Loading...
HomeMy WebLinkAboutSKY RANCH ESTATES #2 BLK 2 LT 9Sky Ranch Estates #2 Block 2 Lot 9 #015-302-33 Municipality of Anchorage • Community Development Department Page 1 of 3 On-Site Water&Wastewater Program 4700 Elmore St. •P.O. Box 196650 Anchorage,AK 99519-6650 •http://www.muni.org/onsite {907)343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP191025 PID Number: 015-302-33 ❑ New ■Upgrade Name: SARAH BIRMANNS ABSORPTION FIELD Address: 0 Deep Trench 0 Shallow Trench 0 Bed P ound 11701 WRANGLERS WAY*ANCHORAGE,AK 99516 0 Other Phone: No.of Bedrooms: Soil Rating: Total Depth from origin. .ade: (907) 947-1461 3 tea.F1. Ft. Depth to pipe invert from original grade Grave -'pth beneath pipe: LEGAL DESCRIPTION Ft. Subdivision:SKYRANCH ESTATES#2 Block: LO�t: Fill added above original grade �\�`�r1G Gravel length: FL Ft. I ownship: Range: Section: Gravel width: Beds Number of lines: Distance between lines: Ft. Ft. SEPARATION DISTANCESNumber of trenches: Dist.between trenches: Total absor.'- area: To Septic Absorption Lift Holding Public/Private From Tank Field Station Tank Sewer Lines S0.Ft. Ft. / Well N/A - - 25'+ TANK • Septic 0 S.T.E.P. ❑Holding 0 Other - Manufacturer: Capacity: Surface Water 100'+ �� - - GREER 1250 Gal. : 4.2- • Material. Number of compartments. Lot Line 5'+ it - - N/A HDPE 2 Foundation 10'+ _ - LIFT STATION Curtain Drain I Manufacturer c" NONE KNOWN Gal. Remarks: 170'TO COMMUNITY WELL-ADEC WAVIER SUBMITTED W1TH "Pump on"level at: "Pump off level at. (High water alarm at: MOA PERMIT Pump Make&Model Electrical Inspections performed by. PIPE MATERIAL House to tank EXISTING Tank to D3034 drainfield Installer WILCO EXCAVATION Drainfield EXISTING CO/MT D3034/EXISTING Inspector GEG, Ltd. BENCH MARK (Assumed elevation) Inspection 100.00 Ft. Dates: 1st 2/18/2019 2nd Location and Description: 3rd - 4th - BOTTOM OF TRIM AT FCO ENGINEER'S SEAL Community Development Department Approval oo6o. ,\�� Conditional approval: Date: - %` .• • 4, 4, . f-4 li D VA kv/) )J frey . arnesPhf 00 0 ,C 795 / . z_ zS- 0% %. ..••4434. I' i loo Approved: v....._ Date. ( LICENSE wi tofess�tO #AECC884c. 00 Inspection Report_1-1-12.doc iPERMIT NUMBER: PARCEL ID NUMBER: OSP191025 RECORD DRAWING 015-302-33 1 ....,..._ a so ,,,,, I I ��\\\\ OSS/0, / � A \ B (Y FCO 23.1 25.5 �YByS — / -- Sly 26.91 31.9 HISPERING -- tiq"� Q / TMT 25.3 37.2 / PRUCE DRIVE h (pp4S / / / DBL1 30.0 37.7 b ••• / DBL2 30.7 38.5 0 F / j DBL3 46.3 55.9 .12.„m / p DBL4 47.3 55.2 4'y. . / 4G, / C01 73.6 50.0 ,, / / MT1 73.1 50.5 co�/7 /• •$���y9/ CO2 40.4 66.0 .- L SKY RANCH ESTATE MT2 39.8 65.2 `O�/ 11 °'' ' #2;BLOCK 2,LOT 10 / / / / / / - • • / / / / • \ / ~�` / / / N. . .., �;� / re / N. / / \ DRIVEWAY , EXISTING 3 BEDROOM Z / \ \ / I": • HOUSE • / NEW 12505LLON HDPE GREER TANK �\ ;: .;:;;; 7., - I 7 / • .e+ ' INE FROM TANK O DRAINFIELD REPLACED \ r • AS REQUIRED BY MOA FOR COSA APPROVAL \ TMTe , 1 / \ —D: = EXISTING DOUBLE CLEANOUTS IN TRENCH \ CO.\`T2 WERE REPLACED WITH NEW PVC CLEANOUT AS //\ \ `T EDD \ REQUIRED BY MOA FOR COSA APPROVAL // \ N..........,............, OLD SUMP WAS REPLACED WITH A NEW ....%,\N DBL CLEANOUT AND MT AS REQUIRED BY MOA // /1E9 G 1 ONSITE DEPARTMENT FOR COSA APPROVAL —.J / VV 9SF\N / 2iF ` / / �. N / N /_` SKYRANCH ESTATES#2; N N ----- / _�1 BLOCK 2,LOT 8 \--VVV SKYRANCH ESTATES#2; BLOCK 2,LOT 11 SCALE: ii 1"=40' .�1 0101. 111 air,C511/ • GARNESS ENGINEERING GROUP, Ltd i X4'1'• .... �.* ENGINEERING SALES -CONSULTING - ik 1.41� 0 3701 E.TUDOR ROAD.SUITE 101•ANCHORAGE.AK 99507•PHONE(907)3376179•FAX(907)339.3246'NEBSITE wnwgemeseen9nemn9 cam re s1 T •PREPARED FOR: PHONE NUMBER: PAGE NUMBER: 0 '.Gacass Qi SARAH BIRMANNS 907-947-1461 2 OF 3 0j J,'e.. 7795)3 ,r1_/ LEGAL DESCRIPTION: DRAWN BY: • •. ... i /q.•'‹ :SKY RANCH ESTATES#2; BLOCK 2, LOT 9 D.J.G. v ��'eep • \... �• TYPE OF WORK: DATE: LICENSE/1�PROFESS," 4 RECORD DRAWING OF SEPTIC TANK 2/21/2019 #AECC884 ilI1111.1111101:‘ J / PERMIT NUMBER: PARCEL ID NUMBER: ` OSP191025 RECORD DRAWING 015-302-33 FINAL GRADE=100.28-100.32 ST i ST2 — TOP OF TANK @ INTLET=95.94 TOP OF TANK©OUTLET=95.97 2"INSULATION // //////////• M/. 1 1. III NEW 1250 INVERT OF BUNG @ INLET=95.13 GALLON H.D.P.E. INVERT OF BUNG©INLET=95.01 SEPTIC TANK 1 I SEPTIC TANK HAS APPROXIMATELY 4.38 FEET OF COVER- HOWEVER,IT HAS 2"OF INSULATION AND IT IS BELIEVED THAT AFTER SETTLEMENT IT WILL BE NEAR 4'OF COVER 9, ..4�1\\\ 1,, Ile IL° 7.I\ c A 44 r• •''.... • q GARNESS ENGINEERING GROUP, Ltd 47 4. v1„ •,�� •••* •• • ENGINEERING. SALES CONSULTING i 3701 E TVOOR ROAD,SUITE 101'ANCHORAGE,AK 99507'PHONE(907)3376179'FAX(907)3394248'WEBSITE'.www 9amessengneenn9 corn • ••c • • •S • • PREPARED FOR: PHONE NUMBER: PAGE NUMBER: •cc % J• re A Ga ss • SARAH BIRMANNS 907-947-1461 3 OF 3 0j�i C 79 3 2Ar ♦ 1, LEGAL DESCRIPTION: DRAWN BY: .• e41,..*** 7 �� SKY RANCH ESTATES#2; BLOCK 2, LOT 9 D.J.G. ♦ D . .�f •'••�P� �• TYPE OF WORK: •DATE: LICENSE •E \�.•• SEPTIC TANK PROFILE 2/21/2019 #AECC884 ,illisss is MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program 1111'77(' j f1 PO Boy. 196650 4700 Elmore Road Anchorage, Alaska 99519-5650 Phone: (907) 343-7904 Fax: (907) 343-7997 httoa/w.vvi.muni.orglonsite ''CIIOknG• Kepi/ 1'[111 C11 f On -Site Wastewater Disposal System Permit Permit Number: OSP191025 Effective Date: 2/13/2019 Work Type: SepticTank Upgrade Expiration Date: 2/13/2020 Tax Code Number: 01530233000 Site Legal Address: SKY RANCH ESTATES #2 BLK 2 LT 9 G:2737 Site Mailing Address: 11701 WRANGLERS WAY, Anchorage Owner: BIRMANNS SARAH J & PETER Lot Size in Sq Ft: It 9682 Design Engineer: GARNESS ENGINEERING GROUP LTD Total Bedrooms: 3 This permit is for the construction of: ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ 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 waste%pater 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. