HomeMy WebLinkAboutRIVER VIEW ESTATES BLK 4 LT 7Riverview
states
lock 4
Lot 7
050- 72 !
-04
O
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program, 4700 Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650 Page 1 of 5
www.ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: SW101074 PID Number: 050-721-04
Name:
Edmonson. Mike Wastewater System: [] New [] Upgrade
Address:
21200 Running Brook Circle, Eagle River, AK 99577 ABSORPTION FIELD
Phone: Number of Bedrooms:
' [] Deep Trench [] Shallow Trench [] Bed [] Mound [] Other:
LEGAL DESCRIPTION Soil Rating: Total Depth from original grade:
1.2 GPD,Ft2 5.5 Ft.
Block: Lot: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe:
4 '~ ~'1 Riverview Estates 3.0 Ft. 2.5 Ft.
Township: Range: Section: Fill added above original grade: Gravel Length:
1.0 Ft. 48 Ft.
Well: [] New [] Upgrade Gravel width: Number of lines: J Distance between lines:
5.0 Ft. 1 -
I
Classification (Private, A, B, C): Total Depth: Cased to: Total absorption area: Pipe Material:
Existing Private Ft. Ft. 375 Ft~ 3034 PVC
Driller: Date Drilled: Static Water Level: Installer: Date installed:
Ft. Flintstone Const 717/2010
Yield: Pump Set at: Ft. Casing Height Above Ground:
GPM Ft. TANK
SEPARATION DISTANCES [] Septic [] Holding [] S.T.E.P. [] Other:
T~To Septic Absorption Lift Holding =ublic/Private Manufacturer: Capacity:
Tank Field Station Tank Sewer Line Anchorage Tank 1000 Gal.
Material: Number of Compartments:
We, 103.7 173.5 ' 200* Steel 2
Surface Water 100+ 100+ ~ / LIFT STATION
Lot Line 15+ 20+~ Size: Manufacturer:
Gal.
Foundation 1 7,0' 75.7' "Pump on" level at: "Pump off' level at: in. High water alarm at:
in. in.
Curtain Drain 50+ Pump Make & Model Electrical Inspections performed by:
Remarks:
Existing field abandoned in place. BENCH MARK
' Location and Description:
Existing tank abandoned per code. Garage Finish Floor
Assumed Elevation:
100.0 Ft.
Engineer's Stamp
Inspections performed by: PANNONE ENG. SVC, LLC Dates: 1st 7/712010
Development Services Department Approval . -- ~'~."
Conditional Approval Date: ~"~ .....
~'~. '~,,~~ CO A B E1 C1
'~ /' ~'~ /× / DC1 16.3 49.7 - -
// / /.. o.7 _ _
~ , . / ~ DC2 26.1 ~.6 - -
~ [ I / / ,/ C~ ~.7 - ~.~ -
_~_~ / :l,~Oq SEPTIC TANK(E) ' ~ ~ / ~ -
/ , ~ ~, ~ f / --' ~: ~ / IN FAILURE. A~ANDONED
/ f / ~~__~:~ ).,':: L ~ NO WELLS OR SEPTIC/
W/IN 200 FEET:
~ ~ n ~ ~CRADE DOWNHILL AREA
20' WAkKWAY& ~~ ~ ~ [ ~ I 20~ ~
~~ D a t e
NOTES: P~O~ ~ ~C, L~ ~O~.~L.'~,~ ' '~ 7/22/10
~.0. ~ox ~oo~z ~c~o~. ~ 99~0 ~.. '~,~.
~co~o om~,N~P~O~Z (90Z) ~-~ r~x (90z) ~z~-~l~'--~ ~ ~:',.~.,,..~,.~ ~,~
1"=60'
RIVER VIEW EST S/D BLk 4 LT 7 ~ ...... ~ P.~.D. NO
Michael Edmonson '~,"~i~ .... ~' ..... ~E~M~T NO.
21200 Running Brook Drive ~.~c. ..~ SW101074
Eagle River, AK 99577 li~o~~,l~ ~-- Sheet
PLAN
622-7971 '~d~D2:~ 2 OF5
SPECIAL PROVISIONS TO SPECIFICATIONS
1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF
ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF
ON-SITE WASTEWATER DISPOSAL SYSTEMS.
2. ALL WORK SHALL BE IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS.
5. SCOPE OF WORK: 5-BEDROOM HOUSE UPGRADE, NEW DRAIN FIELD, REUSE EXISTING FIELD.
4-. GROUNDWATER IS NOT EXPECTED TO BE ENCOUNTERED DURING EXCAVATION, AS EVIDENCED BY THE SOIL TEST HOLE
INFORMATION ABOVE 10.5 FT. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 12
FEET BELOW EXISTING GRADE, STOP WORK & NOTIFY THE ENGINEER IMMEDIATELY.
