HomeMy WebLinkAboutRIVER VIEW ESTATES BLK 3 LT 64, River View Estates Block 3 Lot 6 #050-721-24 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT (Permit Number: OSP221029 PID Number: 050-721-24 Page 1 of 3 (Dwelling: ❑ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ❑Q Upgrade Name Timothy Szika Site Address 21392 Barbara Falls Dr Phone rNum—berof Bedrooms (910) 725-9480 LEGAL DESCRIPTION Subdivision Block Lot River View Estates 3 6 Township Range Section ;EPARATION DISTANCES To Septic Tank Absorption Field Lift Station Holding Tank Sewer Line tom 3ravel width Beds: Number of Lines Distance between 5.0/5-0 Ft. well N/A >1 00' N/A N/A >25' Surface Water N/A >100' N/A N/A Lot Line N/A > 10' N/A N/A NA Foundation N/A >1o, N/A N/A Remarks Slight original grade difference from east to west. All of absorption area is in recieving strata. Installer Precision General Contracting Inspector L. Tidwell Inspection 1S` 3/13/22 2�d 3/14/22 3rd 4th ON-SITE WATER AND WASTEWATER SECTI I Approval: • 9 ❑Deep Trench ❑® Wide Trench ❑ Bed ❑ Mound n Other Soil Rating JTotal depth from original grade 0.8 GPD/SF 1.5-3.0/1.5-3.0 Depth to pipe invert from original grade Gravel depth beneath pipe 1.0-2.5/1.0-2.5 Ft. 0.5/0.5 =ill added above original grade Gravel length 2.7-1.2/2.7-1.2 Ft. 2@57 3ravel width Beds: Number of Lines Distance between 5.0/5-0 Ft. total absorption area Number of trenches Dist. between tren 570 Ft2 2 >6 rANK ❑ Septic-'[] S.T.E.P. ❑ Holding ❑ Other dlanufacturer Capacity Existing Number of compartments lines Ft. Ft.I KATION I Manufacturer Capacity location by Gall PIPE MATERIAL House to tank Existin g Tank to D3034 drainfield Drainfield D3034 CO/MT D3034 BENCH MARK (Assumed elevation) 100 ft Location and description Bottom of siding near tank O N APPROVAL I Engineer's Stamp Date Septic System Approved )9YDate 31.� 3 02002,? Note: this approval does not include well permit requirements. P ,���� 49 TH % BenjaSchiller �F� • CE 12592 ,,��4`L�� �'!l�c • . 3/18/22 , • ��, �k pROFESSI4N��� CO - CLEANOUT2CO - DOUBLE CLEANOUTFCO - FOUNDATION CLEANOUTFD - FLOW DIVERTER VALVEMH - MANHOLEMT - MONITORING TUBESV - SEPTIC VENTTH - TEST HOLELEGENDPERMIT # OSP221029PID # 050-721-24AB2CO17.1FD24.2CO174.2ACMT172.4MT256.2CO256.2MT353.961.761.659.857.651.465.863.51"=50'2- B D R M H O M E RIVER VIEW ESTATES, BLOCK 3 LOT 6FEET050100Benjamin SchillerCE 12592REGISTEREDPROFESSIONALENGINEER3/23/2022BARBARA FALLS DRIVE720710700730EXISTING 1,000 GALLONSEPTIC TANKEXISTING WELLw/ 100 RADIUS10' UTILITY EASEMENTFDEXISTING SEPTIC TRENCHTO REMAIN IN SERVICEFS (PRESENTBUT w/ NOSTAND PIPE)EXTENT OF FILL MOUND2 - 57' LONG x 5' WIDE, 0.5'EFFECTIVE DEPTHABSORPTION TRENCHES10'TH12COMT1MT2MT3CO2MT5MT4CO3PT2CO1CO4MT6PLAN AS-BUILTBCCO3771MT475.0MT561.9CO472.3MT673.467.264.862.183.383.9BNOTE: SWING-TIES ARE PHYSICALLYIMPOSSIBLE TO RECORD DUE TOEXTREME GRADE DIFFERENCES FROMTHE HOUSE TO THE SEPTIC AS WELL ASTREES BLOCKING A STRAIGHT PATH TOSWING-TIE POINTS. THE SWING-TIESSHOWN ARE IN DIRECT REFERENCE TOTHE SURVEYED PIPE LOCATIONS. PROFILE AS-BUILT (NO SCALE) 57' DRAINFIELD ROCKMT TH#1GROUNDWATER @ 63.8 ON 3/6/18 70.8CO CO57.8 70.8 MTBenjamin Schiller CE 12592RE GISTEREDPROFE S S I O N A LENGINEER3/23/2022 PERMIT # OSP221029 PID # 050-721-24 RIVER VIEW ESTATES, BLOCK 3 LOT 6 MTSOUTH TRENCH 57' DRAINFIELD ROCKMT TH#1GROUNDWATER @ 62.0 ON 2/9/22 69.0CO CO56.0 69.0 MTMTNORTH TRENCH 75.0 FINISH GRADE 72.3 - 73.8 ORIGINAL GRADE 71.3 71.3 73.2 FINISH GRADE 70.5 - 72.0 ORIGINAL GRADE 69.5 69.5 2" INSULATION 2" INSULATION LEGAL DESCRIPTION: PERFORMED FOR: DATE:PARCEL ID#: SOILS LOG AND PERCOLATION TEST 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 DEPTH (feet) PERK TEST 2 DATE READING START TIME NET TIME(minutes) DEPTH toWATER NET DROP PERCOLATION RATE: (MIN/INCH) (inches)(inches) DATE OF MONITORING WAS GROUND WATER ENCOUNTERED? DEPTH TO WATER AFTER MONITORING IF YES @ WHAT DEPTH? 12.97 3/12/22 1 2 3 Professional Engineers Stamp: n/a River View Est B3 L6 3/12/2022 050-721-24 Tim Szika 1:261 2 3 0 1:57 2:28 30 Benjamin Schiller CE 12592RE GISTEREDPROFE S S I O N A LENGINEER3/17/2022 TECHNICIAN:L.TIDWELL 22 16 n/a n/a n/a COMMENTS: 6" DIAMETER TEST HOLE PRESOAKED PRIOR TO TESTING SITE PLAN 22 16 30 24 16 24 16 30 25 16 25 16 0 0 PERK OF q .. 49 TH* 1 r SHANE A. HOLT LS -6914 0` O Q�a a o fessions� �Qo THE SURVEY DATA AND MEASUREMENTS HEREONAREPREPARED FOR THE OWNER OF RECORD AS OF THEDATE OF THIS SURVEY. ANY USE OF THIS DRAWING BY THIRD PARTIES IS PROHIBITED UNLESS WRITTEN PERMISSION IS PROVIDED. LOT5 20 \GTIijY s THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES- EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT , ARE NOT SHOUN HEREON ( UNLESS INDICATED) NOTE., FENCELINES THAT MAY APPEAR ON THIS DRAIJING ARE NOT TO BE USED TO DETERMNE PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE - BARBARA - _- N 78 1� G7'�EE-/ pR/vE-yqY AS -BUIL T SURVEY f " = 30' NO CORNERS SET THIS DATE I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY L 0 T 6 BL OCK3 RIVER VIEW ESTATES (PLAT 75-131) 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 16 TH DAY OF MARCH , 2022 15.365 FB 220 55 221 9 10' UTILITY EASEMENT HOLT LAND SURVEYING 9309 GROVER DRIVE ANCHORAGE,AK 99507 223-8615 DWELL LOT -4 *SA 4A T DISH LOT cNED � LOT -3 ,10' SETBACK LINE MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP221029 Work Type: Septic Upgrade Tax Code Number: 05072124000 Site Legal Address: RIVER VIEW ESTATES BLK 3 LT 6 G:0357 Site Mailing Address: 21392 BARBARA FALLS DR, Eagle River Owner: SZIKA TIMOTHY MICHAEL Design Engineer: FORGE ENGINEERING This permit is for the construction of: Effective Date Expiration Date Lot Size in Sq Ft: Total Bedrooms 1»cnr mot c;• f Department 2/14/2022 2/14/2023 44148 Q Disposal Field 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 wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: Issued By: Date: Date: 3 MUNICIPALITY OF Community Development Department r Development Services Division On -Site Water & Wastewater Program ANCHORAGE Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 050-721-24 Property owner(s) Timothy SZika Day phone (910) 725-9480 Mailing address 3505 Hemlock Farms, Lords Valley, PA, 18428 Site address 21392 Barbara Falls Dr Legal description (Sub'd., Block & Lot) River VIEW Estates, Block 3 Lot 6 Legal description (Township, Range & Section) Lot Size 44,148 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (N all that apply) Absorption Field ❑X Initial ❑ Single Family (SF) ❑X (w/wo ADU) Septic.Tank ❑ Upgrade ❑X Duplex ❑ (D) Molding Tank ❑ Renewal ❑ Multiple Dwellings El Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: Date of Payment: Q I o 20 2 Receipt Number: 0 9(. %`ON Permit No. 05P7 Z 102-9 Permit App_'- : • I Waiver Fees: Date of Payment: Receipt