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Home My WebLink AboutMOUNTAIN VALLEY ESTATES BLK 5 LT 22 Municipality of Anchorage Page ! 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: ~uJ ¢/~o~0.~' PIDNumber: o4;o- ~/-oG Name: J~ A~ ~o~ ~ A~¢: c/o p~¢.~¢,~ ~,..r~ ~&~ ¢5r~~.>==v~".- Wastewater System: u New Address: ~ Cq 1 ~¢~s ~n~ P~, ~ ~,.~ ABSORPTION FIELD Phone: No. of Bedrooms: ' ~ . ~ ~ ~OeepTrench ~allow~ DBed ~Mound LEGAL DESCRIPTION so, Rating: ~¢¢~,0~ ~ Total Depth from original grade: ~ ,O GPD/Sq. Ft. J · ¢ ~ ~. Lot: Block: Subdiv~ion: Depth to pipe bottom from original grade: Gravel depth beneath pipe WELL: ~x~xt~ New D Upgrade Gravelwidth: ~ ~ Ft. Number of lines:~ Distance between lines:~ Ft. c~.,ifio,ti~ (P~wt~, A,B,C): Tot.~ D~t~ ~:' Tot~ .b~o~ptio. ~.~: Pip. m~ter~ah ~o / HOe~ / ~&~d~%~ / Et, Ft. ~%~ ¢ SQ. Ft. ~ P~O~ /~ Driller: ~ Date Drilled: Static Water Level:Installer: Date installed: Y] Pump Set at: Casing Height Above Ground: ~,~ ~. ~,. TANK ~ SEPARATION DISTANCES u Septic U Holding ~ To Septic Absorption Lift Holding Public/Pdvate Manufacturer: Capscity in gallons; From Tank Field Station Tank Sewer Lines ~ ¢~o~ ~ ~ Number of Compadments: Sudace Water JOOl+ ~oe~+ /~+, -- - LIFT STATION ~ Lot Size in gallons: Manufacturer: Line ~1~ ~l~ ~5 t~ ~ ~ J~o~ ~o~GE ~K ~E~Co Foundation j ~ i~ ~ i~ J H I + ~ "Pump on" level at: J "Pump off" level at: High water alarm at: Curtain ' ~ 0~ ~ ¢ _ , Pump Make & Model Electrical Inspections pedormed by: Drain ¢11 ost~ R~F C4RCEI. Remarks: ~ %~[¢ I~ ~ t~o4A%~¢ BENCH MARK Location and Description: I Assumed ~levation: Inspections pedormed by: ~g~*¢~ co~4~ Dates: 1st It/~/~e ~*'" ~c, 2nd I~/U]o~ .... ' ...... Department of Health~__and Human Services approval %.~7% .... ~;~ Reviewed and approved by:~~ ~ , . 72-013 (Rev. 9/91) MOA 25 .ERM,TsW..0.0 .UMBE.: AS ' BUILT DRAWING , ~ x, WELL i ~ I t ; .... ~ / X ~ I~ ....... m~ '% // ~" -- - /' ~--NEW ~ GALLON '~ ~ ~ ~¢~ aR UNS~ ,~ RECIRCU~TING SEPTIC ' --~ .... ~--~ ~01. ~~ TANK WII'H TRICKLE FILTER ~ -- ' qo~ NEW LJPFLOW FILTER / ', ~ 22.9 17.8 -_Z i ~P 61.2 37.3 44-.Z_ ! i MT1 ~80.4 Sa.8 ~Z ALAS~ WA~ A~ WAS~WA~ CONS~TA~S, ~C. PHONE: (907) 337-B17g/F~: (907) 338-3246 MOUNIAIN VALLEY [SIAIES S/~, LOT 22, BLOCK 5, AS-BUILT OF SEPTIC SYSTEM (R.U.F. SYSTEM) ., SHARON BARNEY 696-4745 JACK AND J.L.M. I = 40' 2 OF 3 A B C DBLi 21.3 17.7 - DBL2 21.8 17.5 - ST1 22.9 17.8 - MH '-32.3 18.3 _ 4-1___.. SP 61.2 37.3 44. C01 60.6 ~36.B 4-3. C02 ~63.2 40.0 50. MT1 80.4 58.8 71. C03 ._1_00.1 8___Q.O 93. PERMITsw~8031NUMBER:6 AS"'BUILT D][~WING PARCEL015--23~---~-21D NUMBER: ~ ~ ~ / / F{~ ~ ' I0~,14 ~ ' ~ s~v I~&u~o~ 0u~ ~W ' I ~S~ WA~ A~ WAS~WA~ CONS~TA~S, ~C. .~o~: (~o7) 33~-~/~m: (aox) aa~-3~4~ '7' ~OUNTAIN VALLEY ESTATES S/D, LOT 22, BLOCK 5, ...~/' .... ...... ~,,.]~' ~PE OF WORK: J AS-BUILT OF SEPTIC SYSTE~ (R.U.F. SYSTE~) j .... ~ ~ ,.,jet ,ey ~. JACK AND SHARON BARNEY 696-4745 11/10/g8 3.L.~. N.T.S. ~ OF ~ CAIJCEL i~L~C~J~jRIC 10410P!NLI:'YCI~l, ' AN¢;'tORAGE, AK, $~$1~; 907,34~,40~0 , 907.~46.403~ ~ An~,l',, Al,,, ',B9,304 [\~ _\7~/ DRILLING, Inc. P.O. Bo>'4-!22,i . 13]0C International Airport Road (907) 274-461] ANCHORAGE, ALASKA 99509 DRILLING LOG blike Vavra Use of Well Domestic Well Owner_ Location (address of: Tov,'nshir~,. .,a,.~_,° -.~ Section, if known; or distance main road Lot 22 Block 5 Mountain Valley Estates Size of casing 6" Static water level 17 Screen ( ); Depth of Hole 80 feet Cased to 57.25 feet r;.ro:~x~ (below) land surface, Finish of well (check one) f t.. ~.'P~ZX. X2,:. Perforated ( ~D: ). Describe screen er perforation Perforated from L, 0' t.o 4~' : Well pumping test at L gallons per (~7fi~J (minute) for of drawdown from static level. open end (. ); 1~ OPM, 31' Static Jzeda~ hours with lO0~n ~x Date of comoletion--Oc~cober WELL LOG Depth in feet from ground surface Give details of formations p?netrated, size of material, color and hardness 0 TO. 2 Casin~ stick:no ~ .? 