5. VERIFY INTEGRITY OF EXlST'G TANK. REPLACE OUTSIDE 100' WELL RADIUS IF TANK NEEDS REPLACEMENT. ABANDON
EXISITNG TANK PER CODE, IF REQUIRED.
UPGRADE FIELD/-1' Fill over trench
-1.§ I ~Grav?l ~bove
~.s' ~plpe ~nv,
~P ] ~isT]/~typicai
~e== ~4" diam drain
· ~ pipe, ty~ical
-8.o -- --5 Typ.-- ~Gravel
~P/
GM
GROUND WATER ~105
-13.5 ~
-14.5 '~
SECTION
-i ' /3034 PVC d
-- 104.0 ! 102.4
ISEPTIC I~'~ ~ = ' 99.4
I TANK (N)~~ ~?L~;c.~¢~:~;f~:1;~``"~?`~`%~;~;;;~zc~:~:~c.~::~L~;`~:~`~:~ ~
I:~'
A1313 R EVIATr 0 N S PROFILE
CU COPPER
DIP DUCTILE IRON PIPE
TH TEST HOLE DESIGN PARAMETERS LEGEND
FC FOUNDATION CLEAN OUT UPGRADE SEPTIC SYSTEM --w w-- WATER LINE/
T# TANK CLEAN OUT NO. NO. BEDROOM: .3 (4-50 gpd) WELL RADIUS
C# CLEAN OUT NO. TANK SIZE: 1,000 g if reqd
M# MONITOR TUBE NO. PERC. RATE: 1-5 MPI
R.I. RIGID INSULATION SOIL RATING: 1.2 gpd/SF ss --ss EXIST'G SEPTIC
DCO DOUBLE CLEAN OUT AREA RQD: 575 SF
DV DIVERTER VALVE SYS. TYPE: WIDE TRENCH, 2.5'ED, ss ss NEW SEPTIC
FS FLOW SPLI-FFER RF=0.64-, MIN LENGTH: 48 LF
(E) EXISTING USE: 0 CHAINLINK FENCE
48LFxS'WlDE, 2.5'ED, 5.5' TD
(P) PROPOSED TOTAL AREA: .375 SF
(N) NEW
NOTES: PANNONE ENG SVC, LLC Dote
7/22/10
RECORD 0RAWlNG PHONE (907) 272-8218 FAX (907) 272-82~1~'. '+.v ~/*.- ""'TH .~ '.'~'/',~.-~,f
Scole
NTS
RIVER VIEW EST S/D BLk 4 LT 7 ~, "C_~,)'"~,,~"'"~ P.I.D. NO
Michoel Edmonson '~-' ' ~~~ "~onno~e ~ )-50-721-04
21200 Running Brook Drive '~~"'.~,~,~ PERMIT NO.
DESIGN NOTES 622-7971 I ~ ?'£~/~X ~t~:~.~'~x.~ Sheet
SOILS LOG - PERCOLATION TEST
TEST HOLE 1
OR TOPSOIL SLOPE I ~ I ~,TEP~U / /
6
7~
8
9~
~ Poorly Graded
10 -- GP/GM G~VEL & Sand
W/Silt
11 ~
Gray SILT. WAS GROUND WATER SLOPE
14 -- ML ENCOUNTERED? N
15 ~ BOH IF YES, AT WHAT TH 1
16 -- DEPTH? -0-'
X
17 ~ DEPTH TO WATER AFTER
MONITORING? - 10.5
18 DATE: 6/1 0/1 0
WATER
READING DATE CLOCK NET TIME LEVEL NET DROP
TIME
READING
1 6/3/10 11:42 : 4.52 0"
2 11:49 7 MIN 10.63" 6.11"
3 11:51 4.52 0"
4 11:59 8 MIN 10.63" 6.11"
5 12:00 4.52 0"
6 12:07 7 MIN 10.63" 611"
PERO~TION ~TE 1.1 (min/inch) PERC HOLE DIAMETER 6 inches
TEST RUN BE~EEN 7.5 FTAND 8.5 FT
COMMENTS: Test hole excavated by Flintstone Const. Test Hole was preso~ed before perc test. Perc test r~
for one hour. Last three reading repomed on this repo~.
PERFORMED BY: Steven R. P~none, P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST.