Number: Waiver No. February 4, 2022 MOA Development Services, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 2/4/22 Subject: River View Estates, B3 L6 – Barbara Falls Drive Septic system design Dear On-Site Services Engineer: The septic absorption system for the above lot has reached the end of its useful life, so we are submitting this permit application for the construction of a new septic trench. The attached site plan identifies the location of the home as well as the proposed septic location. No conflicts exist between this proposed system and any other well or septic system, whether on this lot or adjacent lots. The ground surface on the lot slopes toward the northeast steeply near the center of the lot, but the grade much milder near the north corner. It is in that flatter area that the new septic system will be located. There are no slopes greater than 25% within 50 feet downslope of the proposed septic site. Elevations are shown on the site plan showing the grade and direction of flow. Stormwater drainage will not impact this septic system. The new trench will be constructed parallel to the slope as much as possible. Wells on this and adjacent lots are shown. The new system will be a minimum of 100’ from all wells and surface water, and more than 5’ away from the septic tank. The trenches will be located greater than 10’ from all property lines and will be constructed more than 6’ apart. Please refer to the attached test hole logs, plan and profile pages for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Benjamin Schiller, PE Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221029, Deb Wockenfuss, 02/14/22 Q w? a V 3 COQ /Z D w! -/J a� Z OgF-U)0O C) U W O' I- z o w ��� w >y�w� /vo,w r' Z Zw w LL FQ F -O W S .-..`tet{ w w C9 w io Z>F-ZZ -j lY [llc� O z O n ��0 C Z� Z w O x W �WOz rn W n "'i; n ,!!1 WU UU) IL W - U Z z � w W O- �' z J 0 J > W 00 QZw FF - O F.-� 0 F- F W w W w / > J > O m z 0 0 0 L-) 0 p JOOoQOCLcn LU o OO O = w UC\lLL�2i�ciH V / ' w o o r... ® LL o ' Z `a- — x w w f i -w cn F— / U) `.�U W cl cl 1 1 w z cn W i w <.!' ui W LlQ j J o r � ' J (n W Wo aO t W Zo \ o O ! X 3 \ p W W w / d U) \ /f z ry ' d (V ! �a w w §; E () W > coS LLd U0 CD w o i O z ~I C f - O O O S F- U) F- U J w z O U O z z 0 S U) W elfQ H of w a_ O cra U) S E- O F- 0 F- a CL S E_ H O J O z ui F) :E Z LU Z:)N O � U U Z OW U) J O w J J W Q F- W W C=) w 0 CD LO 0 Lo 0 RIVER VIEW ESTATES, BLOCK 3 LOT 6 TYPICAL TRENCH SECTION (NO SCALE) NOTES: 1. GRADE AREA OVER TRENCH TO DRAIN AWAY 2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2' WITH 2" OF INSULATION 3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY Benjamin Schiller CE 12592R EGISTEREDPROFE S S I O N ALENGINEER4" PERFORATED PVC (HOLES DOWN) DRAINFIELD ROCK 5' 6" 2' DESIGN FACTORS:SYSTEM REQUIREMENTS: 450 GPD PEAK FLOW PERK RATE: 8.73 MIN/IN APPLICATION RATE: 0.8 GPD/SF SHALLOW TRENCH SYSTEM EXISTING SEPTIC TANK BOTTOM OF TRENCH: 2' BELOW HIGHEST ORIGINAL GRADE FLOW LINE ELEVATION: 1' 6" BELOW HIGHEST ORIGINAL GRADE TOP OF TRENCH: 1' 6" ABOVE GRADE (SEE DETAIL BELOW)) 450 GPD / 0.8 GPD/SF /5' WIDE * 1.0 RED FACTOR (0.5' EFFECTIVE) = 112.5 LF TRENCH REQUIRED (114 LF SPECIFIED) 2/9/2022 GEOTEXTILE FABRIC 3:1 1' 6" 6" 2' 6" 2" 40-PSI INSULATION Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221029, Deb Wockenfuss, 02/14/22 LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 DEPTH (feet) TEST HOLE 1 DATE READING START TIME NET TIME (minutes) DEPTH to WATER NET DROP PERCOLATION RATE: (MIN/INCH) (inches)(inches) DATE OF MONITORING WAS GROUND WATER ENCOUNTERED? DEPTH TO WATER AFTER MONITORING IF YES @ WHAT DEPTH? 8.73 2/2/22 1 2 3 GM (SILTY SANDY GRAVEL) Professional Engineers Stamp: yes River View Est B3 L6 2/2/2022 050-721-24 Tim Szika 1:101 2 3 4 0 16 1:41 2:12 OB/ORGANICS 30 Benjamin Schiller CE 12592R EGISTEREDPROFE S S I O N ALENGINEER2/4/2022 TECHNICIAN: J. Millette 8 4 16 9' 10' 2/9/22 COMMENTS: 6" DIAMETER TEST HOLE PRESOAKED PRIOR TO TESTING SITE PLAN BOH 4 4 16 30 7 8 16 3 8 16 30 7 7 16 3 7 16 4 0 16 4 0 16 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221029, Deb Wockenfuss, 02/14/22 Municipality of Anchorage On -Site Water and Wastewater Program • (907) 343-7904 Page i� of J? ON-SITE WASTEWATER INSPECTION REPORT Permit Number: O_5a/4//y!t/D PID Number: Q SO 7212g Dwelling: FPSingle Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ NewlJpgrade Name: ABSORPTION FIELD r�G/S rl®c/ C Address ❑ Z/3 �Z ������� �,l�.cL�' Q / Deep Trench El Shallow Trench ❑Bed El Mound Phone Number of Bedrooms Soil Ratin El Other 52� r 6�QQ � 9 Total depth from original grade LEGAL DESCRIPTION GPD/SF Ft. Depth to pipe invert from original grade Gravel depth beneath pipe Subdivisions Block Loth ll/ /� 3C> Ft. Ft. Township Range Section Fill added above original grade Gravel length SEPARATION DISTANCES Ft. Ft. Gravel width Beds: Number of Lines Distance between lines To Septic Absorption Lift Station Holding From Tank Field Tank Ft. Ft. Sewer Total absorption area Number of trenches Dist. between trenches Line Fe Ft. Well �i i 1a�/ 10�I !f l/ 1(!j A1,,q zSf TANK Septic ❑ S.T.E.P. ❑ Holding []Other �/� Man facturer Capacity / ����(� � 1� /�0a Gal. Surface Water /aa 1QCJ r,t N,4 Material Number of compartments Lot Line ( Foundation NA LIFT STATION Manufacturer Capacity Curtain Drain — _ r . - Gal. Rema/r�ksF/ C i ��� Pump on level at Pump off level at High water alarm at 416—: AJ T in. in. in. Pump make and model Electrical Inspections performed by Installer IY1l'E MLI 1 FI{141 Tank to /✓n House to tank rlrainfialri- 1 Drainfield 367.� CO/MT Inspector .. / BENCHMARK (Assumed elevation) /l%0 ft Inspection i 7 T 2'"' d % / 5/ 3� 1 Location and description ���� ' �c P 4 m COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp Conditional Approval: Date - Approved 'n , ,e/ Date /0 -z Inspection Report -9 1-12.doc .q,y RIVERVIEW EST 1 = 40 NOR THRIM ENGINEERING =��?��•�•�i, '4 .4sm : *, BLOCK 3 LOT 6 RECORD PO Box 770724 , , :. , f REPLACE SEPTIC �� Eagle River, Alaska 99577 '+m�Z `!. �' LAYOUT Date:10/28/14 2E of 31 907.694. 