2 TO. b . .TO. 8 2'o 60 80 _2'0 8o 2'0 2'o 2'0 .2'o , .2'0 .2'0 . Fill Organic Brovm silty Mravel with boul~Lers Note: wate~ seeps e~nm 40' tn bedrock Gre,y bedrock. : water seep~ in sporadic fractures @ 2~zo__~IEM Bedrock MUNICIPALITY OF ANcHORAG"z Dc~T Cc ":'~Ttt ?. I~NVIRO; lt,',-'t, 241 ""~ ...... C~' ~LLfJc~e No'.".. 814 &-~/~' MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, At( 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Oct 13, 1998 Expiration Date: Oct 13, 1999 Permit Number: SW98040§ Parcel ID: 050-641-06 Legal Description: MOUNTAIN VALLEY ESTATES BLK 5 LT 22 Design Engineer: 0041 AK Water & Wastewater Consulta Site Address: Owner Name: JACK & SHARON BARNEY Lot Size: 78000 SQ. FT. Owner Address: PO BOX 771242 Total Bedrooms: 3 Permit Bedrooms: 3 EAGLE RIVER, AK 99577-1242 This permit is for the construction of: [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. THIS PERMIT ISSUED FOR THE CONSTRUCTION OF AN INNOVATIVE REC,IRCULATING TRICKLING UPFLOW FILTER SYSTEM. AS A CONDITION OF THIS PERMIT, THE OWNER SHALL MAKE ARRANGEMENTS FOR THE SYSTEM TO BE SAMPLED ONCE A MONTH TFIROUGH DECEMBER OF 1998 AFTER BEING PUT IN USE. THE ATTACHED PROPERTY OWNER AGREEMENTS BECOME A PART OF THIS PERMIT PACKAGE. Received By: Issued By: Date:/~:~ ~/3 - ~;~' Alaska Water & Wastewater Consultants, Inc. 7320 East Chester Heights Circle ~ Anchorage ~ Alaska 99504 Phone (907) 337-6179 ~ Fax (907) 338-3246 Consulting Engineers September 18, 1998 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Septic Upgrade for Lot 22, Block 5, Mountain Valley Estates Subdivision RECIRCULATING UPFLOW FILTER (RUF) SYSTEM To whom it may concern: 1. GENERAL: The existing 3 bedroom home is served by a private septic system and a private well. The existing septic system is in a state of failure and must be upgraded. It is believed that the majority of this property has the presence of shallow groundwater and soils that are of marginal permeability. Given these site constraints, we are proposing to install the Recirculating Upflow Filter (RUF) system. 2. SOIL CONDITIONS: Two test hole were excavated on September 3, 1998. Test hole #1 was found to be unsuitable for a on-site septic system. In test hole #2, the soils below the organics was a ML/SP material to a depth of 3.5 feet and than transitions to a ML material to a depth of 11.5 feet (bottom of test hole). Groundwater was encountered during the excavation of TH#2 at a depth of 7.5 feet. After ten days, the monitoring tube was checked and water was found at 6.0 feet. Two percolation tests were performed in test hole #2 between the depths of 2.0 feet to 2.5 feet and 4.5 feet to 5.0 feet~ The percolation rate were measured at a rate 5 minutes/inch and 96 minutes/inch (see attached soil logs). 3. DRAINFIELD: The intent is to install a Recirculating Upflow Filter (RUF) system that will allow the use of a small drain_field in the area around a 30 foot radius of the test hole. The size of the drainfield will be based upon the previously established criteria for the RUF systems, which dictates that soils percolating between 1 & 30 minutes/inch have an allowable application rate of 4 gpd/122, and soils percolating between 30 & 60 minutes/inch have an allowable application rate of 2 gpd/122. Given the soil rating of 5 minutes/inch, a 4 gpd/122 application rate would apply. We are proposing to install a 5 foot wide drainfield that is 45 feet long and has an effective depth of 0.5 feet (reduction factor = N/A). This corresponds to an absorption area of 225 122, or an application rate of 2 gpd/ft2 (assuming 450 gpd total flow). 