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received B� Issued By: Date: Date: �2 15 :2 6 ] Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191025, Rebecca Carroll, 02/13/19 THE STATE °fALASKA GOVERNOR MICHAEL]. DUNLENVY February 13, 2019 Jeffery Gamess, P.E. Gamess Engineering Group, Ltd 3701 East Tudor Road, Suite 101 Anchorage, AK 99507 Re: Sky Ranch Estates #2; Block 2, Lot 9 Waiver Request Mr. Gamess: Department of Environmental Conservation DIVISION OF ENVIRONMENTAL HEALTH Drinking Water Program 555 Cordova Sheet Anchorage, Alaska 99501 Main: 907.269.7516 Email: travis.weaver@alaska.gov Fax: 907.269.7650 dec.alaska.gov File: Sky Ranch Estates #2 PWSID: AK2212916 Class: Community Source: Groundwater On February 7, 2019, this office received a submittal requesting a reduction of the State's minimum separation distance requirements between a Public Water System (PWS) drinking water source and a potential source of contamination. This letter approves the requested reduction in the State's minimum separation distance requirement between the drinking water well serving the Sky Ranch Estates #2 (SRE#2) PWS and the wastewater disposal system on SRE#2 Block 2 Lot 9 (SRE#2 B2 L9) as detailed below. Waiver Determination SRE#2 B2 L9 is proposing to decommission the existing steel septic tank and install a new 1,060 gallon two compartment HDPE infiltrator septic tank. The new tank will be in the same approximate location as the existing septic tank, the existing drainfield will be updated with new cleanouts, sump and monitoring tube, and the drainline connecting them will be inspected. At its nearest, the septic tank and drainfield serving SRE#2 B2 L9 will be no closer than 170' and 185' from the SRE#2 PWS groundwater well, respectively. The following items were taken into consideration as part of this waiver approval: 1. SRE#2 has a relatively deep well, screened from 150' to 172'; 2. A clay layer appears to be confining and should act as an aquitard; 3. The septic system appears to be cross gradient from the well and outside of its drinking (source) water protection area; 4. From August 2000 to July 2017, source water sampling results for combined nitrate -nitrite or nitrate concentration rose from 1.37 mg/L to 3.95 mg/L and in November 2018 dropped to 3.21 mg/L. This suggests that the well is minimally influenced by septic system exfiltradon, decomposition of organic matter in the soils, and/or erosion of natural deposits. Despite this, combined nitrate -nitrite and/or nitrate concentrations remain well below the 10 mg/L Maximum Contaminant Level; 5. Surface topography between the subject well and encroachments slopes towards the well but there are lawns, trees, a house, and a road in between. Sky Ranch Estates #2 PWS AK2210906 Based on an evaluation of the available information and in accordance with the State's Drinking Water Regulations, 18 AAC 80, a Separation Distance Waiver for the encroachments detailed herein is issued. Limitations and Appeal Process Any changes to the design other modifications to the wastewater disposal system will void this waiver approval. This determination is not approval of omissions or oversights by this office or non-compliance with any regulation. This does not imply the granting of additional authorizations, not obligate any federal, state, or local regulatory body to grant future authorizations. This determination does not guarantee correctness of functional design or waiver the owner's responsibility for continued compliance with state, federal, and local regulations. Before proceeding you are advised to obtain any other necessary project authorizations/permits. The applicant, owner or operator, or other person adversely affected by this decision may request an informal review of this decision in accordance with 18 AAC 15.185, or may request an adjudicatory hearing in accordance with 18 AAC 15.195-15.340. Requests may be sent by mail, email, or facsimile. Informal review requests must be received by the Division Director within 20 days of this decision. Adjudicatory hearing requests must be received by the Commissioner within 30 days of this decision or the decision of the informal review issued by the Division Director; otherwise, the right to appeal is waived. For more information, visit https://dec.alaska.gov/commish/review- guidance. If you have any questions please contact me at 907-269-7516 or travis.weaver@alaska.gov. Sincerely, Travis Weaver, E.I.T. Engineering Associate I ADEC Drinking Water Program Encl.: Cc.: David Gayness, Gayness Engineering Group, david@garnessengineering.com Sky Ranch Estates HOA; 11710 Pinto Circle Anchorage, AK 99516 Justin Fenzl, ADEC-DW, justin.fenzl@alaska.gov Jessica Cahill, ADEC-DW, jessica.cahill@alaska.gov 190213 Sky Ranch Estates 2; Block 2, I.ot 9 _212916 WA.docx GARNESS ENGINEERING GROUP, Ltd ENGINEERING— SALES =- CONSULTING .. February 6th, 2019 Alaska Department of Environmental Conservation On -Site Water & Wastewater Program 555 Cordova Street Anchorage, AK 99501 Attn: Bill Reith, P.E. Ref: Waiver request for community water system (PWSID #212916) to proposed septic tank for Sky Ranch Estates #2; Block 2, Lot 9 Mr. Reith: The subject lot is served by a community water system (PWSID # 212916) and an onsite septic system. The existing steel septic tank is approximately 44 years old and is to be replaced for the MOA Certificate of Onsite Septic Approval (COSA). As can be seen on the attached drawings, the existing tank is approximately 170 feet from the subject well. It should be noted that the tank cannot not be moved further south due to an increase in burial depth which would have prevented the standard installation method for an Infiltrator septic tank. In short, if the separation distance is desired to be maximized, a deep burial steel tank would have to be used or specialized deep burial construction methods for an Infiltrator septic tank would need to be incorporated. We are proposing to decommission the existing steel septic tank and install a new 1060 -gallon two compartment HDPE infiltrator septic tank. Justification for granting this waiver are as follows: Recent Nitrate sample results (11/6/18) were pulled from Drinking Water Watch and reported below the concentration level (see attached) The existing septic tank is steel, and the proposed septic tank is HDPE which would be an improvement on the existing condition. The existing tank is approximately 170 feet from the subject well and the encroachment has existing for approximately 44 years, with no significant adverse impact on the water quality. We are unaware of any adverse impacts this installation and or waivers would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistare.. Sinde e ,rte .le Ak GagrIL , P. S. 