7028 ' TANK Q -- 2� < o O 0 h p rn X ZZ ''I ro Q Q V y V h Neor1lZ �i ^Z^ V D Q CA O (D Olt A� f (D c O -9 p o ^, s S -D O �`�q'1� ``'*► ��� bCJ � 'S Q Q Q Q Q O i-) ro (� Q Q D ITl F9 o Q C+r0 0 � � n �� U 7CJ n F9 ofrl _ f*1 F D Dro ro k ro D z Ln Q < QQ (� T U) `+ Lt Lt F9 3 Qp 0 0 F9 7c 0 z a Tl m0 ° ,D .D H < w Q po (D + F9 O _� C? D D Q � C w o O c O 1-1 Ln ro H F- < r F9 T �;7 rD C ro a < ro V) F9 V) 0 � C ` � O Lt o n s V)p � x x Q � D Cil 90 _ Fri cD V -3 D Dn :3n �. n O s w m On -Site Water and/or Wastewater System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP141440 Tax Code Number: 05072124000 Work Type: SepticTank None Permit Effective Dates: October 02, 2014 to October 02, 2015 Design Engineer: NORTH RIM ENGINEERING Subdivision: RIVER VIEW ESTATES Site Legal Address: RIVER VIEW ESTATES BLK 3 LT 6 G:0357 Owner/Address: THIBAULT RAYMOND J & HOLLY A 21392 BARBARA FALLS DRIVE EAGLE RIVER AK 995770000 Site Mailing Address: 21392 BARBARA FALLS DR, Eagle River This permit is for the construction of: N Disposal Field Y Septic Tank N Holding Tank N Privy Lot Size in Sq Ft: 44148 Total Bedrooms: 3 N Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received Issued By MUNICIPALIW of Community Development Department Development Services Division On -Site Water & Wastewater Program Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWERNVELL PERMIT APPLICATION Parcel I.D./J50 Property owner(s) 7H.Z i"(uG R y Day phone 5 Z?-6"�a Mailing address 013 92- 3,+ie& V f FWS- Q/2 Site address 3'fm g� Legal description (Sub'd., Block & Lot) <f ✓f,4W_ Legal description (Township, Range & Section) Lot Size 4141, / tf Sq. Ft. Number of Bedrooms APPLICATION IS FOR: (0 all that apply) Absorption Field ❑ Septic Tank Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ APPLICATION IS AN: 3 TYPE OF DWELLING: Initial ❑ Single Family (SF) Upgrade (w/wo ADU) Renewal Duplex (D) El Al 1 le Dwellings ❑ and/or D) OCT 0 1 2014 THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner Permit/Rush Fees: ZIS Date of Payment: to 11 jig C Receipt Number: Permit No. O`JPI14 IL190 Permit App_9-1-12.doo Waiver Fees: Date of Payment: Receipt Number: Waiver No. a TH IR M �GG NEERING MEMO Steve Eng, PE, PH (907) 694-7028 tel northrimeng@aol.com Date: 10/1/14 Number of Pages: To: MOA On -Site Services Subject: Riverview Estates, Block 3, Lot 6 Septic Tank Upgrade The subject septic tank is too close to the house and will be replaced. Please expedite a permit so the tank can be replaced. We tried a waiver, but we are now replacing tank. The owner is under hardship due to wanting to close. Please review as soon as possible. If there is need for additional information or clarification please give me a call. Thanks-St� Tk I - ENGINEERING Riverview Estates, Block 3, Lot 6 SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: This is an existing 3 -bedroom, single family home. Most of the neighboring lots are developed. The current septic tank is too close to the house- the trench is still useable. These lots are large and are served by private wells. No adverse impacts are expected from tank replacement. The easement is drawn on the lot drawing. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations. • Two compartment, 1000 gallon septic tank. Watertight couplings on inlet & outlet. • 5' minimum between the tank and bed. 10' to property lines. • 4' of cover or insulation is required for tank; an equivalent of 1" insulation for F foot soil cover. Minimum of 2' soil with insulation. Minimum 2" Insulation. • Tank & solid pipe must be set on well compacted, stable soil. • 4 inch diameter cleanouts with airtight caps are required F to 4' from foundation wall, prior to any 90 degree bend in 4 inch line, in each tank compartment, and two adjacent opposing cleanouts between the tank and the absorption field, not more than 10' from the tank positioned to provide cleanout access towards the tank and towards the absorption field. • All cleanouts must extend to at least ground level. • In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron. • Insulation must be placed over any pipe installed under driveways or parking areas. • Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661, • Sewer Service Line is minimum 2% slope. • Septic Tank to be pumped every two years or when required. • Insulation board to be extruded direct burial polystyrene (Dow Styrofoam HI/equal) DESIGN NOTES: 1. Existing trench/Bed Remains In Place. 2. Sewer Service Line minimum 2% slope 3. Replace Septic Tank/Decommission d Tank. 4. Lots Served by Private Wells. 5. No Conflicts Within 200'. 5voIe Well Install New FCO Connect To —//z \ Existing Trench ecornmission Old Septic Tank New 1000 Gal I Tank °F RIVERVIEW EST 1° = 40 1 NOR THRIM *'49 BLOCK 3 LOT 6 PLAN ENGINEERING PO Box 770724 Engle Riven Alaska 99577 a ' LAYOUT REPLACE SEPTIC ' 907.694.7028e: TANK 10/1/14 2 of 3 i' 3 O i C5 0) U i 0 0 a 0 0 O L_ 3 p I � u U 3 i P21 i (4- L� H O O c W in ~ N ~ It di N Q Y O iI— i d O S F- 0d O w F U W poj LUi E:l i' w J W 0 ~ w () U - r U -P V >C5 x c N 2: Ld Y 3 W U v O ro H J N Qf� W o 3 0 p oaja W H ClU �— Ll M:a z Ll v w Cl.L v z El u ai m w Q o L u o cJ -C Z Q u u Q J o as W z d o U Na- H u 0 %, Y LA a v -F' 3Nd SLA a W Q 0 i u oi, v s aN u v I— Ua O i0 OJ O 3 5 a pv o a t u M C � Q1.3 0 0- EmpiU }+U O LJ pU O V �E CD C 0_ JAN U of CD a, • g`�ai j4,o '•y- OI0 01 -1 p C .6� � �$ ii U i' O D F- o6 L` N aU N ri7 �i 0 Ls'__I- i 0 of I- NN -U �Z aj Ln n U Y I L "OU n Z LJ j W ao WN � �v ni�3ii¢�Q �Z ca C7 C) LLI p� p .4 Ou M n �D I�, Z W a s W MUNICIPALITY OF ANCHORAGE ® ` DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 82.5 LStreet -Anchorage, Alaska 99501 Telephone 26.4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT -- - - NAME - PFIONE ---T EW ❑UPGRADE MAILINGp DR ES 1 1161 LEGAL DESCRIPTION ll-. LOCATIO& NO. OF BEDROOMS - TO: Well i t I, oo _ Absorption 'ea L Dwelling _�. J7 PERMIT NOy _71DISTANCE (1 (,;� (� L i �"7 1- Z UJ Manufacturer - 1 Material "�: -i/ No. of mpartments y Li .rapacity In gallons -'� IF HOMEMADE: Inside length_ Width --- Liquid depth =_ Zjo L DISTANCE TO: Well Dwelling PERMIT NO. F- Manufactu-er _ ar Liquid capacity in gallons 0 w 1 DISTANCE TO: Well .''f- i L��i Foundation � � Nearest lot line_ i' C`J� PERMIT NO. �/ -- rJ C' 0, o U- Z z w No. of lines Co V) C_ Length of each line .7. ,2i Total length of lines Trench width inches Distance be w r Ines ,� e� ccH in Top of tile to finish grade ) Material beneath tile -.. _r L Total effectiv al?so.pt��t area w 0 Length - idth th PERMIT NO. Q H w Type of crib Crib diameter Crib iepth Total eff 7cove absorptio ea wWell ti DISTANCE TO: Buil oundation Nearest I' .J `las Depth Driller Distance tolot line PERMIT NO. ..� . W DISTANCE TO: Building fou tion _ � vi Sewer line -( ICU Septic tank Absorption arQals1 OTHER PIPE MATERIALS f SOIL TEST RATING INSTALERh �v w55 L� i` REMARKS PP O,vED DATE. LEGAL LQ 72-013 (flbk3/78) �� Dox 136990 svrAm Hour= A ANCUORAGE, AEAsKA 00502 344®'7714 "meq (s SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF DRILLED AT THE RATE OF 9.20.00 PROPERTY OWNER LOCATION OF WELL DRILLER WELL LOG: lll)to Bohn, gto4,j a. PER FOOT. 73ed stack : 919.00 694-9738 Bik. Sabo l3eJuue C.tau�j of- k:anzpv t. D&,U.L aq, [uo,,4k4. 184 T ee�t. 0 ----?4' Sitta y2w-ue,,l i&w). setup/1aJ -Aura l,! hauJ-de yA. iae t nrtnrl a t17 dee t, 24----60' C)aiiet and bou dem, 60=•157' R f�i wt 4hate )nock. Some 4t)teakj of- caa,(.. 