7/22/~0
P.0. BOX ~02954 ANCHORAGE, AK 995~0 ... ·
NTS
~0-721-04
Micheel Edmonson ~~~
21200 Running Brook Drive~~r¢~,~u CE 8149 .~ PERMIT NO.
SOILS LOG Eagle River, AK 99577 ,li~j~o~s~~ 'Sheet
622-7971 'll~4~------ 4 OF5
WATER
READING DATE CLOCK NET TIME LEVEL NET DROP
TIME
READING
1 6/3/10 11:42 4.52 0"
2 11:49 7 MIN 10.63" 6.11"
3 11:51 4.52 0"
4 11:59 8 MIN 10.63" 6.11"
5 12:00 4.52 O"
6 12:07 7 MIN 10.63" 6.11"
SOILS LOG - PERCOLATION TEST
TEST HOLE 1
SLOPE I ~ t ~,~E ~d~N / /
1-- I o I \ I o
6 /I
9~
WAS GROUND WATER SLOPE
~4 ~ ENCOUNTERED? N
15 ~
IF YES, AT WHAT TH 1
16 ~ DEPTH? -0-'
X
17 ~ DEPTH TO WATER AFTER
~ MONITORING?
~ 8 DATE:
WATER
CLOCK RATE
R~DING DATE NET TIME LEVEL NET DROP
TIME READING (MPI)
1 7/7/10 11:38 2.04
2 11:43 5 MIN 8.90 6.86 0.69
3 11:45 2 MIN 2,16
4 11:50 5 MIN 8.~ 6,1~ 0.77
5 11:52 2 MIN 1.97
6 11:57 5 MIN 8.37 6.40 0.82
7 12:02 5 MIN 1.99
8 12:10 8 MIN 7.90 5.91 1.35
9 12:13 3 MIN
10 12:21 8 MIN 8.49 6,53 1.07
PERO~TION ~TE 1.1 (min/inch) PERC HOLE DIAMETER 6 inches
TEST RUN BE~EEN 5 FT AND 6 ~
COMMENTS: Test hole ~xca~atCd by ~tsto~e Co.st. ~est ~o]~ was p~¢so~ed before pe~c test. ~e~c t~st ~
~o~ o~¢ hour. ~e~c ~ at botto~ of t~e~ch.
~~. D a t e
Noz~s: P~O~ ~G ~C, L~ ~oF~L2~I, 7/22/~o
P.O. BOX 102954 ANCHORAGE, AK 99510 ~ ..... '~
RECORD DRAWING PHONE (907) 272-8218 FAX (907) 272-8211_. _ .__~ ~"*-"--~~ ~ ~ ..... Scale
NTS
RIVER VIEW EST S/D BLk 4 LT 7 ~ ~P.I~D.)50_721_o4NO
Michael Edmonson-. ~ '~ ~ -. anno~e ~
: 2oo unni g D ive
.__~ sw~ OlO7¢
SOIL~ LOO E~gle River, AK 99577 ~"[~ ~?~ ', ....... ~%~ Sheet
6 2 2 - 7 9 7~ - ~c ~0~:~
Permit Number: OSP101074
Tax Code Number: 05072104000
Work Type: Septic
Permit Effective Dates: June 29, 2010
On-Site Wastewater Disposal 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
Upgrade
to June 29, 2011
Design Engineer: PANNONE ENGINEERING SERVICE
Subdivision: RIVER VIEW ESTATES
Site Legal Address: RIVER VIEW ESTATES BLK 4 LT 7 G:0357
Owner/Address: EDMONSON MICHAEL J & YVONNE F
21200 RUNNING BROOK CIR EAGLE RIVER AK 995770000
Lot Size in Sq Ft:
Site Mailing Address: 21200 RUNNING BROOK CIR, Eagle River
Total Bedrooms:
66587
3
This permit is for the construction of:
Y Disposal Field N SepticTank N Holding Tank N Privy 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.
Special Provisions:
The proposed system is in a different soil stratum than the strata that was tested. The Engineer
needs to do an additional percolation test prior to the construction of the septic field. Please
submit stamped and signed results with the As-built Inspection Report. If the results require a
design change, construction of the system will stop pending On-Site review and approval.
Received By:
Issued By:
Date:
Date:
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, Alaska 99519-6650
www. muni.org/onsite
(907) 343-7904
ON-SITE SEWER/VVELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 050-721-04
Property owner(s) Michael Edmonson
Mailing address21200 Running Brook Cir
Site address 21200 Running Brook Circle
Legal description (Sub'd., Block & Lot) River View Est, BIk 4 Lt 7
Legal description (Township, Range & Section)
Lot Size 66,587 Sq. Ft.