4. ORENCO PACKAGE SYSTEM: The STEP tank with the trickling and upflow filter will be manufactured by Anchorage Tank & Welding to meet the latest design criteria established by Orenco Systems, Inc. The point of contact at Anchorage Tank is Lowell McNutt. As with their standard STEP tank, it is equipped with a high water alarm per M.O.A requirements. 5. SURFACE WATER: There is no surface water within than 100 feet away from the proposed upgrade. 6. TOPOGRAPHY: The slope data is on the attached design. As can be seen on the design, there are no slope concerns. 7. CLOSING: I am open to any suggestions from your department that would be an improvement to the proposed system. I mn unaware of any negative impacts that this installation would impose on adjacent wells, or septic systems. If you have any questions, please call us at 337-6179. /4 Presi~e~it ~J , ~ x ~,N I_01 11 BI.OCK 5N I 0 ILOCK '~ / O~ ~~/ 1~, NN '-.. ~N MOUNrAIN VA ID' EST I , x~ / I ~ N~., N~-.. 'i / 'i XX X ~ X' I--OT , BLOCK. . 1t ~ .¢;~X ~ MOUNTAIN VALI.EY ES'I. // ~ ,8~.v' ~, N~ ...... lOT 11 BLOCK 3 ~ I , ~r' ' . -~... ~ , ~/F:LL MOUNrAIN VAI_LF.Y I:~[. t~, I / v i L.OT3 s ~S~ WA~ AND WAS~W~ CONS~TA~S, ~C, 7~20 E. 6HE~rR HEIgmS ClRO~, ANOHO~gE, AK g9504 ~ ~ · · .... LEOAt. DESCRIPJION'. MOUNTAIN VALLEY ESTATES, LOT 22, BLOCK 5 /':' :' "l 't/ ' ,'f-'l. ..... SITE PLAN ~ · ~RFPARED FOR: PHONE NUMBER: 'Ot,~-~'. C~'7953 ..' fiHARON BARNEY Bg~-¢745 ~ACK AND '4[I,~. '". ' .'" ~'~ J.L.M. 1 = 100' 1 OF 5 '~XSx~'Ote~s~°~ i NOTE: TRENCH SHALl_ BE IN!~TALLED PRIOR~ \ i '10 INSTAL.LIN(~ REMAINING PORTION 07' THE X " ~-~'-'~ ~ ~ SYSTEM TO CONFIRM SOIl_ CONTINUI'~. %~ / ~ (SEE DETAIL, PAGE 4 OF 5) ~ ..~' TH¢2~ ~0 PROf OSEI)DI~AINFII~LI]. EXCAVATE ..... ~ WIDE BY 45 LONG MINIMUM. ADD 2 FEEF ~ MINIMUM OF %¢IN'rER ROAD ~AND" (CENfEI~I_ ~ PAVING PRODUC~) AND '[HAN ADD 6 INCHES~ ' CLFAN, W~SHED S~'¢ER I)F~INROCK BELOW ~ ! TIlE PIPE AND 2 INCIIES ABOVE ]HE PIPE ~ ~ (SEE [)~:r~t_, PAOE 5 OF ¢0. PHONE: (007) 357-6179/F~: (907) 3~B-5246 LEOAL DESCRIPTION: MOUNTAIN VALLEY ESTATES, LOT 22, BLOCK 5 DESIGN OF THE SEPTIC SYSTEM UPGRADE (R.U.F. SYSTEM) m~:PA.EDJAcKFO,,:AND SHARON BARNEY PHONE696_&745NUMBEm J.L.M. 1 = 50' 2 OF 5 ~'> INLET ~ ~ ] ~,~ ~, OLJ-]-I ET! CONFIGURAIION~ '[RICKLE FILLER ~ ~TRICK[ING flL.~Tl~ X O IT X.QU'r ' II I~ I1' ~ ~-- --MANHOtE ................ ~ (5~:E NmE) HOLE: 1500 OALLON 'rANKS FOR .~. 7320 E. CHEER HEIGHTS CIRCLE, ~CHO~GE, ~, 99504 PHONE: (907) 337-6179/F~: (907) 33e-3246 ." . h MOUNTAIN VALLEY ESTATES, LOT 22, BLOCK 5, ~,¢.;,,.I',E~,.L% 1: ...... ~,.,~ P~N AND PROFILE OF RECIRCULATING SEPTIC TANK JACK ANDSHARON BARNEY 696-4745 u~'.... -[ ....'¢~ ~,--~ C:HAMDER 0 INSIDE ?~ OUT ~AI. TAR PITCH 4'xB' BOARD INSUt. AqON (~.~) - ~ ~ ~ ~~2~>~x~.~x~y~x~>2~)>~ , = ~.~ dim OAP , -~z I,,,, · :' ': ..'" .: '~ M ] ~ ~M a~~U ~ ~ ~::' :~ :;::~:' ::':: :}:' :-:'.::: ~ OU'FLE' '- 3" MIN. OF SEWER-~ ' ' : .:: ': ':' ' ': : ':' ' : '-: ' 1HE I]OTTOM OF 'file : ', :' 2M ~ SAND:.: .' · ': .'. ~ [ LJ DIS~flBU'ilON I_INE, : : : ::;: (AS~O BLOCK PEA) : .... J : '' ~':' ' '157 eu~ie FEET ":::' ~_ QLEANOUT SEPIIC TANK IN LET ~AS~ WATER & WAS~WATER CONS~TA~'S, ~C. ~~'~c PHONE: (~07) 337-~179/F~: (907) 3~-3246 " LEGAL DE~ORIPTIO~: MOUNTAIN VALLEY ESTATES, LOT 22, DLOOK 5, PkAN AND PROFIkE OF UPFkOW FILTER J.L..M. N.T.S. 4 OF 5 ~ PLAN V~[SW Mf C0 ~ ........ PR. OF~ LE V~F~3~,/ ~AS~ WA~R & WAS~WATER CONS~T~TS, ~C. ~=~ OF A ~ MOUNTAIN VALLEY ESTATES, LOT 22, BLOCK 5, '~:~]~.~..,..){~j~){ .... " DETAIL OF P~N AND PROFILE OF DRAINFIELD ~RFPARED FOR: PHONE NUMBER', JACK ANDSHARON BARNEY 696-~745 ALASKA WATER. 8,:: WASTEWATER. CONSULTANTS, INC. - PHONE (907) 337-617g * FAX (907) 338-3246 I SOIL LOG - PERCOLATION TEST1~0,:' JCJ~H_/I~~;~,'5,:.:j¢ H R/ '"]7,'0-, LEGAL DESCRIPTION: MOUNTAIN VALLEY ESTATES, LOT 22, BLOCK 5, '~/'-"~'],'.~'~'"" PERFORMED FOR: JACK AND S,ARON BARNEY/ ~/~X-7'-~ -~ ~rn.,~' ~~'H'~"~'"~--'-'.:'"'; DATE PERFORMED: 9/3/98 7~-~9~"--.7 (*~ot) ~ TFS¥ HOLF #~ uh ............. FILL 2-- SOIL CLASSIFICATIONS ', -"-. )% ~L~A,N ...... ', ',,//.., Lr: ,o0 ~ GP ,~ ML :.;iiFi~i ORGANICS '" GC OL 'k ~,.