1/.2 yl'!It a.4 water at 156-157° 157784' AcJI.alUf vt %type lwck. ltlo&e- /2o&o !4 andari arm gat /2eh itanate. 1440 a -a A pyi, 24 howl, Vme 4>irme. 7otat pJtaductitoa ijhoutd 2nC uJ "e tD',Lth U'de. IJatyl- &ecdll"j, t0'l.:tlLUt 30 I-eet dl- 4W -ace. 4hau>td .6e ltw taitul tea -fee t; o4f bottom. C.o4 L of- 820 reJt y_oo-tX60 f-eet: 87200.00 is 19.00 /z a o tJtarrz 60 10 184' no Clwale .daft we U jeat. 1.24 Peet X 879000==8.2356.00 Ja,tat:i63556.00 COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF 0.556.00 THANK YOU VERY MUCH. BERNIE CLAUS OF RAMPART DRILLING 01 KS DATE fllcuteJL 3011 7980 SERVICE CHARGE O F IV2% PER MONTH WILL BE ASSESSED ON PAST DSU ACCOUNTS. viU M m__a E"-4 T C- J_ s' fA L— 1 'f` 1-0 [V'ti F�' Fl P-4 A:- F -L ,_e Ef.' F l e_i FE j DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 'L'' _STREET, ANCHORAGE, AF`:. 9950:1 .'•-�- 264-4720 PERMIT" NO. 800033 �cx{�uS APPLICANT JOHN GROSS PO BX 1161 ER. 69.4-9 LOCATION ER. LEGAL. LTS 6 BLK.:. R I VERV I EW EST; LOT SIZE 41000 SQUARE FEE]" TYPE OF' SOIL ABS-ORPT I ON SYSTEM I S : TRENCH NUMBER.OF BEDROOMS = 3 SOIL_ RATING (SO FT,,'F:F;,.)= 100 THE REQUIRED RED SIZE= OF THE SOIL. AB -SORPTION sYsTEM I S : =■ � 8� ° "'�"' �-1=� �d_ � � L._ #v. f =.# e: � "i F�il -.�. ;�.. � e n F�: d �I "•"°" I� N.._ _ [`■ � IF" "T- i--# == �=� THE LENGTH DIMENSION I S THE LENGTH (IN FEET) OF THE TRENCH OR DDA I NF I ELD. ,THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEaEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE. GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL_ BETWEEN THE OUTFALL F'IF'E AND THE BOTTOM OF THE E„CAVATION (IN FEET). E v::� Vim" A" t b_�M: 11� E= 7 e�- f` If-# r-4 F = : '= . ]C Z EE PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMEN-r DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO -THIS PROPERTY ArID THE NUMBER OF RESIDENCES THAT THE- WELL WILL SERVE. MINIMUM DISTANCE BETWEEN A WELL A? -.ID ANY ON -::,ITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR :150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC: WELL. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAY= OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. IF •° IE—E W pi I "ET" EF" x V:° EES "m=: Ic■ F--- e7: F r °w F-• U- F� I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS ANC` WELLS AS 'SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. : I WILL I NSTAL.L. THE SYSTEM IN ACCORDANCE WITH THE CODES. . I UNDERSTAND THAT "THE ON-SITE SEWER SYSTEM MAY REL-.,lU I RE ENLARGEMENT IF' THE RESIDENCE IS REMODELED D TO I NCL,Ur,',E MORE THAN 2 BEDROOMS. �tFPLI! -.-N- JOHN GRCIS ISSUED BY..��1! �� ���? ' _. _ DATE- i 7 V4. 0 BACKFILLING' OF ANY SYSTEM TE:.M WITHOUT FINAL INSPECTION AND APPROVAL. BY THIS DEPARTMENT WILL BE SUBJECT 'TO PROSEWCUTION. MINIMUM DISTANCE BETWEEN A WELL A? -.ID ANY ON -::,ITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR :150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC: WELL. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAY= OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. IF •° IE—E W pi I "ET" EF" x V:° EES "m=: Ic■ F--- e7: F r °w F-• U- F� I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS ANC` WELLS AS 'SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. : I WILL I NSTAL.L. THE SYSTEM IN ACCORDANCE WITH THE CODES. . I UNDERSTAND THAT "THE ON-SITE SEWER SYSTEM MAY REL-.,lU I RE ENLARGEMENT IF' THE RESIDENCE IS REMODELED D TO I NCL,Ur,',E MORE THAN 2 BEDROOMS. �tFPLI! -.-N- JOHN GRCIS ISSUED BY..��1! �� ���? ' _. _ DATE- i 7 V4. 0 >' SOILS LOG MUNICIPALITY OF ANCHORAGE IJ ® �I DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST Pouch 6.650, Anchorage, Alaska 99502 276.2221 �- SOILS LOG - PERCOLATION TESL' PERFORMED FOR: C- l��I Cl i DATE PERFORMED: LEGAL DESCRIPTION: / t-/ / /( �(��� (,'/�C�G(� ,) /7 7 6..J DP S E SLOPE r - SITE PLAN - --- i ----- --1 9 --� - — I 3 U _ r-0 — --' _ 4/-y /CC 6 8 , L 9 r 10- 11 0 11 12 13 12- 14- 15- 16- 17 4 15 1617 18 19 20 COMMENTS PERFORMED BY: 72-008 (7/76) WAS GROUND WATER �6 /L S-� ENCOUNTERED? L 0 P IF YES, AT WHAT E i ✓ DEPTH? Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE TEST RUN BETWEEN CERTIFIED B (minutes/inch) FT AND FT DA December. 31, 1.979 John Gross Post Office Do- 1161. Eagle River, Alaska 9957? Permit =790653 Subject: Lot 6 Ploc}_ 3 River_ View Fstate5 Subdivision A permit issued by this depar.tnent for well and/or sewer systern has expired. Permits are issued on a calendar year basis, as si:ated on the permit, by authority of tdunicioal ordinance. �.I V0 LI IldVct ..IL... .._�.._.. ;_�:C? ",i e.. i. 1., :1 wc311 IOCj S; ' be sent to this depar.tment to document the installation date. I an engineer has inspected the installation of the on-site sewer system, :�j.ease have them send us t;lie as-builts for our files. Tf there ar.e any further questions, clease contact this, office at 254-4720. Sincerely, Les V. Buchholz, - Senior Environmental S ec' LN3/1jw enc Copy v_. Pl _'_-,i Z @] 6� THE LENGTH DIMENSION IS THE LENGTH (lN FEET) OF THE TREHC1 0R 4HlFS, IEL1 i THE DEPTH OF 8 TRENCH OR |`IF IS THE j)ISTRNCE 8ETWEmN TG. niRFHCE 0F THF GkUUND HND THE BOTTOM OF THE EXCRYHT{0M (IN FEET) THERE lS NO ST WI0T|| FOR TRENCHES THE GRHVEL DEP[H IS THE MlNlMUM D[PTH UF GRHVEL WTUE: "J [I H`�i PIPE HND THE END 11111 OF THE EXCHVHTION (lH FEET) ����''ItZ����:, �������, :: ����, �! j� . `�::; 1, � :!� I' � = ����i: ����_����� PERM{T HPPLlCHNT HHS 7H[ REQPOMSIDILlTlNFDRM THIS mEPWTMENT ;i/PIMG TA INSTHLLHllIS! INSPECTIINC O[ HNY |WLi ; 9DJRCENT iO THlS PROPERTY 10 NUMB�R OF RESl|)ENCES 1114 THE HELL w}|'L SERYE �������� --- BHCKFILLING OF HNY SYSTEM |dlTHOUT FINHL lN�PECTI0N H!�� HPP�OVHL VEPHRlMENT WlLL Bg 0U8JECT Ti Pk0SECUTl0N [ CERTIFY THRT 1� I HM FHMILIHR WITH THE REQUl0EMENTS FOR ON-SlTE hEwERS HNo WFLi SET FORTH BY R/E MUNICIPHLllY Oc RNCHORHGn 2� I NILL INS!KHLL THE SYSTEM lN HCCORDRNCE WlTH THE CU�ES J I UNDERSTHND T|/RT THE ON - SITE SEW0R SYSTEM MHY REQUlRE ENiQW, E!1E�T RE�lnENCE IS REM00?iAED TO INCLUDE MORF THHQ ] BEDRO0to; HPH-ICHNT J�HH (�ROS� I: �SUiD BY___�--- _-__-_------'1-,.-0H1E c"- -1 `/4� Y: Y '-jr" C Er= % -1 k' °! fl ::= 6-d C r F� R= -Y flFE - DEPAF:TIIENT HEALTH AND EN'%.'IROi-4NENTAL -: TEC:TICIN '1'3 STREET. t=iPdi::hlOr FICiE, hi K. =?: _ Ct1. 1 °a r_ L_.. L__ Fl 1v -a 1_ F v PA --- ----; I' —f-. � � � n_°-1 � :1= ° 1-° � rw r° � :r T - PERMIT NO, APPLICANT LOCATION LEGAL_ LJ� 2 �_�� � LCIT Ii:E_ SGKIARE FEET TOF :-:iilL AE,�,iaf?F�l-Iiir,1 :-;4'=�T"Eh1 I.��: ����� In C) � NUMBER OF BEDROOMS �_�__ F:ArIhi 1 C OCAhiAXIMIJM TWE I r<'EC' S I ?E OF THE St1I L At- d .:.'r STEr1 I 1� Co CE: 1=-, '-F V..9 Z _:: ( 0fl_ G :_ B°.. a_y ..I_ 9-1:=: o B_a F =_ 6-=l \.°" C—� L.