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com GREs,. ER ANCHORAGE AREA BORA JGH �, Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 y� INSPECTION REPORT ON-SITE SEWAGE: DISPOSAL SYSTEM /,/ NAME .L` �°-&! i% MAILING ADDRESS +•�� �� '�� r'Y _ PHONE-3�6 -a O n LOCATION LEGAL DESCRIPTION SEPTIC TANK: /� n DISTANCE A� �¢r- f NUMBER OF FROM WELL— MANUFACTURER tit's— MATERIAL i�j COMPARTMENTS— INSIDE LENGTH__ INSIDE WIDTH_ _ LIQUID DEPTH _— LIQUID CAPACITY_ JS(,' GALLONS. TILE DRAIN FIELD: C TOTAL LENGTH DISTANCE FROM WELL( C�V'ti _ FOUNDATION_NEAREST LOT LINE _04> OF LINES _ NUMBER OF LINES '—.—DISTANCE DISTANCE BETWEEN LINES _ r.� p TRENCH WIDTH P IN. TOTAL EFFECTIVE ABSORP"TION AREA_LSPSQ. Ff. LENGTH OF EACH LINE —�•� / '/� DEPTH OF FILTER - DEPTH: TOP OF TILE TO FINISH GRADE ��y _MATERIAL BENEATH TILE _�� 15�. ABOVE TILE c�IN. WELL: P TYPE C.p�..(_ CONSTRUCTION BUILDING NEAREST FOUNDATION LOT LINE CESSPOOL .— . OTHER SOURCES APPROVED DISAPPROVED — — DISTANCES: DEPTH __—DISTANCE FROM: NEAREST SEPTIC SEEPAGE SEWER LINE , TANK SYSTEM_ INSTALLED BV:✓�'' ��" �I �' SEWER LINE DEPTH: - � Q PIPE MATERIAL: N1 ,4 LOT SLOPE: REMARKS Form EQ -032 REMARKS DIAGRAM OF SYSTEM '7 DATE ii w i r R� v ROVED e NAME OF APPLICANT INSTALLATION LOCATION LEGAL DESCRIPTION GRE/ cR ANCHORAGE AREA BOF, UGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED MAI PIT DRAIN FIELD PERMIT NO. .Z FINANCED THROUGH TO BE INSTALLED BY 1�10 soa resT REsu Lrs �+� � �' / NNj107131 THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED I p J Ix _r)A I FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE TYPE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION "r0 SEPTIC TANK b'^, FOUNDATION TO SEEPAGE PIT DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK —. SEEPAGE PIT . DRAIN FIELD TO NEAREST LOT LINE. SEEPAGE AREA SIZE Ire M1 WELL TO SEPTIC TANK _--! , SEEPAGE PIT DRAIN FIELD — ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK —, SEEPAGE PIT _ DRAIN FIELD SEPTIC TANK, , SEEPAGE PIT ___, DRAIN FIELD TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL, 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. G.A.A.B. OR LICENSED DESIGNER I CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUG14 ORDINANCE N DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE `" R_. • d�-- APPLICANT'S SIGNATURE FO RM NO. EQ -016 l,C�-11�.1� ` I � Y"Y�'� S -'o eff Sv���-1j ��.Yr/ ✓l,I �k��I I�. t1UlJ`'s��haL.. is AND THAT THE ABOVE f ,f f,: r7��F-tet YY'I. Ud I.hlLk lu, ;14. l;l. ;,..IN UUKUU Department of GwironmchtaI Quality 3330 "C" Street Anchorage, Alaska 99M SOILS LOG - PPROLATION •1•IsS•I• Performed for 6epple_.Hood 71__6Ltic-lekk Legal Description=:„ D This form reports: Soils Depth Feet 1_ drawn, 2 __._.__.�. 3- r%0 W N S 001 Ov S l L ru . . !Vl L 6- - 9 10 11 12 13{ -/ S�oAe rco Date Performed (a 7� Was ground water encountered? If yes, at what depth? AIa D® nom. b .0 AIin,f A, /4iOAIPe .-I V.V�/ Reading ��•i_�4_I'�moi. Date ,...I- �w Gross Time ey-_------- . Net Time ___ Depth to Water Net Urop Pereohalion rate 4-; ,2.�._!»nuLe. iN " " Drain Field •Proposed installatio Seepage Pit _ Depth of Inlet ._ _ _• Depth to bottom of pit or trench COMMENTS:.��, L YL✓5�% Jate:' Pa'rfornicd cy:j!?.%Yl — Crt9 fi od I3 ]Svs l6iol ('(0/7,10 S S3` PROPOSED llWl'sLL1NG O M , I hereby certify that I have surveyed the following It is tie tractor's rekponsibiiltj+ fo—j &6& described property:A./_ — 9 Top of Foundati(hi in.rclaiionshil) to lihAb S%47z! Grade. Top of Foundation as indicated is one ///t//f— IVO, e 000rdo of block aUovc F Gtado, �i Anchorage Recording Precinct, Alaska, and that the improvements thereon are within the ' °°9p°, '' situated property lines and do not overlap or encroach on the property :' ,,�,�i' a•°°• cS�,,,, Q •... •oo �' lying adjacent thereto, that no improvements on prop- erty lying adjacent thereto encroach on the premises in , p°Ga.,. _„�:. s -'._ `•'1 question and that there are no roadways, transmission lines or visible easements on said property except PO J•,•••D'° % °%/°°° �•n•�°^•• C� other as indicated hereon. Dated at Anchorage, Alaska 7� Fred Walalka p°t�°t4f�s this ZSr. day of A��f •°� No, -32595 '• ! FRED WALATKA & ASSOCXATES yJe .9ap Engineers and Surveyors • Municipality of Anchorage 5 6 - J_ On-Site Water&Wastewater Program - (907) 343-7904 a. FFAx: ;1) 4 ' 20in CERTIFICATE OF ON—SITE SYSTEMS APPRO �a g ti �ti Parcel I.D. 015-302-33 Expiration Date: -ZOZO 1. GENERAL INFORMATION Complete legal description SKY RANCH ESTATES#2; BLOCK 2, LOT 9 Location (site address) 11701 WRANGLERS WAY*ANCHORAGE,AK Current Property owner(s) SARAH BIRMANNS Day phone 907-947-1461 Mailing address 11701 WRANGLERS WAY*ANCHORAGE,AK Real Estate Agent Day phone 2. TYPE OF DWELLING: ▪ Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings(Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site Individual Water Storage 0 Individual Holding tank ❑ Community Class Well II Community On-site ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for. N/A Distance: - Received by: Date: COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee$ SS 0. OD Waiver Fee$ Date of Payment 0.'1 11 Date of Payment Receipt Number 611 1+61 Receipt Number COSA# oS 0 & ) Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are)safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are)in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP,Ltd. Phone 337-6179 Address 3701 E.TUDOR ROAD,SUITE 101 *ANCHORAGE,AK,99507 !I /I Engineer's Printed Name JEFFREY A.GARNESS,P.E. Date 2` 2t/jq Engineer's Comments: In conducting this evaluation,GEG provided an engineering evaluation of the well andbrseptic system in accordance with the .***IMAM I ii i guidelines and regulations established by the Municipality of Anchorage and industry practices.The reported results describe the .44- <_ OF ,e . fr. condition of the system's on the dates of the evaluation.Separation distances were measured to readily identifiable features. ♦ '"• •,• • Hidden defects or encroachments may exist that were not identified during the evaluation.The operational*of all weds and septic I � • •• • l • ,## systems depend on a variety of variables including,but not limited to,soil conditions,groundwater levels(that may fluctuate during • . , # the year),quality of construction(materials and workmanship),and the water usage of the family utiing the system's.These s *'• .P, rl. I\ 31'# • # conditions can vary and are outside the control of GEG.Satisfactory fest results do not guarantee future performance of the AI% ".