~,~/'* /I "'% "%" ~2 % % ....¢,---EX S' NC, ' 7-- "~, ~,' DEPTH TO ~-, !!! i! ML GROUNDWATER DATE -.. ..... ¢ ,,I~ 9/~/.~ : ~..~"~"*-' 6.5' 9/4/§8 9-~ B.O,H. ]]]]~]~ 5]~ ~.,,..'~, ....... ]""~., , 'r .PROPOSEI) , : (.%I~ DESIGN, PAOE2 OF 5) J 10-- ;\ 11 I DATE READING CLOCK NET TIME WATER LEVEL NET DROP TIME (MINUTES) READING (INCHES) 12-- 1~I 17-- 18-- 19-- PERCOLATION RATE - (MIN,/INCH) PERC. HOLE DIA. 6" (INCHES) 20 I ~ TEST RUN BETWEEN - FT. AND -- FT. COMMENTS: UNSUITABLE FOR ON-SITE SEPTIC SYSTEM. PERFOMED BY ALASKA WATER & WASTEWATER I, , CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: DEPTH TO GROUNDWATER DATE 7' g/5/g8 6.5' 9/4/~8 7320 ~' CHESI~R HTS. CIRCLE * ~CHORAGE, AK. ggS04 PHONE (907) ~7-8179 * F~ (907) ~a-~2~ ~GAL DESCRIPTION: MOUNTAIN V~ ESTA~S, LOT 22, BLOCK 5. DATE PERFORMED: 9/3/98 f"")' t~ [TEST HOLE 4 GC OL SH OH ~%~ / ~ ~/ ~'~c- GROUNDWATER DATE ~--~ -~. X ~ A ML 7.~' e/3/e~ ~H S.O' ~/4/aS , ', ,, 10 11 BATE RE~IN6 CLOCK NET TIME WATER LEVEL NET BR~ TIME (MINUTES) RE~IN6 (INCHES) 12 9/4/98 1 1 :~2 UPPER 2 2:02 50 MIN. O' 6' 13 -B'~'C'H 3 2:03 ~ 2:33 30 MIN. 0= 6' 14 5 _ 2:3~ ~ 6" 6 3:0~ 30 MIN, O" 15 9/4/98 1 1:35 16 LOWER 2 2:05 -BEN~ 3 2:05 17' 4 2:35 30 MIN, 5" 7/16' 5 2:35 5" 18 6 3:05 30 MIN, ~-11/16" 5/16" 19 ~RC~TION ~TE 5 · 96 (HIN,/INCH) P~C, HO~ DI~ 6' (INCHES) 20 TEST RUN BE~EEN 2.0-2.5 COHHENTS: aO~ PERC BENCH~ WERE PRESO~EO 4 HOURS PRIOR TO ~. PERCO~TION ~ ON LOWER BENCH W~ FOR PERM~LI~ PURPOSE ONLY. PEEFOMED BY A~ WATER · W~T~ATER I, , CERTI~ T~T THIS W~ PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIP~ GUIDEUNES IN EFFECT ON THIS DATE. DATE: DEPTH TO GROUNDWATER DATE 7.~' ~131~ ~.o' FROM : ALASKA WATER & WASTE[.#qTER.. PWONE NO. : 90?3383246 1998 ~5:26PP1 P3 Rick Mystrom, Mayor Municip- ty of Anch.orage Department of Health and Human Services 825 "L" Stree[ P.O. Box 196650 Anchorage, Ateska 99519-6650 htlp;//www,ci.anuhorage .ak.us Dear Itomeowner/Prospective Buyer: The on-site wastewat~ disposal 3ystem you are purchasing/installing is ~m "sirra'native" wastewater disposal system, ]"ais system, M~own as a "Recircula6ngFtJpflow Filter ~eptie System", is undergoing testing within the Municipality of .~nchorage under the Alternative System section of the Was[ewater Disposal R. egulatiens (AMC 15,65). There ate certain risks involved with the ownership of one of these systems: 1. The t~ctmology used in Ibis system has been ~hown to be effective in other areas. The system is currently und~gt~ing a two year ~esting period in Anchorage ~mder the guidance of the Departrnent of Health and Human Sea'vices (DI32I-I$) and the Stat~ of Alaska Department of Env/ronmentaI Conservation (ADEC) to dcten~ime Its effectiveness in a subarctic environment. 2. The system for this propjet, reeuived a vertical separation distance waiver from both Sta~ of Alaska and Anchorage MunlcipM Codes to gzound water. This waiver ,vas granted due to the system's expected perfomma~e within the: s{to conditions on tkis propen'y. I (w~) eertit'~7 that I (we) have read ~e above stat~Taents and am (are) aware of the risks outlined, I (we) also c.m'fify that I. (we) am (roLe) i:n the. process of purchasing (property legal description): .............. Notarize Here State of ~~ ~¢3_d~_~ Personally appeared before .me. who im p~:rsonally krtewn to me who,e ~a,~y ~ proved on the · rhoee identity I proved On £e be the signer o~ ~he r[be¥e document, and he/she ackho~ledged that he/she signed -- ~Z/ No taf~~Publie--~ ~00~ aH H&VI,$,:I qVHH Vi$IA 1,9P96~9 XVd 9[:~'[ NOI~' FROH : ALASKA HATER ~ WASTEWATER .... PHONE NO, ; S073383246 PB~OPERTY OWNER AGREEMENT FOR TI~ MAIN'I~NANCE OF A.N ON-SITE WASTEWATER DISPOSAL SYSTEM This agreement is made/bt th~ purpose of maiutain~g eax on-site wastewat~ disposal system on I'Ve subject property. The ~rol~e~7 ow~e~ a~ree to tl},~ following: Submit to the Municipality of Anchorage, on au opera,on ~m~ent ~om a regarded profession~ ~g~e~. operation m~temen~ s~J ,teri~ ~at ~e eng~e~r p~ps, ~ers, ~d ~, ~d ~at ~y deficiencies have been r~ ~d ~t ~e sys~m ~ ~cfio~g ~ d,:si~. ~t~ N~ne) .................................... Notarize Here 2~T.E who i~ personally kno~ :o me ~ whose id~nti~y I ~ov~d on the basis of~~~ ..... whose ldal~tizy I provdd on ghe bagh/afffrmat~on of g00~ HH H&V$S~ qV~ V~SIA D9~9689 XVH 9I:g[ NOI~ 8fi/lg/60 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 [~NEW [] UPGRADE MA:L,NO^DDRES8 LLo,/ ¢ LEGAL DESCRIPTION 'Om,ON IlWel] I DISTANCE TO: Ov I ~ ~ Manufacturer ~ _ ~ Uq. copacitg in ~allons I ....... I0 O0 ....... EMADE: 5,.~ I DISTANCETO' IWell ~Z I ' I ~ M~.ur~tu~.~ ~ We ~Z I DISTANCE *O: I ~ [ No. or lines/ I Len~;h%f ~ach line Top ot tile to fi.ish grade Length Width ~ /Class Depth ~ ] DISTANOE TO BuildMg foundation Absorption area Inside length Dwe ng Foundation ~0 Total length of lines Material beneath tile Depth Width PERMIT NO, No. of compartments Liquid depth PERMIT NO. Material Liquid capacity in gallons Nearest lot line Trench width ~/~ f inches inches Distance between lines Total effective absorption area bV'7 PERMIT NO. Crib depth Total effective absorption area Building foundation Nearest lot line Driller Distance to lot line PERMIT NO, Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS ~AcT E SOIL TEST RATING' /7~ INSTALLER APPROVED 72-013 (Rev. 3/78) DATE LEGAL ~/~-W DRILLING, Inc. P. O, Box 4-1224 * ]3]0C International Airport Road (907) 274-4611 ANCHORAGE, ALASKA 99509 DRILl. lNG LOG Well Owner Mike Vavra Use of Well Domestic Location (address of: Township, Range, Section, if known; or distance main road Lot 22 Block 5 Mountain Valley Estates Size of casing 6" Static water level 17 Screen ( ); Describe screen or perforation Perforated from h0' to ~5': Well pump/ng test at, 4 gallons per ~ (minute) for 1 of drawdown from static level. Date of completion 0clober 2, 1~82 .Depth of Hole 80 feet Cased to 57.25 feet ft.i ~ (below) land surface. Finish of well (check one) Perforated ( xxx ). 1~- GPM, 31' hours with open end (- ); Static J~_eve 1 WELL LOG Depth in feet from ground surface Give details of formations p~_netrated, size of material, color and hardness 0 TO. 2 Casing stickup 2 TO /* 4 TO 8 s TO 55 55 TO 60 60 _TO 80 _TO TO TO .... TO .TO. .TO. .TO ,TO. Fill Organic Brown silty gravel wiih boll]xieors Note: wa.ret saeps Crnm I:O' to_ bedrock Gr~¥ bedrock : water seep~ in sporadic fractures @ 2~ GP~ Bedrock ~UNICIPALITY OF AblcHORAt)~- : ,,O, 2CT!O~d ENVIROi lh,',~h ;,* .... .TO IJ~'-.~[:,EF.'S-;..TFI~ £:, I-HI:IT TF~ ~".lLl~-~ ."~ C: ]:.. F'l-.'.:~L. :[ DEPFIRTMENT OF HERLTH FIN[.', EN',/IRONMENTFIL PROTECTION 825 "1._'" STREET, ANCHORFIGE,, FIK. 99501 264-4720 ( 820988 ) PERMIT NO. BPPLICRNT LL. O9D CROW CONST 12~7 W ±t RV RNCH LOE:FITION ER LEGRL LT22 BLK5 MTN VRLLEY EST LOT SIZE TYPE OF SOIL FIBSORPTION SYSTEM IS: TRENCH MRblIMLIM NUMBER OF' BEDROOMS = ~ SOIL RRTING (SQ FT?BR)= THE REQUIRED SIZE OF THE SOIL RBSORPTION SYSTEM IS: 279-5205 40000 SQURRE FEET THE LENGTH DIMENSION IS THE LENGTH ,.'.'IN FEET) OF THE TRENCH OR DRFIINFIELD. THE DEPTH OF Fi TRENCH OR PIT IS THE DISTBNCE BETWEEN THE SURFBCE OF' THE GROUND RND THE BO]'TOM OF THE E::.~CFI',,,'FITION (IN FEET). THERE IS NO SE]' 1.4IDTH FOR TRENCHES. THE GRBVEL DEPTH IS THE MINIMUM DEPTH OF' GRFI',,,'EL BETWEEN THE OU'TF~LL PIPE BND THE BOTTOM OF THIS E~:CFI',,,'FITION (IN FEET). PERMIT FIPPL. ICRNT HRS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE INSTFILLRTION INSPECTIONS OF' RNY WELLS RD..TRCENT TO THIS PROPERT'T' RND THE NUMBER OF RESIDENCES THRT THE WELL WILL SERVE. ....... Ti,J,] .:: 2 ) I I'-.l_"E... P E [: T I Ol'-,IS FIF..:E F..: E ¢.