__ H ti IC= F:-° 7-1---9 == THE t_ENG"TH DIMENSION I., THE. L_E'NGTH 'AN FEET) OF THE. TRENCH OR DRAINFIELG. THE DEPTH OF A TRENCH OR PIT I,S THE. DISTANC:E BETWEEN THE SURFACE O1- THE GROUND ANE:•' THE BOTTOM OF THE EXI__: v'ilTION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMI. -IM DEPTH OF GRFilv'EI__ BETWEEN THE OUTFALL F'IF'E AND THE BOTTOM OF= 'rHE EXC'A'S'ATI0N 1;IN FEET). I: Ir=. FE E✓` F:.:�- ° -T, I l _.y-.. f -9 r-.1 F e I ' E=_' ._ l C) O s F� L__ 1._ rVt k .1 PERMIT APP- I CANT HAS THE RESPONSIBILITY TO I Nh= OF:M THIS DEPARTMENT DURING THE INSTFILLATION INSPECTIONS OF ANY WELLS AC)..TACENT TO THIS PROPERT'r' AND 'T•HE NUMBEF✓ OF RESIDENCES THAT THE WELL. WILL `;FRVE. `y-1 ° CH °- "_ _b .I` 1"d F' k _ _ i__V T. 1. -fl 1''d 9 '�� 9 Fes: 6a ` E. G:? t_I L. 3' _ Fm F-:2 BACKFILLING OF ANY SYSTEM WIT ROUT FINAL INSPEC:TION AND APPROVAL EIY THIS DEPARTMENT W I L.L. BE -SUBJECT TO PF:OSECUT I ON. MINIMUM DISTANCE BETWEEN A WELL FIND ANY 01--4--SITE SEWAGE DISPOSAL SYSTEM IS 1.00 FEET FOR A PRIVATE WELL.; OR 1.50 TO 200 FEET FROF'1 A PUBLIC WELL DEPENDING UPON THE TYPE: OF PUBLIC.' b.IELL. WELL. LOGS ARE REQUIRE[:: AND F91_IST E.I. RETUF<:NED TO THE DEPARTMENT 1,11THIN 2.F DAYS OF THE WELL. COMPLETION. OTHER REQUIREMENT'S MAY APPLY. SPEC I F I CAT I ONS AND CON"~TRUC_.T I ON D I AGRAF"I'w ARE AVAILABLE TO INS UF:E= PROPER INSTALLATION. ll_ lr_ EE :}=o F l: ERE _ C:• r- a" %=1- 1 EE'F--- f -' ; 'L. I CERTIFY THAT I.: I AM FAMII._IAR WITH THE REQUIREMENTS FOk' ON-SITE SEwE_FFs FORTH BY THE. h1LiF� I (;.I COAL_ I "r4' OF ANC :h-IORAGE. I WILL INSTALL THE=AYSTEM IN FiC:C:OW)FI•ICL= WITH THE: CODES. I CINDERS-F'AND THAT THE ON--SI'1-E SEWER SYSTEM MAY REQUIRE RESIDENCE 15 REMO[)E LEL: TO INCLUDE MORE 'THAN BEDROI-IMS. I_ I CANT I SSLIED B`r'_ . �C9�u �� �h2 4_ . D1=ITE_ A._ t� 7ID AND 14ELLS A'S SET ENLARGEMENT IF THE V3. 2 April 2f.r 1.97'8 I 7� J772221 llm-1 1161 'Naglo " I -. illiw-r, Ala -Ra 9 9 5T/ Sub-, oI I j ct Pnr-d,., �. A perYi it. issuo'd by t.M.0 doi,)artc.ment for well and/or on-site scw(-��)'. insta-1.3,11.ion on Lot 6 Block 3 River View 1,'statO8 Subdivision 1w; expirc!O the issu." Otate O,rcecl.j ye-ar. In tho avent you still plan to ins -'Call the well and/or on-sito so.wor a new permit -i.,.; rn(puirc?d. The Original soil t it, est may bn us&ll to obtain a curron4t. -oc�rrii If! the well has boon dlrillod# a well, log sliciii-ld bo sent, to t hi c7E2Ssa7 iti9c zai to cloc-mmeni-- tlie dato. If voll have- ally citlet"ticn-.ts reqardinrf the above mark ter, p: ear( c.-ontact this of,.'Ffice, irm"ndlntely at 264-4720. Ties N. 31-tchhO.,U70, ROSO Senior Enviroweicntal (11ppciullisi- LU.B _ SIGNE0� ��� HPPLlCH ISSUED BY ^� 71 / / MUNICIPALITY OF ANCHORAGE Development Services Department Phone: (907)343-7904 On -Site Water & Wastewater Section Fax: (907)343-7997 Certificate of On -Site Systems Approval OSC251167 Parcel ID 050 -721-24 Expiration Date: 5/5/2026 Legal description RIVER VIEWESTATES BLK 3 LT 6 Site address 21392 BARBARA FALLS DR Current property owner(s) CORRAO AUSTIN X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or conditions: Original Certificate Date 5/14/2025 ThisCe icate of 6n -Site Systems Approval (COSA) is intended to demonstrate the subject syst (s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Dvelopment Service Department (DSD) issues COSAs based upon representations provided by an V independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's submittal. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 050-721-24 Complete legal description RIVER VIEW ESTATES BLOCK 3 LOT 6 Location (site address) 21392 BARBARA FALLS DRIVE EAGLE RIVER, ALASKA 99577 Current property owner(s) AUSTIN CORRAO 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS Day phone 3. TYPE OF WATER SUPPLY: RN Private Well serving # 1 dwelling units F-1 Other Non-public well as regulated by MOA ❑ Water Storage ❑ Community Well or Public 4. TYPE OF WASTEWATER DISPOSAL: F0 Private Septic ❑ Private Septic serving 2 dwelling units R Holding Tank R Community Septic or Public Sewer 6. SEPTIC TANK: RE Steel R Plastic R Concrete R Fiberglass Age 11 - See advisory if steel or fiberglass older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS E] Bed F-1 Deep Trench � Wide Trench Fj Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $. f_5-0 Date of Payment COSA # 0 SUS -11 U-7 Waiver Fee $ Date of Payment Waiver # COSA Application—Apr2025.doc COSA Checklist.docx COSA Checklist Legal Description: RIVER VIEW ESTATES BLOCK 3 LOT 6 Parcel ID: 050-721-24 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA Well log is filed with Onsite (or attached) Date drilled 3/30/1980 Total depth 184 ft Cased to *60 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 36 in. Date of flow test for COSA 5/5/25 Static water level at beginning of test 36 ft. Well production at time of test 1.23 gpm Water storage tank volume None gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date 5/5/25 Comments *Well log indicates cased to 184’ but also indicates bedrock begins at 60’. B. TANK DATA Measured operating fluid level in septic tank 49” Date of pumping 5/5/25 Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 3/14/2022 ALL standpipes present per record drawing Total measured depth from existing grade 3.4 ft (max) Measured depth to pipe invert from grade 2.3 ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes (MT) go to bottom of effective. (ED) If not, state depth into effective Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) N If yes, enter date Adequacy test date 5/5/2025 Results Pass (Trenches North / South) Fluid depth prior to test 2 / 0 in Water added 450 gal New fluid depth 3 / 1 in Elapsed time 30 min Final fluid depth 2 / 0 in Absorption rate 450 gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) 6 in (MOA 0.5’ ED) Effective depth used 2 / 0 in (Final Fluid Depth) Effective depth (ED) remaining 2 / 0 in Comments/Deficiencies: COSA Checklist.docx E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No >5’* ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS *Met code at time of installation. G. CERTIFICATION & 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, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 05/13/2025 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & 05/13/25 Certificate of On -Site Systems Approval Parcel I.D. 050-721-24 Expiration Date: _ JWAC- '� 3 , a OO Q 1. GENERAL INFORMATION Complete legal description River View Estates Block 3 Lot 6 Location (site address) 21392 Barbara Falls Dr, Eagle River, AK 99577 Current property owner(s) Szika, Timothy Michael Day phone (907)725-9480 Mailing address 3505 Hemlock Farms, Lords Valley, PA 18428 -ter y Bacon(907)9471-1140r Real estate agent Day phone 2. TYPE OF DWELLING: ❑ Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single f=amily and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY:. TYPE OF WASTEWATER DISPOSAL: Private Well ❑ Private Septic no Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ W Waiver Fee $ Date of Payment 3 a a o 2 a Date of Payment Receipt Number 0 2 f o 3b Receiot Number COSA# 050,2 f 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Forge Engineering W -J.) Phone (907) 522-7773 Address 1399 W. 34th Ave Suite 101, Anchorage, AK 99503 Engineer's Printed Name Benjamin Schiller, P.E. Date 3/16/2022 OF •`��ll qs i TH /*:49TH •* 6. DSD SIGNATURE System #1 A � • • • • ��:�: y Approved for bedrooms / '. •Ben'jaVSchiller _System #2 Approved for bedrooms��`�is�,; __s/E?o z . •�;'`� Disapproved 1`PROFESSIONa�.