Day phone 862-7971
Zip Code 99577
Zip Code 99577
Number of Bedrooms 3
THIS APPLICATION IS FOR ([~ all that apply):
Absorption Field []
Septic Tank []
Holding Tank []
Privy []
Private Well []
Water Storage []
THIS APPLICATION IS AN:
Initial []
Upgrade []
Renewal []
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
Pannone Engineering Services, LL_C ~
(Signature of property owner or authorized agent)
Permit/Rush Fees: j. _~ ~C, Waiver Fees:
Date of Payment: ~ - / '~7/ '~ / ~ Date of Payment:
Receipt Number: ~ ( ? ~'~"/ ~- Receipt Number:
(Rev. 11/05)
Pannone Engineering Services LLC
Steven R. Pannone, Principal
Registered Professional Engineer
E-maih steveCe)., panenRak.com
June 14, 2010
Municipality of Anchorage
Development Services Department
On-Site Water & Wastewater Program
4700 S. Bragaw Street
P. O. Box 196650
Anchorage, Alaska 99519
Subject:
River View Estates S/D, Block 4 Lot 7
Septic System Permit Upgrade Request
Ladies and Gentlemen:
I am writing to request a permit to construct an upgraded septic system be issued for this property. The
proposed systems will serve an existing three-bedroom house. Currently the lot is developed. The lot is
served by a private water supply. The existing septic system shall be reused. A new drain field will be
installed southeast of the existing field and will be sized to handle a three bedroom waste stream. The
surrounding developed lots are served by private water systems. The private wells are located over 100 feet
from the proposed soil absorption system.
1. Soils. A single test hole was excavated by PES on June 3, 2010. See the attached soil log. Ground
water was monitored for seven days. Ground water was monitored at a depth of 10.5 feet below ground level
after the monitoring period. Bedrock was not encountered in the test hole. It is my opinion, based on the
results of the percolation tests and overall soils appearance; an application rate of 1.2 gallons/day/square feet
should be used, using a conventional wastewater treatment system.
Soil Absorption System Design.
See Design Drawings sheet 2 of 3 for the design calculations.
3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and the
existing drain field. The proposed drain field upgrade will maintain at least 100 feet from all surface water
and drainage ditches.
4. Topography: The average topography in the area of the proposed septic system is approximately 20
percent based on the survey information in the area of the septic system. The north side of the drive way
slopes steeply (25%) to the north. The proposed installation will be approximately 50 feet from the shoulder
of the steep slopes.
Mailing: P.O. Box 100217, Anchorage, AK 99510-02:L7
Physical: 615 East 82~d Ave, Cuite B6, Anchorage, AK 99503
Telephone: (907) 272-8218 FAX: (907) 272-821:t
Page 2 of 2
5. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification
that the review is complete and that there are no further comments is received from MoA On-Site
Department, the note will be removed and "Issued for Construction" drawings will be issued.
The proposed installation will not affect the future development of the surrounding or existing lots. There
are no wells or septic systems within 100 feet of the proposed septic location.
If you have any questions or concerns, please contact me at 272-8218.
Sincerely,
:.....~...t~..~,~ ........ a.....~
~ ............................ ....,e~
~. Steven Ft. Pannone
Steven R. Pannone, P.E.
Owner/Civil Engineer
Attachments:
Mailing: P.O. Box 100217, Anchorage, AK 99510-0217
Physical: 615 East 82~d Ave, Cuite B6, Anchorage, AK 99503
Telephone: (907) 272-82:18 FAX: (907) 272-8211
%.. ~- ~ / / ",,,,,,
//~ / / ~~ ...... ~'~, X ~ ,./'
W:LL
/ ~ ~----_~ ~ ~ ~ AR~ UNDEVELOPED J
/ [ ~ ~ /~/ ~.~. .'~ NO WELLS OR SEPTIC J
W/IN 200 FEET~
~GRADE DOWNHILL AREA
'. ~ /
: / WELL(E)--
~ , _~ Date
6/24/10
P.O. Box ~oo~z ANOHORA~[, AK ~S~O ¢~...~~~:,-..,.
ISSUED FOR CONSTRUCTION PHON[ (907)272-82,8 FAX (907)272-82,,
Scale
1"=6o'
RIVER
VIEW
NO
............ 350-721 -Oz
M'choe, Edmonson
21200 Running Brook Drive f~A.. .~ SWxx~x~x
PLAN Eegle Rfver, AK 99577 ~ 78" ...... '~ Sheet
6 2 2- 7 9 7 ~
,~~ 1 OF 3
SPECIAL PROVISIONS TO SPECIFICATIONS
1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF
ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF
ON-SITE WASTEWATER DISPOSAL SYSTEMS.
2. ALL WORK SHALL BE IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS.
5. SCOPE OF WORK: 5-BEDROOM HOUSE UPGRADE, NEW DRAIN FIELD, REUSE EXISTING FIELD.
4-. GROUNDWATER IS NOT EXPECTED TO BE ENCOUNTERED DURING EXCAVATION, AS EVIDENCED BY THE SOIL TEST HOLE
INFORMATION ABOVE 10.5 FT. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 12
FEET BELOW EXISTING GRADE, STOP WORK & NOTIFY THE ENGINEER IMMEDIATELY.