% system's;therefore,GEG makes no warranty(express or implied)regarding the Mum performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the .. •.0 current systems fail.The content of this report is for the sole benefit of the perscoparty who retained GEG.Reliance upon the # • ;••�J•• y •.Garners e ii information provided in this report by any other person or party,including but not limited to subsequent property purchasers.is not ## • CE- •53 authorized.In short,GEG disavows any legal duty to anyone other than the persenrparty who paid for this report #. ... , • 6. DSD SIGNATURE •�*��� FESS1 :4.•• LICENSE 111„"��4 Y. System#1 Approved for 3 bedrooms. nLICENS a System#2 Approved for bedrooms. ,, �h ,,,� � . i> Disapproved. . ) �� ON-SITE , Conditional approval for bedrooms,with the following stipulall fns:WATER AND a WASTEWATER A PROGRAM e 4��'-Mr 8FR'INC,,, By: Original Certificate Date: 2-•Z-'' /9' 7 The Municipality or Anchorage Develop,emt Services Division(DSD)issues Certificates of On-Site Systems Approval(COSA)based only upon the represenatations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTCHMENTS: \� COSA Checklist N Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other (Rev.10112112) COSA Checklist Legal Description: SKYRANCH ESTATE#2; BLOCK 2, LOT 9 Parcel ID: 015-302-33 If more than 1 septic system on lot: COSA Checklist# of Structure served by this system A. WELL DATA ❑Well log is filed with Onsite (or attached) Well production at time of test gpm Date drilled Water storage tank volume gallons Total depth ft Well disinfected for coliform test? ❑ Yes ❑ No Cased to ft ❑ Coliform bacteria is Negative ❑ Sanitary seal is functioning correctly Nitrate mg/L ❑ Nitrate less than MRL (ND) ❑Wires are properly protected Arsenic ug/L ❑Arsenic less than MRL (ND) Casing height (above ground) in. Collected by Date of flow test for COSA Date of Sample Static water level at beginning of test ft. Comments SUBJECT LOT IS ON A COMMUNITY WATER SYSTEM PWSID#AK2212916 B. TANK DATA C. LIFT STATION Age of tank(s) NEW years ❑ Required maintenance completed Tank type/material HDPE Age of lift station years ❑■ Standpipes/foundation cleanout per record drawing Lift station material Date of pumping NEW Comments: N/A D. ABSORPTION FIELD DATA Which system tested (date installed) 9221575 Adequacy test date 2/5/2019 ❑■ ALL standpipes present per record drawing Results E Pass For 3 bedrooms Total measured depth from grade 12.8+ft(max) Fluid depth prior to test 5 in Measured depth to pipe invert from grade 4.5 ft(min) Water added 1057 gal ❑ N/A—pressurized field New depth 18 in ❑■ Monitor tubes go to bottom of drainfield. If not, state Elapsed time 120 min depth into effective 8 1 FEET ❑� Code-required soil cover over field Final fluid depth 10 in Absorption rate 450+ gpd ❑ System presoaked No (Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) date of test) gallons introduced N/A If yes, enter date n/a Comments/Deficiencies: COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot> 100' Community Sewer Manhole/Cleanout> 100' ❑Yes if No ft ❑Yes if No ft Neighboring Tank > 100' ['Yes if No ft Private Sewer/Septic Line>25' ['Yes if No ft Absorption Field on Lot> 100' ❑Yes if No ft Holding Tank > 100' ❑Yes if No ft Neighboring Absorption Fields> 100' Animal Containment> 50' ❑Yes if No ft ❑Yes if No ft Manure/Animal Excreta Storage> 100' Community Sewer Main >75' ❑Yes if No ft 111 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations> 10' ❑✓ Yes if No ft Surface Water> 100' 0 Yes if No ft Property Line>5' ✓❑Yes if No ft Driveway/Parking> 0' ✓❑Yes if No, comment Absorption Field > 5' ['Yes if No ft Wells on Adjacent Lots: Water Main > 10' ❑✓ Yes if No ft Private Wells> 100' ✓❑Yes if No ft Water Service Line> 10' 0Yes if No * ft Community Wells>200' ❑Yes if No **170 ft From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ❑✓ Yes if No ft Driveway/Parking >0' ✓❑Yes if No, comment Property Line> 10' ❑✓ Yes if No ft Wells on Adjacent Lots: Water Main > 10' ✓❑Yes if No ft Private Wells > 100' ✓❑Yes if No ft Water Service Line> 10' 2Yes if No ft Community Wells>200' ❑Yes if No *185 85 ft Surface Water> 100' ❑✓ Yes if No ft F. ENGINEER'S COMMENTS *ASSUMED BASED UPON KEYBOX LOCATION **WAIVER APPROVED BY ADEC ON 2/13/2019 - ATTACHED WITH SEPTIC TANK PERMIT i �.,,. `o0p G. ENGINEER'S CERTIFICATION o c - A ��d I certify that I have determined through field inspections and review 's---..• , �s. O of Municipal records that the above systems are in conformance with 43 ' �� ` V0 MOA COSA guidelines in effect on this date. IA i— n .•.J ; .rness; V CE-795 c;0 Vs' COSA Checklist yellow sheet WQ4O o f 6 S si0°p o #AEcc884 �pppp �---,TNiSPE G / �- SPRUCE_--_MILE_ , / / 4 / / .Zg 19 =74.60(PLAT)76.67(COMPUTED) / / ` / 7 / ff^^/V/ oma, cVo'v. `9ir �� o Q :41I, ` y i�;/ z % 3C, S/NG46 9 1:?,4A1 '44'ik y / -+ _r1P DECK / CAI Pit C x'9(1 4k /��i/��� • P / p ' Q • • / O e sV a / // 00oa s • IN,„ 4 / N7 `D 6, :N,„ ' 00000p0 Ao 'rep.... ,�� ., � o OF e‘N 009 1/ 7... �►� tS,'�DO �' ,co.. 49 TH ) .`y�(/ E/0.50 O SHANE A.HOLT O N�2n 49" le>, .'••. LS-6914 ,.'ayoOO 440o'O7e ssional zoo DOO0000� A5-BUILT SURVEY 1" =30' NO CORNERS SET THIS DATE I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY .___ _ _i LOT 9, BLOCK 2, SKY RANCH ESTATES NO. 2 THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IS VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES. THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT , ARE NOT SHOWN EXIST OTHER THAN NOTED. HEREON ( UNLESS INDICATED) DATED AT ANCHORAGE,ALASKA THIS _21 ST_ DAY OF NOTE: FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE _FEBRUARY 2019 PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. HOLT LAND SURVEYING ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. 