� Conditional approval for bedrooms, with the following stipulations: /JJJJ y0 ON-SITE G;) VA ER z r�'v AT o PROGRA 1� 1 v\GC Rw v By cax - e: Original Certificate Da a 3Igo g t The Municipality of Anchorage Development 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. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet COSA Checklist yellow sheet COSA Checklist Legal Description: Parcel ID: 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) Date drilled Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test?Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date of Sample Comments __________________________________________________________________________________ B. TANK DATA Age of tank(s) years Tank type/material Measured operating fluid level in septic tank Standpipes/foundation cleanout per record drawing Date of pumping C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA ______________________ Which system tested (date installed) ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) N/A – pressurized field Monitor tubes go to bottom of effective. If not, state depth into effective Code-required soil cover over field System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Adequacy test date Results Pass For bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) If yes, enter date Comments/Deficiencies: River View Est Block 3 Lot 6 050-721-24 ■1.5 3/30/80 n/a 184 ■ *60 ■ ■ ■ ■ ■ 24+ Forge Engineering 1/24/22 49 12/9/21 *Well log records bedrock from 60' to 184' indicating that the well is cased to at least 60'. 7 Septic/Steel 54 ■ 3/18/22 Wide Trench 3/14/22 ■ 4.2/4.2 3.7/3.7 ■ ■ NEW ABSORPTION FIELDS 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’ Yes if No ft Neighboring Tank > 100’Yes if No ft Absorption Field on Lot > 100’Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’Yes if No ft Holding Tank > 100’Yes if No ft Animal Containment > 50’Yes if No ft Manure/Animal Excreta Storage > 100’ 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 Property Line > 5’Yes if No ft Absorption Field > 5’Yes if No ft Water Main > 10’Yes if No ft Water Service Line > 10’Yes if No ft Surface Water > 100’Yes if No ft Wells on Adjacent Lots: Private Wells > 100’Yes if No ft Community Wells > 200’Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to:(Please enter distances if less than required) Building Foundation > 10’Yes if No ft Property Line > 10’Yes if No ft Water Main > 10’Yes if No ft Water Service Line > 10’Yes if No ft Surface Water > 100’Yes if No ft If absorption field is under driveway comment below Wells on Adjacent Lots: Private Wells > 100’Yes if No ft Community Wells > 200’Yes if No ft F. ENGINEER’S COMMENTS G. ENGINEER’S CERTIFICATION I certify that I 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. 3/23/2022 ✔✔ ✔ ✔ ✔ ✔ ✔ ✔✔ *>5 ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ *Tank met code at time of installation. ✔ Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 050-721-24 1. GENERAL INFORMATION Expiration Date: / ' a <q Complete legal description River View Estates Block 31Lot 6 Location (site address) 21392 BARBARA FALLS DR, Eagle River, AK Current Property owner(s) THIBAULT RAYMOND Day phone 529-6300 Mailing address same Real Estate Agent Brandon Tatum, Day phone 865-6549 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) SURWITAL SEP 18 201A 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class C Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Received by: ZEE y 4V Date: COSA to be released to the engineer, unless otherwise quested by the engineer. COSA Fee $ 5a6 Date: 1210 / 4,, Date of Payment �%�� �� Date of Payment I�0 Receipt Numbern�J�`J�U�i Receipt Number COSA # U SC��i �`lg� Waiver #� l'I ZZ 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 NorthRirn Engineering Phone 694-7028 Address PO Box 770724, Eagle River Engineer's Printed Name Steve Eng Date 6. DSD SIGNATURE _LZ System #1 Approved for -3 bedrooms. System #2 Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following By: , y Original Certificate Date: The Municipality of Anchorage Devlopment 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. ATTACHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory COSA blue sheet 9-1-12 doc X Nitrate Advisory Arsenic Advisory Other If more than 7 septic system is on the lot: COSA Checklist # Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: A%5e V/FaJ /�Sr&jT6_(' 13-3 /_ Parcel ID: 050-%Z% 2V i A. WELL DATA Well type P_ If A. B, or C provide PWSID # Well Log (Y/N) Date completed .3 30 8Q Sanitary seal (Y/N) * Wires properly protected (Y/N) Total depth ft. Cased to 66 ft. Casing height (above ground)_in. FROM WELL LOG AT INSPECTION Date of test 3 301'0 Static water level 30 Well production ( 9 -P.M. WATER SAMPLE RESULTS: Coliform _colonies/100 mL Nitrate _ eLmgIL Arsenic 4/6 ug/L Date of sample: B. SEPTICIHOLDING TANK DATA Tank Type/Material 5 C%/ Tank size 00-0 gal. Number of Compartments 2 Foundation cleanout (VIN) Dpnression C.e tank (vm i / - '::i A —. 0. _T g.p.m. Collected by Date installed Cleanouts (Y/N) Hlrteh vYater aICa,m (ViN) �_ Date of pumping Pumper 29W N � 7?Lo j k C. ABSORPTION FIELD DATA Date installed 0 Soil rating (g.p.d./ft2 orft2/bdrm) X00 System type—Te-4C Length Z 3 ft. Width 3 ft. Gravel below pipe 8 ft. Total depth _10_ ft. Eff.absorption area 3�ft . Monitoring tube Depression over field Date of adequacy test /(/ Results (Pass/Fail) For 3 bedrooms Fluid depth in absorption field before test L_ in. WateraddedSO gal. New depth 2C' in. Elapsed Time: 30 min. Final fluid depth /Z' in. Absorption rate >= SQ g.p.d Any rejuvenation treatment (past 12 mo.) (Y/N & type) Nd If yes, give date D. LIFT STATION A(14 Date installed Size in gallons Manhole/Access (Y)N) _ "Pump on° level at in. "Pump ofP level at in. High water alarm level at Datum . Cycles tested E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot z/gr7 r -(-- Absorption field on lot �� O Public sewer main /�<} Sewer /septic service line Z 5 Animal containment areas g O d" Meets alarm & circuit requirements? i On adjacent lots /DD f On adjacent lots d Public sewer manhole/cleanout AJ Holding tank /V- Manurelanimal excrete storage areas /Q0 r or SEPTIC/HOLDING TANK ON LO TO: Building foundation 0#5 Property line _/j Absorption field S v4— Water main A,16Water service line Surface water Wells on adjacent lots�¢ ABSORPTION FIELD ON LOT TO: in. Property line /0 ' - Building foundation eV fi Water main A112 Water Service line /0 le Surface water /DG f Driveway, parking/vehicle storage ZO f Curtain drain 4/4 Wells on adjacent lots F. COMMAEiv T S A Ak ( , STEP -L P�r'� .v►� .l �t/ ��w S f -P% r � �� JCtr G. ENGINEER'S CERTIFICATION 1 certify that f 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 Printed Name S�r—,S&hF FAQ C Date COSA brown sheet 10-10-12.doc of At Steven W. 