=l LI I: F-:E [-'. ....... BRCKF."ILLING OF RN'¢ SYSTEM WITHOUT FINRL INSPECTION FIND FIPPRO'¢RL BY TFtIS DEF'RRTMENT 1.4ILl. BE SUBJECT TO PROSECUTION. MINIMUM DISTRNCE BETWEEN R I.,.IELL RND RNY ON-SITE SEI.4RGE DISPOSRL SYSTEM IS :.t. E10 FEET FOR R PRI'v'RTE HELL OR :].50 TO 200 FEET FROM Fi PUBLIC WELL DEPENDING UPON THE" T'¢PE OF PUBLIC WELL MINIMUM DISTRNCE FROM R PR I ',,,'RTE WELl. TO R F'RI",,'RTE SEWER LINE IS 25 FEET RN[:, TO R COMMUNIT~r' SEWER LINE IS 75 FEET. OTHEF.'. REQUIREMENTS MR"¢ FIPPLN". SPECIFICRTIONS RND CONSTRUCTION DIRGRRMS RRE R'v'RILRBLE TO INSURE F'ROPER INSTRLLRTION. I CERTIF:"r' THRT 1: I RM FRMILIRR WITH THE F,'.EL~4UIREMENTS FOR ON-SITE SEWERS RND I.'.IEL,LS FIr:'] SE]' FORTH BY THE MUNICIPRLITY OF RNCHORRGE. 2: I WILL. INSTRLL THE SYSTEM IN RCCORDRNCE WITH THE CODES. ~:: I UNDERSTRN[:, THRT THE ON-SITE SEWEF.'. SYSTEM MR'¢ F.:EG~.UIRE ENLRRGEMENT IF THE RESIDENCE IS REMODELED TEl INCLLIDE MOF,'E THRN 3: BEDROOMS. s I GNEr:,: ....... RF F'I.~]:RNT LLGYD E:RGI.,~CONST '" "' r ~ · 6, .A'rER AN¢IIORAGE AREA BORO[t,,,~ '~' ' , ~,...~--.., '~ DEPARTHENT OF E~JV,r, RONMF, TA~ 0~.;',~[ li'Y Case ~ D.'~J '~/ 3330 C Street" ' '' -- .~/~ -.ANCHORAGE, ALASKA 99503' .. ,.. . ~ ' ~ .~ .. . Eegal Description: Lot 7~.Block__~_Subdivis~.on M~m~_~e_~r_ This Form Reports Soils Log 2~ Percolation Test DepthSOil Tes~ Hust Be Lo~ged To 4' Below Proposed Seepage System - Feet Soil Characteristics '~,~ ~F:~: ~'~--~ Nas Ground Water Encountered? ~ ~ . I'f Yes, At What Depth? ., Reading Date Gross Time . Net Time ~'*'~:~}~z ~6h- Net Drop Pe~'cola[ion. Rate ([ ' ' M) n :. - =-[2~ -~.-,,.~u. :;..:~ . Proposed Install~'~i6-~: Pit ura~n eield Depth of Inlet ~' Depth to Bottom-~Pit Or l'eSt Performed BY__~22~=: ~-- =~L~ ...... Date C'ertifieDate~5~Th:_~:__d BY:,''X~--"m '- 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. # 050-641-06 x'' 1. GENERAL INFORMATION Complete legal description Lot 22; Block 5; Mountain Valley Estates Location (site address or directions) Mile 5.5 Hiland Rd. Eaqle River, AK Prope~yowner Jack & Sharon Barney Day phone 696-4745 Mailing address c/o Prudential Vista Real Estate Eagle River, AK Lending agency Mailing address Day phone Agent Eva Loken/ Prudential Vista Day phone 689-6476 Address "16635 Centerfield Dr. Eagle River, AK'- 99577 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: XX If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-02§ (Rev. 1/91) Front MOA #21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I 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 ccfnpliance with all Municipal and State codes, ordinances, and regulations in effect on the date ~[ this inspection. Name of Firm Address Engineer's signature ALASKA WATER & WASTEWATER CONSULTANTS, IS TO BE PAID ~ 2~7~-- AT CLOSING FOR ENGINEERING SERVICES PERFORMED. DHHS SIGNATURE ./~v' Approved for bedrooms. Circle Phone Date INC Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments Date [' 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 satis~ 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 ~21 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES~u Environmental Services Divis on .... 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Legal Description: A. WELL DATA Well type 10 Log present ((~i~'N) Total depth Sanitary seal ((~) Health Authority Approval Checklist ~h~t.~¥ E~-T~-r~s ~ L.o-r ?-'z~ Parcel I,D,: Date completed Cased to ~-/,2.~' oS'o-Gql - o G 1 7_. + Date of test Static water level If A, B, or C, attach ADEC letter. ADEC water system number Casing height (above ground) Wires properly protected (~N) FROM WELL LOG AT INSPECTION g.p.m. Well production z./,o g.p.m. ?:,, o WATER SAMPLE RESULTS: Nitrate I. Collected by: Coliform J Date of sample: ~t /~.) B. ~I.li~B#~IG TANK DATA Other bacteria A.