIA BLJII,..DIIkl8 [.,0.?.)[:.,::~,~ THEN (1) AN ELIECTRICAL I:'ERMIT AND ):N,~F'IECT]:[IN MUST BE O[¢1"AINED; (2) AD-Bt. IIL/IT; W]:I,..I.. NOT,BE APPROVED WITHCIUT AN EI_.E[:TRICAL INSPEEC"FZOI~I REF'ORT~ AND (:S) THE AF:'PL, ICAN'I": R SOl LS LOG PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14- 15 16 17 18 19 2O COMMENTS PERFORMED BY: 72-oo8 (6/79) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST [] PERCOLATION TEST /f~,~.",'&m ~i[~',~ '(&¢/A&4l~lsLoP. 5'"""'/"4S,TE5 Z,'?)p,_AN '7, q~J ~;~ WAS GROUND WATER ENCOUNTERED? · MO IF YES, AT WHAT DEPTH? NO, 1782.B Jun~ ~2, 1968 Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE (minutes/inch) TES FT AND -- FT / DATE: MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # (~.- (D*.~- ]L-'t HAA# 1. GENERAL INFORMATION (Musl be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 2; B~ock 5; Mountain Va~ey EStates; Location (address or directions) First Driveway on right on Michae~ Dr~ve (b) Property owner Car~ ' Disote~l Telephone: (home) 694-5797 Business Mailing Address P.O.Box 770210 Eagle River, A~aska 99577 (c) Lending Institution Mailing Address Telephone (d) Real Estate Company and Agent Address Telephone (e) Mail the HAA to the following address: (or check here I~,if hold for pick up.) List contact person and day phone number below; ~ & ~ ~NGINEERING ::,~:!i,~ ,~lver, Alaska 99577 2. TYPE OF RESIDENCE Single-Family ~ Number of bedrooms $ '~ 3. WATER SUPPLY Individual Well ~x. Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site,[~( 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. 72-025 (R~v. 7/88) Page 1 of 2 5. 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, I verify that my investigation o! 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 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 Telephone Address Date ..... .5~;;!,~ f~ivcr Loop I.~oad No. 204 River, ~~la~'~a ~99577 Recommend a conditional approval. Septic system is to be upgraded in the Spring 1991, for a three (3 bedroom house. ~__~ bedrooms b ¢ te Approved for Approved [.::'-'~'~:' '- , Disapproved Terms of Conditional Approval ~//¢~A¢/¢~ Conditional /72/ The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated 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. 72-028 (Rev. 7/88) Back Page 2 of 2 WELL DATA~,~,~;'~ Well Classification Well Log Present ¢:~?N) ~ Date Completed Total Depth_f'~ Cased to (¢2¢'j Depth of Grouting Static Water Level / z'/L! Pump Set At Casing Height Above Ground /'2. ~/-~ Sanitary Seal on Casing~¥N) ' Electrical Wiring in'Conduit~2'N) ~/ Depression Around Wellhead (Y~i) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot MUNICIPALITY OF ANCHORAGE (MOA) ~ Health Aulhority Approval (HAA) CHECKLIST- FEBRUARY 1984 343-4744 Legal Description: _L~---~ ~ ~ ~- // If A, B, C, D.E.C. Approved (Y/N) ~//~ "~/~1p' Yield ~f', ~ ~ f2/v~'d~ ; On Adjoining Lots 1 ~1~- To Nearest Edge of Absorption Fie,Id, op Lot ,V.?...fC~ ; On Adjoining Lots ' To Nearest Public Sewer Line I' To Nea,rest Public Sewer Cleanout/Manhole To Nearest Sewer Service Linde on Lot '~,~ "~r"~ Water Sample Collected by ~ J~ ~ ~~, ;Date I ~, "¢'2~(:;:> _ Water SampleTestResults ..~'~, ~,~--~::::,/~(2s¢~ .-----~ ~ Comments To Water Main/Service Line To Stream,~l~ond, Lake or Major Drainage Course B, SEPTIC/HOLDIN?ZANK DATA Date Installed (-~/~;~F Size StandpipeS) ~( _Air-tight C a psd. tS~N) Depression over Tank (Y~i) Pumping/Maintenance Contact on File (Y/N~..~ /,t~' Holding Tank High-Water Alarm (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well \ "'~-¢:* ~ To Building Foundation To Property Line ~.c:> t .~ To Disposal Field No. of Compartments ~ Foundati.~Cleanou~) y i.~/~bDate Last Pumped j ; for ~ / Temporary Holding Tank Permit (Y/N) 72-026 (Rev. 7/88) Fronl Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption St/rata Date Installed ~/~;'/-~ Width of Field F/~''' Type of System Design Length of Field Depth of Field .~ravel Bed Thickness Square Feet of Absortion Area "'7 ~ Statndpipes Presentd~TN) Depression over Field (Y~::p /"J Date of Last Adequacy Test Results of Last Adeq u acy Test '~¢~'¢~, ~--~~ ~ \ SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well \'"2~=~' To Property Line ~ ~ "'~ To Building Foundation/ (..~-6) To Existing or Abandoned System on Lot ; On Adjoining Lots To Water Main/Service Line ~. ~ I..