'Eng ' 6 56 " -ASRI111 T OPWAKI) n A'50CIATES LAND SURVEYING 694-0829 1 HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALEr FOLLOWING DESCRIBED PROPERTY it so Qf ACO�R rii� ' /= r i r. .o:�1s� X07 s Af: � DATE. r ( .... 9 AND THAT NO ENCROACHMENTS EXIST EXCEPT ASr �- INDICATED. IT IS THE RESPONSIBILITY OF THE y / 6;'a ��: OWNER TO DETERMINE THE EXISTENCE OF ANYGRIDi i * +� * ✓•::• s EASEMENTS, COVENANTS, OR RESTRICTIONS'••,{��, rte WHICH DO NOT APPEAR ON THE RECORDED SUBDI- o e�. Merk S�werd VISION Ar PLAT. UNDER NO CIRCUMSTANCES SHOULD FB' tt� r l5' bg18 j 41 ANY DATA HEREON BE USED FOR CONSTRUCTIONff OF FENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES. DRAWN: {Sy^rstxal��" MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services to 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. #>= =' '721 - Z` 1 1. GENERAL INFORMATION 2. 3. 4 HAA# IFI `fl,oLll(c Complete legal description // I �11 /�,I .z t'ie_„', F IC2/cs Location (site address or directions) Property owner Day phone e— r, Mailing address Lending agency C--Ia�"AI, l>> :... kik _ Day phone Mailing add Agent [ 1« rt -c.: C,t, <;'c,�Day phone -2-�Z`1,_ I(v3 Address Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water V 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 �Z' Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA H21 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 :<, ` P �- + . `r3 Phone L113 Address v PI -roe 1 , i1 ci9 So l Engineer's signature �� �./� C== Date— n kk 3 P CL 8828 6. DHHS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments 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 (Rev. 1/91) Back MOA M21 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825"L" Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744 0th �_C�� Health Authority Approval Checklist Legal Description: _Lo-- is Bk 3 J?,, ,_ro esfcr4e5 Parcel I.D.: 0s`o 17L 1 - `( A. WELL DATA Well type Rwa+e� If A, B, or C, attach ADEC letter. ADEC water system number N/A Log present (Y/1) \/e5 Date completed m a,,ah3p , a Total depth IP L1 ' Cased to 166 ll Casing height (above ground) 3. S Sanitary seal (YN Date of test Static water level Well production es FROM WELL LOG WATER SAMPLE RESULTS: Wires properly protected (Y/N) – AT INSPECTION 8//6/96 g.p.m. Coliform 0 —Nitrate -0-t0- n�1 /L Other bacteria Alon e, Date of sample: ' I// (o Collected by: k4- P EGo B. SEPTIC/HOLDING TANK DATA septi'- tank au.440- c%a r)ot, -i ex �e � oLc eG fia /� ' ek 9rau vnot s tr r_rcte e , h%/e 4+ p -f -lank pa"eob Date installed YS Tank size ZCoo Q Number of Compartments Z Cleanouts (Y/l)4� Not re$o(, Foundation cleanout (Y,© ca fimP, Depression (Y/N) –�— High water alarm (Y/N) 1V6 Date of Pumping yt Pumper C. ABSORPTION I7ELD DATA Date installed W S c'7 Soil rating (g- �2 or ft2/bdrm) /00 System type Length 2-3 Width 30 Gravel thickness below pipe c)6 Total depth Effective absorption area _ 3C, s Monitoring Tube present(Y/N) 1_ Depression over field (Y/1) NO Date of adequacy test /a12 3Z9� Results (Pass/Fail) Pass / For bedrooms Fluid depth in absorption field before test (in.); 33, 5 Immediately afters D gal. water added (in.): 5`( Fluid depth /(-.), o " (ins.) Minutes later: 9 `1K min. Absorption rate = 1.°/Z g.p.d. Peroxide treatment (past 12 months) (Y/N) Alb If yes, give date e1/1A Sy6+n,,- presoakaol, to; -K Z,tco jcjt"s -trawl, fo/zz, -Fo /Ohs D. LIFT STATION Date installed Manhole/Access (Y/I) High water alarm level at* Cycles tested E. SEPARATION DISTANCES r1/A Size in gallons "Pump on" level at* *Datum "Pump off' level at* SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot I o 3 ; On adjacent lots I o© Absorption field on lot 101 ; On adjacent lots I00 + Public sewer main `75 / Public sewer manhole/cleanout /00 Sewer /septic service line '70 Lift station 6tAA /00 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 2.5- Property line 9�5 Absorption field S Water main/service line 75 Surface water/drainage /oo Wells on adjacent lots /GYM SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation /C) Property Line �/ r Water main/service line %S Surface water /C>b f Driveway, parking/vehicle storage area /S Curtain drain /00 Wells on adjacent lots /06 F. ENGINEER'S CERTIFICATION 0�-®a� OF 44 I certify that have determined thru field inspections and review of Municipal reca 0,1 gtal Pliea 1 s hRcare in conformance with MOA HAA guidelines in effect on this date. <tP-• ' •,a9Ahl Signaturee �..... .... ....'���day, ��°�•....rs. .a ..a� Engineer's Name _Z(�L2:K (,,.J`i,/-t GF 8828 �? Eng�p y(gg r�j1jMere s Date //�G �9� • HAA Fee $ (� �. �O Waiver Fee $ Date of Payment- �.(� Date of Payment Receipt Number Receipt Number Rev. 8/95 OSS: haa.wk.doc Presoak (gallons) Date Time 22 -Oct 4:00 P.M. 22 -Oct 4:25 PM 22 -Oct 7:00 PM 22 -Oct 10:00 PM 23 -Oct 9:00 AM Adaquacy Test 23 -Oct 1:00 PM 23 -Oct 1:33 PM 23 -Oct 2:07 PM 23 -Oct 5:12 PM 23 -Oct 5:35 PM 23 -Oct 5:50 PM 23 -Oct 6:12 PM 23 -Oct 6:42 PM 24 -Oct 9:46 AM Meter Rdg. Volume 5985 6050 6110 6440 0 65 125 455 Sheetl Water Depth Flow Rate (inches) (gpm) 0.0 3.0 2.4 33.5 2.4 33.5 45.0 54.0 50.5 48.0 47.0 40.5 16.0 2.0 2.0 Start Test 6G.0 - -------- — -- - ------ -------- ---- 50.0 N 40, 30.0 20.0--- 10.0 0.0 0 100 200 300 400 500 600 700 800 900 1000 1100 1200 1300 1400 1500 Time (min.) q-5'.5, 9� , /. 3q 910ol- 3110 fvj;e) -- OZ7 qqI Pell C&Y Page 1 —Rto'e.- V,eLo Cs -/-,a -Ar,-5 . 9roLl (gallons) 3928 0 4004 76 4377 449 4810 882 5985 2,057 5985 6050 6110 6440 0 65 125 455 Sheetl Water Depth Flow Rate (inches) (gpm) 0.0 3.0 2.4 33.5 2.4 33.5 45.0 54.0 50.5 48.0 47.0 40.5 16.0 2.0 2.0 Start Test 6G.0 - -------- — -- - ------ -------- ---- 50.0 N 40, 30.0 20.0--- 10.0 0.0 0 100 200 300 400 500 600 700 800 900 1000 1100 1200 1300 1400 1500 Time (min.) q-5'.5, 9� , /. 3q 910ol- 3110 fvj;e) -- OZ7 qqI Pell C&Y Page 1 —Rto'e.- V,eLo Cs -/-,a -Ar,-5 . 