¢. ~J, c. Date installed Tank size ~ Number of Compartments Z- Cleanouts (~N) ¥~-~ Depression (Y/~) /'J ~ High water alarm (~/N) '{~' Foundation cleanout (~fN) Date of Pumping r~ ~ ¢ Pumper Date installed "/,o/~ Soil rating ~~) Length ~ ~ Width ~ Effective absorption area ~Z~'~ ~,o Systemtype ~R~,~_o~ Gravel thickness below pipe O. (; Total depth Monitoring Tube present ~N) Yz~ Depression over field ~ Results (Pass/Fail) For ~ bedrooms Date of adequacy test Fluid depth in absorption field before test (in.); - Immediately after ~ gal. water added (in.): Absorption rate = If yes, give date .g.p.d. Fluid depth (ins) Minutes later: ~ Peroxide treatment (past 12 months) (Y/N) ~ //"'-, 72-026 (Rev. 3/96)* LIFT STATION Date installed Manhole/Access (~/N) High water alarm level Cycles tested E. SEPARATION DISTANCES ~000 Size in gallons ' ~--'~ - "Pump on" level at* Ac-r~,'feo "Pump off" level at* *Datum ¢o~--ro,~ o,¢ T'~ Absorption field on lot Public sewer main Sewer/septic service line SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/t~,~,g tank on lot, I ~ ¢ On adjacent lots On adjacent lots Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/~ TANK ON LOTTO: Foundation J L~ Property line '~'¢' ~ ~ Absorption field .~o ' +- Water main/service line h3t + Surface water/drainage J~o"~' Wells on adjacent lots J0o~ + SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line '~'7 ~ ~ Building foundation ~0 ~:~ Surface water ~ °o~ -I" Curtain drain in conforma~ w , Signature ~ Engineer's Nam~ ENGINEER'S CERTIFICATION/.¢// n~l/fpru find inspections ~~n effect., on ,his date. Water main/service line Driveway, parking/vehicle storage area Wells on adjacent lots I co ,Iold- and review of Municipal~t~ C,~,,,l ~;r terns are HAA Fee $ ~ ~ ' [T--~ Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* 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 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Complete legal description Lot 22; Block 5i Mountain Valleq Estates Location (site address or directions) Mil, e 5:5; :Hi,a, nd Road Eaqle River, AK 99577 Property owner Mailing address Lending agency Mike and Karen Vavra ~c~ C/0 Anchorage Cold Storage 500 West Ist Anchorag6, AK Day phone 99501 Day phone 694-5915 (h) 264-0202 (w) Mailing address. Agent David Zaboroscki¢/Polar Realty Address 1101 E. 76th, Saite "B" Anchorage, AK Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well ×XX Community well Public water NOTE: Day phone 249-7681 99518 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: XXX If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Fronl MOA #21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of tile validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my inves_ti_gation 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 ENgI~ER~'I'~6° ~ ,4 , 17034 F..~gl.~ River Logo/fC'l,toacl ~. 204 ~aaress ~.¢e ~/ //Rive"' Alas~¢77 / Engineer's signature ,~/~' D~S SIGNATURE Approved for bedrooms. Disapproved, Conditional approval for Phone Ho. 1457-~ ,2 .;~"" .~'~ bedrooms, with the following stipulations: Additional Comments Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (ROY, 1/91) Back MOA #21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL OHECKLIST A, Well Data Well type ~¢-~'J >--3'-¢- If A, B, or C, attach ADEC letter. ADEC water system number Log present(~/N) Total depth Sanitary seal ,~/N) Date completed \ o - ?_ ~ Cased to .5-7. 2 ,~-/¢¢.,~,¢ f:o'-¢,~asing height Wires properly protectedd~/N) FROM WELL LOG Date of test t,O ¢7.- ¢'15'-Z~ Static water level /"~ ~ Well flow 4. O Pump level1 ~..) ~,z__ SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main ~,t~ Sewer service line g,p.m. AT INSPECTION MuNICIpALITY OF \ ¢~ ' ~,~,~O,%Mr:NTAL SERVICES DIVISION REC[IV[D ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform ~ Nitrate Date of sample: '~ ~ '7~o ~ c[ -~ B. SEPTIC/HOLDING TANK DATA Date installea /~ ~'?