9309 GROVER DRIVE ANCHORAGE,AK 99507 12865•F8170-38,SCAN,195-11 345-5513 Municipality of Anchorage On -Site Water & Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I. D. 015-3D2-33 Expiration Date: 1. GENERAL INFORMATION Complete legal description SKY RANCH ESTATES d#2• LOT 9, BLOCK 2 Location (site address) Current Property owner(s) Mailing address 11701 WRANGLERS WAY *ANCHORAGE, AK 99516 ROGER FUSON Day phone 345-9658 11701 WRANGLERS WAY *ANCHORAGE AK 99516 Real Estate Agent Day phone 2. TYPE OF DWELLING: N Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class A Well Community On-site ❑ Public Water System ❑ Public Sewer ❑ Received by: C / Date: 6 a 3 COSA to be released to ti ngine r, 0 ess otlberwiae requested by the engineer. COSA Fee $ Date of Payment Receipt Number O�11gq COSA# (Y�'C15160 Waiver Fee $ _ Date of Payment Receipt Number, Waiver # Distance: — 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, 1 verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 - ANCHORAGE, AK, 99507 Engineer's Printed Name Engineer's Comments: JEFFREY A. GARNESS, P.E. In conducting this evaluation, GEG provided an engineering evaluation ofthe well and/or septic system in accordance wifh the guidelines and regulations established by the Municipality ofAnchorage and mdustryprodices. The reported results describe the condition of the systems on the datele of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend on a variety of variables including, but not Wiled to, soil conditions, groundwater levels (that may f uckme, during the year), quality of consimclion (materials and workmanship), and the wafer usage of the family utilizing the syslemis. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the systemis,' therefore, GEG makes no warranty (express or implied) regardingthe future performance of the well or septic system. -GEG makes no representation whether an altemative`mell or walk system can be installed on the property in the event either of the current systems fail. The content of this report is for the sole benefit of the personipady who retained GEG. Reliance upon the information provided in this raped by any other person or party, including but not limited to subsequent property purchasers, is not authorized. In short, GEG disavows any legal duty to anyone other than the pereonipady, who paid for this report. 6. DSD SIGNATURE V System #1 Approved for bedrooms. System #2 Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following y p -- Origin-! Certificate Phone 337-6179 Date 1 tv l .K C -79 3 PROFESS _� El The Vunicipality or Anchorage Develop, amt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTCHMENTS: / COSA Checklist t0 Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other (Rev. 10112/12) If more than I septic system is on the lot: COSA Checklist # _of_ Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: SKY RANCH ESTATES #2; LOT 9, BLOCK 2 Parcel ID: 015-302-33 A. WELL DATA Well type A Date completed Total depth ft. Date of test Static water level Well production WATER SAMPLE If A, B, or C provide PWSID# 212916 Well Log Sanitary seal (Y/N)— Cased to ft. FROM WELL LOG Wires properly protected Casing height AT Coliform ��' colonies/100 ml. Nitrate mg./L. Collected by: Vinic: —ug./L. Date of sample: B. SEPTIC/HOLDING TANK DATA 40 YEAR OLD SEPTIC TANK IS APPROACHING THE END OF ITS USEFUL LIFE Tank Type/Material SEPTIC/STEEL Date installed 11/10/1975 Tank size 1250 gal. Number of Compartments t Cleanouts (Y/N) in. Foundation cleanout (Y/N) YES Depression over tank (YIN) NO High water alarm (Y/N) N/A Date of pumping Pumper A toy. ( C to c k C. ABSORPTION FIELD DATA OBELOW EXISTING GRADE Date installed 11/10/75 Soil rating (g.p.ddftlor � 225 System type DEEP TRENCH Length 75 ft. Width 3 ft. Gravel below pipe 10 ft, Total depth* 12.50 Eff. absorption area 1500 ft' Monitoring tube **YES Depression over field NO Date of adequacy test 9/14/15 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 3 in. Water added 533 gal. New depth 11 in. Elapsed Time: 150 min. Final fluid depth 3 in. Absorption rate >= 450+ g,p,d, Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date — NEW C/O AND MT WERE INSTALLED 9/15 ON WEST END OF TRENCH **NEW MT ONLY EXTENDS 8.24 FEET BELOW INVERT OF DRAINPIPE D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on" level at in. "Pump off' level High water alarm level Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: COMMUNITY Septic tank/lift station on lot On adjacent Absorption field on lot On adjacent lots Public sewer main Sewer /septic service line manhole/cleanout Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation *5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots **100'+PRIVATE: 120'+ FROM CLASS A SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water service line 10,+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots** 100'+ PRIVATE; 120'+ FROM CLASS A F. COMMENTS *TANK PIPE IS 10.75 FEET FROM FOUNDATION AND IS UNDER CONCRETE SLAB FOR STAIR LANDING, SEE ATTACHED PHOTOGRAPH. **120.'+ PER AS—BUILT DRAWINGS AND 1975 MOA APPROVED PERMIT. SEE ATTACHED DOCUMENTATION G. ENGINEER'S CERTIFICATION 1 certify that l have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printedame JEFFREY A. GARNESS Date l �/ t L Zf' (Rev. 11105) M Jetf� —0191 A7ss;" A ® E�9,5f� � J•'Qf!y�•Fo°�oo 0 74.60( PLAT) 76.67( ILESS INDICATED) °LINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO Be USED TO OETERMNE NE5 OR POSITION ADDITIONAL IMPROVEMENTS. SHOWN HEREON MAY BEAPPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. W i 49 TH` r< SApo..+"' H N p°p SHANE A. HOLT...* �m i JN°. LS -8914 o`O� AS -BUILT SURVEY V =30'. NO CORNERS SET THIS DATE I HEREBY CERTIFY THAT I HAVE PERFORMED ASURVEY OF THE FOLLOWING DESCRIBED PROPERTY NNN LOT 9, BLOCK 2, SKY RANCH ESTATES NO. 2 ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATED AT ANCHORAGE,ALASKA THIS _26 TH DAY OF _SEPTEMBER , 2015. HOLT LAND SURVEYING .600 HI&HVLE W DRIVE ANCHORA6E,AK 99515 12865, FB 170-38, SCAN 345-5513 MUNICIPALITY ANCHORAGE • DEPARTMENT OF HEALTH &HUMAN SERVICES j� 1 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 l.D.# D1':�)-SLa-;�i HAAlt 1. GENERAL INFORMATION Complete legal description - Lot 9; BKock 2; Sky Ranch Eb.tateh 112 Location (site address or directions) 11701 w/LangZena Way Anchoaaae. AK Property owner Kevin Meyea Day phone 257-2622 Mailing address P.U. Box 338, G.tndwood, Ata6ka 99587 Lending agency Mailing address. Agent Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual well Community well XXX Public water Day phone Day phone NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XXX Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) FroN MOA 021 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 compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm s & s ENGIP 17034 Eagle Address Finlr Rlvn� -r Engineer's signature 6. DHHS SIGNATURE --4— Approved for Qx, N ( 1-1 _ bedrooms. Disapproved. Conditional approval for Phone 204 Date bedrooms, with the following stipulations: Additional Comments ADVTSORL There wab 8.9' oU etand .ng water in .the _teach�iietd obaenved du2�,nobaenved du2�,ng a recent adequacy tut. Thi6 indica.tee 89% oA the abhabh e oU .the 2eaehA A ahea ie 6ukcha)caed. .thene4o7ie .the Remains may be C mited. 