~ To Cutback (if present) To Stream, Pond, Lake, or Major Drainage Course t. I To Driveway, Parking Area, or Vehicle Storage Area ~ ~ ) ~ Date Installed "Pump On" LovoI~ High Water Alarm Level at ~ Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) ~~ Pumping Cycles during Adequacy Test. **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 t. be'~te of this Date of Payment / *¢~ b Waiver Fee: $ Amount:$ --/~/~. O0 Date of Payment 72-026 (Rev. 7/88) B~ck Page 2 of 2 A3A~QS ...Lq 1138 ~ El-~) -0 rq CITY MORTGAGE C 0 R P [] R A T I ~v~r4. ~,~r~ ~ -,~ ~ P~Ol~lO~ Mr. Carl Disotell P.O. Box 770210 Eagle River, Alaska 99577 RE: Lot 2, Block 5, Hountain Valley Estates S/D Dear Mr. Disotell: City Mortgage is in nhe process of trying co close the above referenced property. We will Cscro~ one and half times the amount of the highest bid in order to upgrade the septic system for approval for a three bedroom house. We will not release the funds until a Municipal inspection and approval is provided for us. If you should have any questions please do not hesitate to contact me. Sincerely, Barbara Baker Loan Officer P.O. Box 92810 · ANCHORAGE, ALASKA 99509-2810 · (907) 563-0700" FAX 562-0889 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL GENERAL INFORMATION (a) OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date Legal Description (include lot, block subdivision, section, township, range) Location (address or directions) (b) Applicant Name ~¢'°~¢'["Dt.~'~"~[[ Telephone:Home f~_~.9~ST~"~ Business Applicant Address (c) Applicant is (check one): Lending Institution []; Owner/builder~i:~'; Buyer []; Other i'-I (explain); (d) Lending Institution Address _ Telephone (e) Real Estate Company and Agent Address ~.,~' Telephone (f) Mail the HAA to the following address: 2. TYPE OF RESIDENCE Single-Family~'[~ Multi-Family [] Other Number of Bedrooms ~"=~ WATER SUPPLY Individual Wel~[~/ 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 Onsitex~' 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 72-025 111,84) ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AN[) INFORMATION As cedified by my seal affixed hereto and as of the validation date shown below, I 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 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. llV~elephone . Address .%0 t'- ~c)J~ Date [ Z ° I DHEP APPROVAL Approved for Approved Disapproved Conditional Terms of Conditional Approval CAUTION The Mbncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11/84) MU C PAmIT OF CHO ASE (MOA) mmO T A PROV L CHECKLIST - FEBRUARY 1984 Legal Description: Date Completed Cased to ~ I Pump Set At ¥ Well Classification Well Log P~esent (Y/N) Total Depth Static Water Level '~ Casing Height Above Grcund Electrical Wiring in Conduit (Y/N) Separation Distances f~cm Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot i~t9' To Nearest Public Sewer Line If A, B, or C, D.E.C. Approved(Y/N) Depth of G~outing. -~ Sanitary Seal on Casing (Y/N)\/ Depression Around Wellhead (_Y/N)l'~J ; On Adjoining Lots ; (kl Adjoining Lots To Nearest Public Sewer Cle a ncu t/Ma nho le Water Sample Collected By Water Sample Test Pesults To Nearest Sewer Service Line on LOt~"~rff Date B. SEPTIC/HOLDING TANK DATA Date Installed -~o~.e t~4 Size ~ ~o :~ No. of Ca:~a~tments '~. Standpipes (Y/N) ~/ Ai~-tight Caps (Y/N) '~/ Foundation Cleanout (Y/N) ~/ Depression over Tank (Y/N) ~ Date Last Pumped ~J ~ Pumping/Maintenance Contract on File (Y/N) ~ ~ ; for ~ Holding Tank High-Water Alarm (Y/N) ~'~ ~ Temporar.y Holding Tank Permit (Y/N) ~ ~ Separation Distances f~om SePtic/Holding Tank: TO Water-Supply Well To Property Line To Weter Main/Service Course '-k ldY~ ~ [Page 1 of 2] To Building Fcundation ~ ! To Disposal Field ~O~ To Stream, Pond, Lake, or Major D~ainage, Receipt % Date Paid: Amount: 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date .Installed ~)~ 19~ Width of Field ~.~t Square Feet of AbsorDtion A~ea Depression ove~ Field (Y/N) ~ Results of Last Adequacy Test I ~O Type of System ,Design Length of Field ~ Depth of Field ~! Gravel Bed Thickness O.~ Standpipes P~esent (Y/N) Date of Last Ad~=quacy Test Separation Distance frcm Absorption Field: To Water-Supply We 11 l ZO ~ To P~operty Line I ~ To Building Foundation '~/O~ To Existing or Abandoned System on Lot ~$ a ; On Adjoining Lots ~O~ To Water Main/Service Line ~OO! To Cutbank(if present) TO Stream/Pond/Lake/or Majo= Drainage Course ~ ~00( To Driveway, Parking A~ea, or Vehicle Storage Area '~0! D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level Tested for ~ Electrical Codes(Y/N) Dimensions · a~ole/Access (Y/N) .~ (~ "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted BedrccmRatingA~ainst HAARequest ** I certify that I have checked, verified, or oonforn~d to all MOA HAA Guidelines in effect on the date of this inspection. Company ¢.~v-l%.-.)-~-.,~t+~c:-~-~,,'q,,:~eq_/~ 1,-~cMOA No.~ ~ i'3o 0 -,~ KB1/d5/s [Page 2 of 2]