5. VERIFY INTEGRITY OF EXlST'G TANK. REPLACE OUTSIDE 100' WELL RADIUS IF TANK NEEDS REPLACEMENT. ABANDON
EXlSITNG TANK PER CODE, IF REQUIRED.
FiELn ~/-1' Fill over trench
UPGRADE
102.4 / _,~'""' r ~.................~ il t e r Fabric
-1.5 --~- J ~.,, ~Gravel above
~¢. ~pipe inv,
{ { ' IJ ~4"diam. drain
~ pipe, typical
-8.C -- --5 Typ.-- ~Gravel
GM
GROUND WATI~R ~10,5
-13.5 --
ML
-14.5 eo'~'-'
SECTION
o~
/--4 Dia Perf Pipe
o ~o ,~ /3034 PVC
-- 10,4-.0 ~ 102.4 /
/
- -r~00 g
JSEPTIC =
LTANK (E)
5-WIDE TRENCH, SEE DESIGN
ABBREVIATIONS
CU COPPER PROFILE
DIP DUCTILE IRON PIPE
TH TEST HOLE DESIGN PARAMETERS LEGEND
FO FOUNDATION CLEAN OUT UPGRADE SEPTIC SYSTEM --w w WATER LINE/
T# TANK CLEAN OUT NO. NO. BEDROOM: 5 (450 gpd) WELL RADIUS
C# CLEAN OUT NO. TANK SIZE: 1,000 g if reqd
M# MONITOR TUBE NO. PERC. RATE: 1-5 MPI
R.I. RIGID INSULATION SOIL RATING: 1.2 gpd/SF -- ss -- as -- EXIST'G SEPTIC
DCO DOUBLE CLEAN OUT AREA RQD: 375 SF
DV DIVERTER VALVE SYS. TYPE: WIDE TRENCH, 2.5'ED, ss ss NEW SEPTIC
FS FLOW SPLITTER RF=0.64-, MIN LENGTH: 4-8 LF
(E) EXISTING USE: ~.~;z ,,,0-~ 0 CHAINLINK FENCE
48LFxS'WlDE, 2.5'ED, ,..4.r5" TD ~','
(P) PROPOSED TOTAL AREA: 575 SF
(N) NEW
NOTES: PANNONE ENG SVC, LLC O.E .~..L.._~,~J, D6a~4/10
RIVER VIEW EST S/D BLk 4 LT 7~ ~"'~'~ ~1~ ~"'~"'"~ 2N'- '"'~"'~ ~I!.50-721-04P'I'D' NO
Michael Edmonson ~~~. · .~'~ PERMIT NO.
21200 Running Brook Drive
Eagle River, AK 99577 ~i~.E-. .%¢?~ SWx×xxxx
~ ;?d ....... ',',,~:...'~' s~t
DESIGN NOTES 622-7971 ~.~'
SOILS LOG - PERCOLATION TEST
TEST HOLE 1
OR TOPSOIL SLOPE I _ ~ I ~ITE PLaN / / \
3
5--
6~
7
9-
Poorly Graded
10 -- GP/GM G~VEL & Sand
W/Silt
Gray SILT. WAS GROUND WATER SLOPE
14 ~ ML ENCOUNTERED? N
15 ~ BOH If YES, AT WHAT TH 1
16 ~ DEPTH? -0-'
X
17 ~ DEPTH TO WATER AFTER
MONITORING? - 10.5
18 DATE: 6/1 0/1 0
WATER
READING DATE CLOCK NET TIME LEVEL NET DROP
TIME
READING
1 6/3/10 11:42 4.52 0" i
2 11:49 7 MIN 10.63" 6.11"
3I 11:51
4.52
O"
4 11:59 8 MIN 10.63" 6.11"
5 12:00 4.52 0"
6 12:07 7 MIN 10.63" 6.11"
PERO~TION ~TE 1.1 (min/inch) PERC HOLE DIAMETER 6 inches
TEST RUN BE~EEN 7.5 FTAND 8.5 FT
COMMENTS: Test ho~e excavated
fo~ o~e ~ou~. ~ast three reading reposed on this repo~.
PERFORMED BY: Steven R. P~none, P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST.