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.M (Rev. 1N1) Back MOA 1121 I S. 'STATEMENT OFANSPECTION BY',ENGINEER As certified by 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 watersupply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein; I furtherverify that based on the information obtained from the Municipality of Anchorage files and from; my investigation and inspection, the on-site water supply and/or wastewater disposal system is in with all Municipal and State codes, ordinances, and regulations, in effect on the date of this inspection. Name of Firm EERif �j c/�� Z 97 � Phone Address 17034 Eagle Rlvar Lpe Bg a River, Alaska 9 - r Engineer's signature DateJ? / 6- 9 `f 9 14 0 �� 1 a'1•� ' i+'^ � 91� 9a9M•�MMIIP o rf d Y�SJ .^ Pto. 74.ti7 C , ±oto 6. ` DHHS'-SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: s Additional Comments O e Y°0 8e97G o e �" QKC. /.S .1liJ/-Cfl �l�leC' 7� �G+"-rrtiC 7 /Ip . /�i�rani� /ivy /e<rC�J e�C>/ rmvr�ae By: 4g Date n / 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 ordertosatisfy certain federal 'and state requirements. Employees of DHHSdo not conduct inspections or analyze data:before;a certificate is Issued. The Municipality,of Anchorage 1s not responsible for errors or omissions in the professional engineer's work. ___ 72-025(Rnv 1/91) Back MOA 921 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Loi y &X Z SKY t�AA)a-t _Parcell.D. ES7/}7 S IT-?— A. T'ZA. Well Data Well type CLKI SSA If6B, or C, attach ADEC letter. ADEC water system number Z 1 Z 9 /(o Log present (Y/N) _ _Date completed _ Driller Total depth _ —_Cased to Sanitary seal (Y/N) FROM WELL LOG Date of test Static water level Wires properly Well flow / g.p.m. SEPARATION DISTANCES FROM WELL TO: AT INSPECTION SepticRieldtng-tank on lot zoO,t ; On adjacent lots i Absorption field on lot ZDO f ; On adjacent lots _ Public sewer main Sewer service line WATER SAMPLE RESULTS: Colfform Date of Nitrate Public sewer Collected by: J0 f`il9 g•p•rM -v e� Other bacteria SEPTIC+I"0f 4WTANK DATA Date installed /c / 2-�- --Tank size 1;-'50 6AL Compartments CleanoutsoYN) YEs Foundation cieanoutON) Y61S Depression (YOy� High water alarm (Y(N)) �� _ Alarm tested (Y/N) A14 Date of pumping _Pumper (foH !E S��LVICES SEPARATION DISTANCES FROM SEPTICHdA;• rTANK TO: Well(s) on lot /JotiE /�26jeAjon adjacent lots Zoo Foundation To property line _ 2 f Absorption field (7 Water main/service line Surface water/drainage 7z-026(3W)•Front CONTINUED ON BACK PAGE C. LIFT STATION WOE Date installed Size in gallons - Vent (Y/N) allonsVent(Y/N) High water alarm level _ "Pump on" level at Meets MOA electrical codes (Y/N) SEPARATION DIST D. ABSORPTION FIELD DATA LIFT STATION TO: On adjacent lots Manufacturer Manhole/Access (Y/N) tested at Surface water Date installed �I10/ i� Soil rating (GPD/Ft) ZZS �2 System type Tf2�/�GN Length � S ( Width Gravel thickness Total depth 12 fi Total absorption area I SOD d Cleanout present/N) Depression over field Date of adequacy test 3 II S y Resultspas ll) IDA for Bedrooms Water level in absorption field before test /O (� 5�1 After test Peroxide treatment (past 12 months) (Y/N) ko /J& KL)oW A.1 If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot NokAz P2(=SEAJT On adjacent lots 200 r� P' C(A.Ss4 Property line 20 �(- To building foundation 10'4- To existing or abandoned system on lot Alo,<j6 /moi &E?sT- On adjacent lots 2-0 `f Cutbank OJC Water main/service line /D'- - Surface water IW r f_ Driveway, parking/vehicle storage area - _�Mr+CL S7Z)r,UH66_ SHea �p of TrcENCH, Curtain drain A f OAU Kc) or. iti ) E. ENGINEER'S CERTIFICATION 1 certify that/ have checked, verified, Signature ING Engineer's Name& o verNc Lc Date Eagle file , Alaska 9 HAA Fee $�� o Date of Payment Receipt Number 72-026 (3/93)' Back to all MOA and HAA guidelines in ate of this inspection. :. Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES () DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL f C(D OF ON-SITE SEWER AND WATER FACILITY Y 264-4744 Application Date GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range)%(-� LC'T� sky RANCH E.�TAT� �SELC. 22, TI2M 31te.1 Location (address or directions) 11701 (b) Property Owner Wey b+e,� Telephone: Home Business CAVI -1201 - Mailing Address_ 11,701 t7./ Y0.1n 6) I -e e uz/��/ (c) Lending Institution Mailing Address (d) Real Estate Company and Agent Telephone Address 3o -ms A S ee Svi 71r_ Telephone �5 e> (e) Mail the HAA to the following address: or: Check here, if hold for pick up. List contact person and day phone number below. -1:- r_ 1_ 1 _ 0 2. TYPE OF RESIDENCE Single -Family X Number of Bedrooms 3 3. 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. 4. SEWAGE DISPOSAL Onsite%-! Public ❑ Community ❑ Holding Tank El 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 72-026 (Rev 8/861 Front 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 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. �1 Name of Firm S Telephone Address o� Gtr/ is L-4 Date 6. DHHS APPROVAL Approved for llak�_ bedrooms by %�jN Date Approved 1�— Disapproved Terms of Conditional Approval Conditional CAUTION Engineer's Seal 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 1 72-025 rRev 8/861 Back MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 OF ANCHORAOk 264.4720 tINICIPALIIY VISION Ii 4004MEKVAL SERVICES DI Legal Description: 1.07"q. Sk !Z wssV.y1ZAHC14 t r B 17 1'.aS6 EST—AME.