9roLl r MUNICIPALITY OF ANCHORAGE DIVISION OF ENVI.RONMENTA, HEALM DEPARITMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH A[ITHORITY APPROVAL CERTIFICATE 1. General Information Application Date �J-"/✓� J 1 (a) Legal scr�'�tion (ync.ludo,lot, bloc , subdivision, section towrshi. r n ) Loation (ad ess or 1rectio s) / �ti-1 rale (b) ApplicantsNance a � <��' �71� 1�lepIhcre I'? — - - _ Applicants Address .5� `� cl-) l (c) Applicant is (check one) Lending Institutic ; Owrer/builder ; Buyer Other (explain); (d) Lending Institution a� Telephone Address G- lel;J' �.�.- (e) Real Estate Co. & Agent 1 Address ��-� A"Y Telephone 2. TVpe of Residence Single-Family,Pr Multi. -Family Other (describe Number, of Bedrooms 3. eater Suoulv Individual t ll Cp mrrunity j Public Note: If coa uanity well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Is the well adequate for the n«nber of bedroomixs scified in this HAA (/&�- 4. Sewwaw Disposal Onsite Public Corrnnur:iLy I=olding Tank Is the wastewater disposal system adequate fc�,_ the number of 17xdroans [Page 1 of 21 2-15-84 5. Engineering Firm Providing Inspections, lbsts, Data and Inforiaotion I certify that=l have checked, verified, or conformed to all MDA HAA Guidelines in effect on the datspectior.. Signed Date .✓�zj Name of irm Telephone Address Signed by Date (ENGINEER SEAL) 6.DHEP Approval Approved for _ lx)drocgTo Approve Disapproved Terms of Conditional. Approval F3141�G'-t L v( -C ��Gt-%- -bate rY' Conditional r The Municipality of Anchorage Department of. Health and Environmental Protection does not guarantee the continued satisfactory performance of the water supply and/or the wastewater disposal system. This approval indicates that, as of the validation date shoran above, based on the data and information furnished by an engirnner registered in the State of Alaska, the water supply and wastewater disposal system is safe and func— tional unstional for the number of bedroom and type of structure indicated. (DHEP SEAL) 7. Mail the HAA to the following address: KB2/d5/s [Page 2 of 21 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & MUNICIPALITY OF ANCHORAGE (MOA) ENVIRONMENTAL PROTECTION HEALTH .AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 MAR 2 9°�'^ RECEIVED' A. WELL DATA Well Classification _S-�,-� If A, B, or C, D.E.C. Approved(Y/N)yy''� f� Well Log Present ( ) Date Completed Total Depth Cased to Lt G� Depth of Grouting L�• /O 71)Aso Static Water Level �5r' - _Pump Set At _fes Casing Height Above Ground ��) (� Sanitary Seal on Casing('I Electrical Wiring in Condui (Y Depression Around Wellhead (" ) Separation Distances from We . 7 / On A �C `� Adjoining Lots To Septic/Tank on Lot -- To Nearest Edge of Absorption Field on Lot. ./- ; On Adjoining Lots To Nearest Public Sewer Line /J� To Nearest Public Sever Cleanout/Manhole Water Sample Collected By Water Sample Test Results IS4 Cents _--- -_-- To Nearest Sewer Service Line on Lot B. SEPTIC/HOLDING TANK aNTA % r�� Size /C No. of Compartments Date Instal d pe) Standpipe (Y Air -tight Caps ( /)� Foundation Cleanout `N r Depression over Tank (-') Date Last P d IV ,�.,. pumping/Maintenance Contract oFile Y/N)� ��; for Temporary Holding Tank Permit (Y Holding Tank High -Water Alarm I(IyL4Y Separation Distances from Septics Tank: _/ To Building Fcazndation Z-3 To Water -Supply C4e11. �� •7 � To Property Line 5To Disposal Field To Water Main/service Lire To Stream, Pond, Lake, or Major Drainage Course Comment 'ci �'CJJ�� 5' /� d �u✓P!t. �' :`` - i"taL� c� oy�tC� 11G� / CJ4 c�l� 6�rE� /?C_ !^11,t� A 12 � /!:z �71 A1c�-6�. [Page 1 of 21 - '2--15-84 't 141t3 /}2 7 ley `= ,144zu �G«- ZG } ,/u ��L- ,(,0`/ / Eezv,A, I1C_ O 14&&A:, �,n.ar,: • i/ C� �Y f1'! ggC3l"q �l�c'. hid �'� CGAS� /LL3[ c },t} �l•`c `I G �,� f !J[5G �C(` ict�te C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 0 Type of System Design Date Installed -_-t `� 7 / Length of Field z5 Width of Field Depth of Field Gravel Bed Thickness Square Feet of Absorption ea�_�� Standpipes Present .(Y Depression over Field ) Date of Last Adequacy Test _-Z2-A, Results of Last Adequacy 'rest ' « 4, .- Separation Distance from Absorption Field: To Water -Supply Well To Property Line �� f To BuildingFoundation �� �/ 7�' 3'o Existing or Abandoned System on Lct /J On A joining Lots To Water Main/Service Line /12 To Cutbank(if present) ` To Stream/Pond/Lake/or Major Drainage Course /j 0 A -/l To Driveway, Parking Area, or Vehicle Storage Area Comore nts D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at Dimensions Manhole/Access (YIN) "Pump Off" Level at High Water Alarm Level a)t V Vent (Y/N) Tested for i g ycles during Adequacy 'rest. Meets MOA Electrical Codes(Y/N) Coirenents ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I h ve checked, verified, or conformed to all MOA HAA Guidelines in effect on the date of th's,iY,'Jztion. S KB1/d5/s §y1 v,t tilp �yCS� e`a't. (Page 2 of 2] Date O��J• MOA No. 2-15-84 5. LEGAL DESCRIPTION DATE RECEIVED INSPECTION APPOINTMENTS STREET LOCATION TIME 6. TYPE OF RESIDENCE TIME n TIME ❑ One ❑ Four ❑ Other SINGLE FAMILY P' Two ❑ Five ❑ MULTIPLE FAMILY DATE 7. WATER SUPPLY DATE _ DATEI *ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well In INSPECTOR 8. SEWAGE DISPOSAL SYSTEM INSPECJOR INSPECT R / YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLICUTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROWMALITY OF ANCHORAGE 825 L Street . Anchorage, Alaska 99501 DEPT. OF P.:ALTI I & ENVIRONMEIIIAL i ,OIECTION ENVIRONMENTAL SANITATION DIVISION Telephone 264.4720 MAY 2 '7 1980 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND S&VVEI T S DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTYOWNEq /PHONE MAILING ADDRESS ff /3oX e Cl - (�7 Xe PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE Cid% / /'V MAILING ADDRESS 3. LENDING INSTITUTION PHONE / < 5'/<'cr ' � C MAILING ADDRESS 4. REALTOR/AGENT PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION le, r c Izld clr 3 STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF�BEDROOMS ❑ One ❑ Four ❑ Other SINGLE FAMILY P' Two ❑ Five ❑ MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SUPPLY INDIVIDUAL* *ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM [,M' INDIVIDUAL/ON-SITE** YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLICUTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. M 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE THREE ❑ TWO ❑ FOUR ❑ FIVE ElOTHER ❑ SIX 2. WATER SUPPLY 4 INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER CCL ° ` t C DATE INSTALLED INSTALLER L kz-) _-- Septic Tan', or ❑ Holding Tank Size: IL�o If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK 0 Z- n MANUFACTURER TOTAL ABSORPTION AREA �7 MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption AreaNearest 77� Lot Line Absorption Area to nearest Lot Line 5. COMMENTS ❑ APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY M 72-010 (Rev. 6/79)