NOTES:
ISSUED FOR CONSTRUCTION PHONE (907) 272-8218 FAX (907) 272-8211 ~.~.. ~ .~. ,~ Sco~e
Michael Edmonson ~ ~~/wp~hX6~e ~)50-721-04
21200 ~un~in9 Brook Drive ,~.. .~&~ swxxxxxx
SOILS LOG Eogle River, AK 99577 ,i~¢~M~¢~ Sheet
622--7971 '~X~4~ 3 OF3
WATER
READING DATE CLOCK NET TIME LEVEL NET DROP
TIME
READING
1 6/3/10 11:42 4.52 0"
2 11:49 7 MIN 10.63" 6.11"
3 11:51 4.52 O"
4 11:59 8 MIN 10.63" 6.11"
5 12:00 4.52 0"
6 12:07 7 MIN 10.63" 6.11"
MUNICIPALITY OF ANCI4ORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAl- SYSTEM AND/OR WELL INSPECTION REPORT
MAILING ADDP2~SS
~'E GAL DESCRIPTION
Manufacturer
Liq. capacJt~,i r~qal[ons
/ ~2 ~..~) C) IF HOMEMADE:
Well
DISTANCE TO:
Vidth
pENO, OF BEDROOMS
RMTN
No. of co~p:artments
Liquid
PERMIT NO.
inside length
DISTANCE TO: It
No. of ,~nes ~gti~ ea~,i~ Total length of ,i~
J~ ~ Material beneath tile
Top of tile to finish grade
Length Width
Well
DISTANCE TO:
DISTANCE TO:
Depth
depth
fou ndation
Driller
foundation Sewe~ line
4earest lot line / ~MIT NO, ~>~/ 0 :~ / /
y- dO
Trench width . !tv lines
~- ,~ ~,inclles
Fetal effective absorption area
MIT NO.
line
Distance t.o lot line
tank
~-~'ERMIT NO. ,
IAbsorption area(s)
OTHER
PIPE MATERIALS
SOl L TEST RATIN/.¢~- k~~ ~
NSTALLER
EMAR KS C~~'k'~''~
DATE LEGAL
F:'E!;I"a:M I T 1'.4 3
I::IF'[::'L I C:FII",IT Bi::iR E',RI;~:[:I
L. OCI::IT Z ON [~:l..J[",,![',l I NG E~F4:f""3[( C: I R.
I._EGF:II_ I...O'1" '7 E',L.[::: 4 ['~:I',,,'EFi:',,,'IEI.,-! [T.~7.,T.
'T"¢F'E CIF' :E';O]:L. [:tE~SC~F,'.F'TI[)I",I Sh.'?FEM :IS: TF.'.EtqE:H
L.. 3T ~!; I ZE
THE: LEIqGTH C, iMEN'.'.-7, iO?',I IL:i; THIE L. ENGTH ,'IN FEET) OF THE Tf4:ENC:H 0[:?.
'C.ql[:?Ff:CE OF THE
THE Ei[.:-.'.R',,,'EL DEF'TH :[¢; THEE MINIMUM DEF'TH OF GF::FI',,,'EL Effi:Z'Tt.,.IEEN THE OUT[FILL PIPE
I L.E:.[. I ].[ 'T'HFIT
J..' I Fff,'l F:Fif,IlL. IFIF;: !.,.II;TH THE f~iE':.,_If~EP1ENTE; F'O[~: OIq-:!;ITE S11.;:.[,.l[El';i:S; FIND I.,.tEI...L2Z.;
E' h' THE MI..II.,I I E: I F'FILI T'.r' 3F
F:' 0 f;?."l' H :,
2' [ HII_.L ~Iq:'.!;T[::ILL. 'TH[; ::,~.:,fE.M Ii",! FICCOF.'.DFII",tL:E Id'[TH '['HE C:E~E:'E:E;.
2' I Ui'.,![)E3;-'Z6T[aI",t[::' THF:IT THE 3hI-'.::';ITE ~;Et.,.tEF4: :::,-r =,'l [:.l l MFI"," f,i'E:~.l'[I;.£'~ E'I",II I::IF"3EI"IEI'"IT IF THE
F~:E'E; ~ DI:ZNC:E 1:7.', F~:11EMO[::'EL..E;I:;:' TO 1 i'4 '31...IDE MOF::E THFIf',I 2-: E:[EDfqtOOM:5.
O&E
ENG,,qEERING & DEVELOi-MENT CO.
Box 90, Davis St., Eagle River, Alaska 99577
694-2774 or 688-2280
Russell Oyster
694-2774
Performed for:
Name:
Legal Description:
Depth (feet)
SOIL LOG
Soil Characteristics
Earl Ellis
688-2280
Tel. N0.~~/~-'/-'::~ / ~ ~
6 -~
7__
8__
9__
10__
PLOT PLAN
12__
13__
14.__
15__
16 __
PERC. TEST
Ground Water Encountered: Yes
Proposed Installation: Seepage Pit__
No If yes, what depth
Drain Field ~
Comments:
~Permit ~: 820031
January 31, 1983
TO: Permit Applicant
Subject: Lot 7 Block 4 River View Estakes Subdivision
A permit issued by this department for an individual well
and/er on.-site sewer system has expired as of December 3!,
1982.