-, -�'-moi t�1, e -& yez A. WELL DATAK� Well Classifigtgnc If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) Date Completed Total Depth _ Cased to Depth of Grouting — Static Water Level Pump Set At Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Yield Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot On Adjoining Lots To Nearest Edge of Absorption Field on Lot)ining Lots — To Nearest Public Sewer Line Cleanout/Manhole _ Water Sample Collected by _ Water Sample Test Results _ Comments 0' 2'44 sAG.la,4s B. SEPTIC/HOLDING TANK DATA — To Nearest Public Sewer To Nearest Sewer Service Line on Lot 4 q ro 77 ; Date � � a Date Installed W",;1975_ Size o No. of Compartments Standpipes (Y/N) 4)e Air -tight Caps (Y/N) — Foundation Cleanout (Y/N) 7, Depression over Tank (Y/N) N R Date Last Pumped r % 10WAAC i Pumping/Maintenance Contract on File (Y/N) N4A _ ; for L®— Holding Tank High -Water Alarm (Y/N) NVA _ Temporary Holding Tank Permit (Y/N)—_WlA_-- Separation Distances from Septic/Holding Tank: To Water -Supply Well — i o 5r To Building Foundation To Property Line To Disposal Field — To Water Main/Service Line �! / 0 _ To Stream, Pond, Lake, or Major Drainage Course _— Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 4.015 Type of System Design 702ENC M Date Installed. ©cA !975Length of Field 7,4; * Width of Field 7J Depth of Field Gravel Bed Thickness lZ80 Square Feet of Absorption Area Standpipes Present (Y/N) Tom/ 0 ev Depression over Field (Y/N) N Date of Last Adequacy Test 7/��9 7 Results of Last Adequacy Test Fok s 5 �A r✓ i G t u 'a ee/y pma iN Separation Distance from Absorption Field: To Water -Supply Well IQ5 To Property Line > 10 To Building Foundation Z/1 To Existing or Abandoned System on Lot NO N On Adjoining Lots > 3b To Water Main/Service Line i /C) To Cutbank (if present) N o eyo To Stream/Pond/Lake/or Major Drainage Course _ To Driveway, Parking Area, or Vehicle AAStorage Area Comments 'K 75 O.er %ysKrot0 •� �4.4A D. LIFT STATION No h� I Date Installed 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 " Check Permitted Bedroom Rating Against HAA Request "' Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA I certify that I have checked, verifi d, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Date Company Receipt No. MOA No. — Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) Engineer's Seal i, LUN E 25. 1971 ;r,+ fl���. � $ E or � USMAV / STEVE COWPER, GOVERNOR DEPT. OF ENVIIIONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 3601 C STREET, SUITE 1334 ANCHORAGE. ALASKA 99503 DATE: February -5,--1-988 PWSID: 212916 To Whom It Nay Concern: 563-6775 According to the records on file in this office, the SKY RANCH ESTATES__ _ II Water System is in compliance with the State of Alaska Orinkinq Water Requlations. Please note that departmental records indicate that the public water system was installed prior to the 1978 implementation of the Alaska Drinking Waiver Plan Review regulations. No as -built Plans have been reviewed or approved by the department. nor are anv necessary. Since the system has submitted acceptable water samples on a regular basis and received a satisfactory sanitary survey evaluation by the department, the system is acceptable under the standards in effect at the time of installation. An official "Certificate to Operate" may be issued upon receiving a complete set of as—built plans. Any expansion of the water system after 1978 will require plan review and the issuance of a "Certificate of Operation" permit. Sincerely, Ronald S. Klein Environmental Field Officer RSK/MPL: Pkl< cc* Nike Lewis, ADEC, Anchorage MUNICIPALITY OF ANCHORAGE r7 Q 3 DEPARTMENT OF HEALTH & HUMAN SERVICES U > DIVISION OF ENVIRONMENTAL. SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL l OF ON-SITE: SEWER AND WATER FACILITY 264-4744 �J Application Date 1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) —L_o� Location (address or directions) I I � O I l�/,n,a.t�u„Qw• LY/ (b) Property Owner 4 4-eA��'L— _Telephone: Home 32 — "�13) Business ate• IRo2 Mailing Address l L "1 D I I'Vi'1 .Iwt &"e L� (c) Lending Institution _ Telephone — Mailing Address �. �11 -- (d) Real Estate Company and Agent F:D'n�°vrtud Address 3 O� r, �\ S _�.�f 4r4 rte.1921 U_3 Telephone _ 6(09- Ji 653 (e) Mail the HAA to the following address: or: Check here X if hold for pick up. List contact person and day phone number below. i;. 2. TYPE OF RESIDENCE Single -Family' Number of Bedrooms / 3. WATER SUPPLY Individual Well ❑ Community L Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite g(1 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 (Rev 8/88) Front 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 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. c Name of Firm !�� Telephone _V-7 ` _ 14, Address 1,54-41 Date 0 9 Liu �.. �. •ysy.a.�.f,o ..2225-E 6. NE 25, 19IJ ,•'i Engineer's Seal DHHS APPROVAL Approved for bedrooms by ^ A' w Date /c' 3/8 Approved Disapproved Conditional Terms of Conditional Approval 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 doesthis as a courtesy to purchasers of homes and theirlending 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 (Rev 8/861 Back A. (NUNICIPALITY OF ANCHORAGE (MOA) MgNtONW," OEHN� s �tk,,ALTH AUTHORITY APPROVAL (HAA) tkON CHECKLIST - FEBRUARY 1984 FNV 2644720 Q ,��a1 p1_3 Legal Description: _ L_oTgr'RK. P–,SM1R V4U_V WELL DATA R��t Y �D Pf1Cr Q f (t{iii p �1rf�� Well Classification�4 aC S� If A, B, C. D.E.C. Approved (Y/N) Well Log Present (Y/N) Date Completed Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: Depth of Grouting __ Pump Set At Yield Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) To Septic/Holding Tank on Lot 165 ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot IS9c' ; On Adjoining Lots — To Nearest Public Sewer Line Cleanout/Manhole _ — To Nearest Public Sewer To Nearest Sewer Service Line on Lot Water Sample Collected by Date Water Sample Test Results Comments B. SEPTIC/FF&•TANK DATA Date Installed OGT 1975 Size )�-$D No. of Compartments t)r%r_ Standpipes (Y/N) O N ie Air -tight Caps (Y/N — Foundation Cleanout (Y/N) y Depression over Tank (Y/N) , hyA { Date Last Pumped zJaL �B,,.,S Pumping/Maintenance Contract on File (Y/N) NA ; for NSA Holding Tank High -Water Alarm (Y/N) _ t -1/A Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply Well _W 11a-6 To Building Foundation _ To Property Line _ i yO To Disposal Field I C� nc To Water Main/Service Line _ > © To Stream, Pond, Lake, or Major Drainage Course L Comments W Fe o m Fit U N I ve E C-0 R.DS Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA 12 Soils Rating in Absorption Strata 1 e2 -5 Type of System Design 71Q-2 K G{4 Date Installed O c - T- 1 Q %5 Length of Field 76)c f r Width of Field 3 Depth of e Gravel Bed Thickness I 0 Square Feet of Absorption Area Standpipes Present(Y/N) TV-, O 6 - i ic-t 9 Depression over Field (Y/N) t Date of Last Adequacy Test a3I& 7 Results of Last Adequacy Test 'PR85 / o, � l �ovNS Separation Distance from Absorption Field: To Water -Supply Well ;t*= /6s To Property Line i r To Building Foundation ///*t To Existing or Abandoned System on Lot ^j 0 til L On Adjoining Lots i 3 O To Water Main/Service Line i / l7 To Cutbank (if present) N O n/A!r To Stream/Pond/Lake/or Major Drainage Course NONE To Driveway, Parking Area, or Vehicle Storage Area Comments -)� A —10 S' "'."'" W_i_R�_ D. LIFT STATION N u 1\1 E Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) 'Pump Off' Level at " Check Permitted Bedroom Rating Against HAA Request "' Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA I certify that I have checked, verified, onformed to aJQ MOA and HAA guidelines in effect on the date of this inspection. Signed Date °� 7r 9& 7 Company MOA No. Receipt No. Date of Payment®(� CSF /1(''@ Amount:$ ,fCjUi' r14 *"491!1 y�.