-'- Tank size Collected by: Other bacteria $& $ ENGINEERING 7034 F.a!lie River Laop Eagle Eiver, Alaska 99577 \ oo ~ Compartments Cleanouts ~/N) '~ High water alarm (Y/~ Date of pumping Foundation cleanout (~f/N) ~ Depressio8 (Y~.~ Alarm tested (Y/N) "1 ~ 'J..-~ ~ ~"5 Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot \o~ ~ ~ On adjacent lots To property line '~. o \ ¥ Absorption field Sudace water/drainage \ o ~ Foundation Water main/service line 72-026 (3,'93)' Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) Manufacturer Manhole/Access (Y/N) "Pump on" level at "~" Level at High water alarm level .~~Cydes tested Meets MOA electric~ SE~TANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION F ELD DATA Date installed Length L¢ Total absorption area Date of adequacy test Water level in absorption field before test Peroxide treatment (past 12 months) (~) Soil rating (GPD/Ft2) Width ~"-~-- ~ Gravel thickness <id 4 Cleanout present (~/N) '-]- '2_ \ ~-c~ 3 Results~fail) After test If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: System type Total depth "7 Depression over field (Y(~.) r~ for "~ Bedrooms Well on lot To building foundation On adjacent lots Sudace water ~ o~ Curtain drain ~o ~ 6- ¢-~"¢'~,~\ E. ENGiNEER's CERTIFIcATIoN On adjacent lots \ c~\ ~ Property line · /¢o~ To existing or abandoned system on lot ~/ /~ Water main/service line Cutbank Driveway, parking/vehicle storage area ~o I certify that I have checked, verified, or conformed to all MOA and HAA guidelines Signature Engineer's ~a~~' ~-~l'q;o°P jZoad No. 2.04 HAAFee$ /7~-~ Date of Payment Receipt Number Waiver Fee $. Date of Payment Receipt Number inspection. 72-026 ~3/98)' Back APPLI¢ ~,IT FILLS OU'l'; UPPER HA[ ONLY Buyer Address Zip Code Realty Co. & Agent Phone Address Zip Code Ty~f Residence '~. Single Family ~ Mulllple Family No. of Bedroo~ ~ Other Wa~ Supply --~,lndividual ATTACH WELL LOG. A w~l log is required for all wells drilled since June 1975. ~ Community For wells drilled prior to that date, give well depth (attach log if available). ~ Public Utilily Sewer Disposal --~, Individual Year Individua~ Installed: ~ Public Utility When Connected to Public Utilily: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. 'rime Time Time Time Date Date Date-,-,~"/A Dal~. Inepector ~nspector Inspector ~nspecter Pield Notes: , :' ~ ~ ~...ow~ ~.oo~s 'co.~mo.s o~ ~...ow~ ~ ~ co.~mo~...ow~' Soils Rating Date ~wer Installed Well To Absorption Area ?¢2 ,~ / ~L Well Log Received APPLI( FILLS OUT UPPER HA[ ONLY Pr0perlyOwner /')'(. ( ~ (-/ ["'/ ~il/~..~ ~/-~i~'~i/'~-.~. A_[ ¢/"1 ~r~- ~'~'"[ Phone Address ~ Zip Code Lending Institution t-'{ /~ ~. "[' t:::' ~'_l O ~ ~.[") O- ;::~,~ /:-._~ Phone Realty Co. & A~nt Phone Address Zip Code Type of Resl~nce .Slngle Family Multiple Family No. of Bedroo~ ~ Other Water Supply ~ Individual /~= d~ ¢/(1¢ /L.~Q/~ ATTACH WELL LOG, A w¢l Icg is required for all wells drilled since June 1975. ~ Community For wells drilled prior to that date, give well depth (attach log if available). ~ Public Utility ~O ~D~ P~q /34~- Sewer Disposal ~ ~ ~ l ~ S Year Individual Inslalled: ~ Public Utility When Connected lo Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time Time Time Time Date Dale Date Dale Inspector Inspector Inspector Inspec~r~ MUNI ;IPALITY OF ANCHORAGE Field Notes: DFPT. OF ENVIROHb,/,21'; ~ A..; .,o, ':-cHON CCT RECEIVED ( ) APPROVED BEDROOMS *CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL* DATE BY: Well to Tank Septic Ta~k Size 72.023 (318~) Z 2 / VICINITY MAP OTlO01~t39 MOUNTAIN VAt-,[ F'Y , ES~TAT E S · ~DITION ~C). I E M* LINDSEY ~ ASSOC. 5 5 m DTI001140 MOUNTAIN VALLEY ESTAT ES ADDITION NO.I 5 J~'HNNY [0 J8 MOUNTAIN VALLEY ESTATE S ADDITION NO, I 9 MOUNTAIN VAII F"Y ESTATES F. M. LINDSE¥ & ASSOC. 4 5 \ VICINITY MAP NOTES DT[001143 IVlOUNTAIN VALLEY ESTATES F M LINDSEY 8 ASSOC