Permits are issued on a calendar year basis, as stated en
the permit, by authority of Hunicipal Ordinance.
If you have drill, ed the'well, a well log needs ko be sent
te this department for documentation of the installation
date and to close the permit.
If a private engineer inspected the installation of the
on-site sewer system, please have them send us the as-builts
for our files and clocumentation.
If there are any further questions, please call. this office
at 264-4720.
Sincerel~
Robert C. Pratt, R.S.
Sewer and Wa her Program
RCP/ljw
eric: Copy of Permit
swP/057
I.. E (!ii:::![...
F'ORTH iiii'."i" 'I'I"'IE I'"IUN]iC]:P~::II..;t~"i'"r' OF::'
;~i;: ]; t4 ]; i...L ]; !"J'.ii;"i'l:;:IL.l._ THE!: 'i~;'?'Ei; i'Ehi ]] !"J R(:;;(]:I;~F;i'.t.)F!I'-,I(;;:I~; 14 ;!; TH THE
MUNICIPALITY OF ANCHORAGE
Health and Environmenta~ rotection
99577
Department
825 m Street, Anchorage, AK. 99501
264-4720
Permit ~ * * * HANDWRITTEN PERMIT * * *
WELL:~:~[I~:~x~T~F~~PERMIT
Applicant: John Gross Mailing Address: PO Box 1161
Location: Eagle River Phone Nu~er: 694-9138
Legal Description: Lot 7 Block 4 River View Estates Lot Size: 60000
Type of Soil ~sorption System Is:
Trench: Drainfield: Seepage Bed: Holding Tank:
Maximum Number of Bedrooms: Soil Rating(sq.ft/br)
The Required Size of the Soil Absorption System Is:
DEPTH -0- LENGTH -0- GRAVEL DEPTH -0- WIDTH -O-
The length dimension is the length(in feet) of the trench or drainfield. The
depth of a trench or pit is the distance between the surface of the ground and
the bottom of the excavation(in feet). There is no set width for trenches.
The gravel depth is the minimum depth of gravel between the outfall pipe and
the bottom of the excavation(in feet).
* * REQUIRED SEPTIC(HOLDING) TANK SIZE = -0- GALLONS * *
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the number
of residences that the well will serve.
* * * TW0(2) INSPECTIONS ARE REQUIRED
Backfilling of any system without final inspection and approval by this departmen'
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 fee
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a conlmunity sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 1 9 Q 2 * * *
I certify that:
(1) I am f~iliar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) I understand that the on-site sewer system may require enlargement if
the residence is~remodeled to include more that 3 bedrooms.
'%pplicant
, Date: Feb. 16~ 1982
swp/o24 (1/81)
January 4, 1982
John L. Gross
P.O. Box 1161
Eagle River, AK
99577
Permit ~ 810410
Subject: L 7 B 4 Riverview Estates
A permit issued by this department for a well and/or sewer
system has expired as of December 31, 1981.
Permits are issued on a calendar year basis, as stated on
the permit, by authority of Municipal ordinance.
If you have drilled the well, a well log should be sent to
this department to document the installation date.
If an engineer inspected the installation of the on-site
sewer system, please have them send us the as-bui!ts for our
files.
If 'there are any further questions, please call this office
at 264-4720.
Sincerely,
Les ~'I. ~uchholz/fl.~.
Program Hanager~
Sewer and Water Program
Enclosure: Copy of Permit
E.::, I M
I.. 7' E: 4. RI',/ER ',,,'IEH " ....... '"'
I'"IIH:I:I"IUM DI.'.=J;"f'FII",ICE BE-I'HEEN F:t HELL F41'.,l[::, l::lt'.,t'.r' f"H'.,I-SI"FE :E;.,E:HFIGE: I::,I:~JI::'O.':J;I:IL :E;"r'5'TEM I.'."7,
:Lt?JE~ F:E:'E'T' F'OF(i F! F'F:'.:[VFI'f'E HELL. EIR :'LSEI TO ;E.!E'IE~ FLEET Ffl?.EH"t R I:::'UE',L.ZC: I.,.IEI...L. DEF'ENDING
UF'OI",I THE; T'¢F'[E OF PI.JBL..tE: 1.4EL_L.
M :[ I",I ~ MUM E:, ! 2;TF:INCE FROM FI F:'F;~: I ',,,'I::ITE HELl... TCI FI F'F.: I ',,,'!::I'T'E :SE:I.,.IER L. I hie
'TO R COI'"If'IUI",I]:"I"'¢ 'JSEI.,.IEF4: LINE !'.5 75 F'EE'f'.