• Page 2of2 ,''p IIODV y)-;+ 7 i225 -r it 72-026(11/84) Pi , ` Seal s D D �UV IU �UUUULAVUVLJ9 U ,�V 2 03 W. 15th AVE 'C SUITE 203 1, V ANCHORAGE, ALASKA 99501 CONSULTING ENGINEER TELEPHONE. (907)279-3916 S E P T I C S Y — — — — — — — S T E — — — M — A D E Q U A C Y T E S T — — — — — — — — — — — — LEGAL: LOT 9, BLOCK 2, SKYRANCH ESTATES #2 LOCATION: OWNER: RESIDENCE: WELL: SEPTIC SYSTEM: DATE OF PUMPING: DATE OF TEST: 11701 WRANGLER WAY "'T�•". ~• F� ♦ 5 'l HERBERT HEAVNER SINGLE FAMILY, FOUR BEDROOMS' CLASS A COMMUNITY SYSTEM 4s1,' % • I 'I FROM MUNICIPAL RECORDS: TANK: GREER STEEL, ONE COMP. 1250' ABSORPTION SYSTEM: TRENCH ABSORPTION AREA: 1500 SOIL RATING: 225 INSTALLATION DATE: NOVEMBER 1975 JULY 23, 1987 ISAACS PUMPING SERVICE JULY 24, 1987 TEST PROCEDURE: SYSTEM WAS INSPECTED AND MEASURED. TANK WAS FOUND WITH 3.75 FEET OF COVER AND 49.5 INCHES OF LIQUID. 6 -INCH SUMP FOR TRENCH WAS 18.5 FEET DEEP WITH 8 FEET OF LIQUID. 6 -INCH CLEANOUT WAS FOUR FEET DEEP AND DRY. DISTANCE BETWEEN STANDPIPES ARE 64 FEET. TANK IS 165 FEET AWAY FROM CLASS A WELL, NEAREST END OF TRENCH 185 FEET AWAY. 2000 GALLONS OF CLEAN WATER WAS ADDED TO THE TRENCH CLEAN OUT, THIS CAUSED THE LIQUID LEVEL IN THE TANK TO RISE 3 INCHES. THE TANK WAS THEN PUMPED. 24 HOURS LATER WATER WAS ADDED TO THE TRENCH UNTILL WATER COULD BE HEARD ENTERING THE TANK. A TOTAL OF 450 GALLONS WAS ADDED BEFORE INFLOW INTO THE TANK. TEST RESULT: THIS SYSTEM MEETS THE OPERATIONAL REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. THE SEPARATION DISTANCES BETWEEN THE WELL AND THE SEPTIC SYSTEM IS LESS THAN THE 20 The operational life of all septic systems depends on the local soil conditions, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this septic system. We can therefore not give any estimate of how long the system will continue to meet the operational requi- rements of the Municipality and State. S�I AJAIM or IRUPII�I (DEPT. OF ENVIRONMENTAL, CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 3601 C STREET, SUITE 1334 ANCHORAGE, ALASKA 99503 PWSID: To Whom It May Concern: -1-uIY 30�-198Z_ --- 212216 ----------------- STE 212916--------------- STEVE COWPER, GOVERNOR 563-6775 According to records on file in this office, the ---SKYBANCH__._ -.__ESTATES__IL-------------- Water System is in compliance with the State Drinking Water Regulations for monthly bacteriological sampling only.' Sincerely, /�` _ng, PE District ngineer "NOTE: Alaska State Drinking Water Regulations require that sampling for primary inorganics be taken at prescribed intervals. Since this is a groundwater system, primary inorganics sampling is required every three (3) years. The last sample was received Please submit a current sample in order to bring your system into compliance with the inorganics sampling requirements. ST' Q) n LM3 K[ / STEVE COWPER, GOVERNOR E DEPT. OF ENVIRONMENTAL CONSERVATION/ ANCHORAGE/WESTERN DISTRICT OFFICE 563-6775 3601 "C" STREET. SUITE 1334 ANCHORAGE. ALASKA 99503 72 - DATE : --/ 6- -/-�----------- PWSID #: i Z 6) To Whom It May Concern: According to the records on file in this office, the I-,-- Water System is in compliance with the State of Alaska Drinking Water Regulations. Sincerely. �) Ronald S. Klein Environmental Field Officer GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received February 28, 1977 Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF JLI. INDIVIDUAL SEWER & WATER FACILITIES mo ou LoLff Mme°f FOR Conv. 1. Approval requested by: First National BAnk of Anchorage Mailing Address: Post Office Box 4-2090 99509 Phone: 2. Property Owner: George L. Hood Phone: 274-1521 Mailing Address: % Pat Stephen, Realtor 272-1541 3. Legal Description: Lot 9 Block 2 Sky Ranch Estates 4. Location: 11701 Wrangler's Way 5. Type of facility to be inspected Single Family No. of bedrooms _ 2 6. Well Data: A. Type Public tILW,_ B. Depth C. Construction D. Bacteria] Analysis 7. Sewage Disposal System: On-site system A. Installed / D 7< 13. Installer C. Septic Tank: 1. Size /.ZI 2. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines �:L�c••w /U / r — 8. Distances: A. Well to: Septic tank Absorption area Sewer Lines Nearest lot line Other contamination B. Foundation to septic tank _ Absorption area C. Absorption area to nearest lot line EQ -034 (1/74) Page 1 of two pages Page 2 of two pages 'RegL.;:st for Approval of Individual S �r & Water Facilities Legal Description' Lot 9 Block 2 Sky Ranch Estates Comments oved CJ - Disapproved —�— Date Approval,Valid for one year from date signed / Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ -034 (1/74) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 -East -Tudor -Road, Anchorage, Alaska 99504 276-2221 2S L Sd'. REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO VA _FHA__ 2. 3. 0 5. a 7 Mi NDfR CJ0 OF A vvrRONr OF I,,, cflnoArs MFNrgI RROlkciluly 8197/' �C�1 V� CONV XX Property Owner: George L. Hood (builder) Mailing Address:_ contact realtor _Day Name of Buyer: Herbert L. and Eve T. Heavner Mailing Address: 3500 Mt. View Drive #32 _ Day Phone: 243-]J 45 Name of Lending Institution: First National Banlc of Anchorage Mailing Address:_ P. 0. Box 4-2090 (99509) _Phone:_ 271 Name of Realtor or Agent:__ Polar Realty -Pat Stephen Mailing Address: 101 E. International Airport Phone: 272-1541 Legal Description: Lot 9, Block 2, Skyranch Estates Location 1 Wrangler's Type of Facility to be Inspected: SFD No. Bdrms.-1 8. Water Supply Type of Supply a Public Utility XX Individual If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System Type of System: Public Utility If Individual, date of installation 72-003(3/76) Individual (on-site) xx