I,.IE;L.L. LO(:Ji.';.:~; I:::II:~'.E RE6:!I...I:[F;:IE[:, I::II",ID f"ll..IS-f' BE RE:TUt:;~:NEE:' TC~ THE I::'EF'I::tR-I~f'iENT I.,.IITHIH
OF THE !,.IEI...L E:E~MI:::'I...ETION.
OTHIEI:;i: I:;;:E6!U ~ REI"iEI"4TE; I't1";:1"¢ F:IF:'F'L."r'. E;F'E:E: IF I CI::I"f'I EH'4~:5 F:IND CON'.'~;TI:;.:UCI' 1 O1"4 [::' I FIGF.:I::II"I:E; FIRE
¢::1',,"1::! :[ L.I::IEH..[E "I"L3 I [",ISI.JF::E PF?.OF'E:F:: :[ NL'!;TF:ILL_FIT :[
J.. I FII"I FF:IMIL. II;:IF:: KII'I"H THE F;%;!_:I'F;:E:HEi"4T'~']; F:'OF.: OI"4-:E;ITE :E;IEI,.IIEF.'ti.:.; FINE:' HEL. L.L'::; ~::IE; :'];ET
F'Of:~:TH E~' "r'HE M..MIE:IF'FIL.]:'T"¢ OF-"
;2: ' ]: I.,I ]' L.L I H'~;"f'RLL 'l"hlE' ~:, .=, [ E.i'l I I",1 I::iCCOI~:[:,I::II'.4CE: I.,.! I ]"H THE
'NICIPALITY OF ANCHORAGE
Department o~ Health and Environmental _£otection
825 L Street, Anchorage, AK. 99501
264-4720
* * * HANDWRITTEN PERMIT * *
WELL AN -. , PERMIT
Applicant: <--~C~I_ ~/L~2~"~d Mailing Address: ~ ~d~ //~ /
Location:
Legal Description: d-~ ~ ~/~~ ~-%~ Lot Size:
Type of Soil Absorption System Is:
Trench: Drainfield: Seepage Bed: Holding Tank:
Maximum Number of Bedrooms: ~-~ Soil Rating(sq.ft/br)
The Required Size of the Soil Absorption System Is:
DEPTH LENGTH GRAVEL DEPTH WIDTH
The length dimension is the length(in feet) of the trench or drainfield. The
depth of a trench or pit is the distance between the surface of the ground and
the bottom of the excavation(in feet). There is no set width for trenches.
The gravel depth is the minimum depth of gravel between the outfall Pipe and
the bottom of the excavation(in feet).
* * REQUIRED SEPTIC(HOLDING) TANK SIZE = GALLONS * *
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the number
of residences that the well will serve.
* * * TWO(2) INSPECTIONS ARE REQUIRED
Backfilling of any system without final inspection and approval by this department
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 fee~
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 1 9 8 1 * * *
I certify that:
(1) I am familiar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) I understand that the on-site sewer system may require enlargement if
that 3 bedrooms.
the r~sidence is remodeled to include more c~/~ .~~~~
Signe~: -'~twh~ / ~/:z-~ Issued by:
~plicant Date: -~/...7~
SWP/024(1/81)
by
DOC Co. dba
SULLIVAN WATER WELLS
P,O. BOX 272, CHUGIAK, ALASKA 99567 · TELEPHONE688-2759
OWNER OF LAND
ADDRESS /o O
LEGAL DESCRIPTION
DATE - Started
DEPTH OF WELL
PERMIT NUMBER
STATIC LEVEL OF WATER FT.
7 ~t¢, 9 ,eto~,~ 0~~'t DRAW DOWN FT.
Ended -~/¢P / GALS. PER HR
KIND OF CASING
35-
KIND OF FORMATION:
From 0 Ft. to ~ Ft.
From ~' Ft. to ~g Ft.
From ~_.~ Ft. to ng Ft.
From Ft. to Ft..
From ~ ~" Ft. to q / Ft.
From ~/ Ft. to~ ,Ft.
From Ft. to Ft.
From~ Ft. to ~o~ Ft.
From._ Ft. to
From.~_Ft. to Ft.
From_~Ft. to__Ft.
From~Ft. to Ft
From Ft. to Ft.
From Ft. to Ft.
From ~ Ft. to Ft.
From Ft. to Ft.
From Ft. to Ft
From Ft. to Ft..
From_~_Ft. to
From~Ft. to Ft.
From Ft. to ~Ft
From Ft. to Ft.
From~Ft. to ~Ft.
From ~ Ft. to_~ Ft._
From ~Ft. to .Ft.
From~Ft. to__Ft.
From ..... Ft. to__Ft.
From
From
From__
From __
From
From
. MUNICIPALITY OF ANcHOP, A(~
Ft. to_ DE~:.t.oF t4E,~,L:~H &
ENVIROI'~,,~ENTAL PROTECTION
Ft. to
Ft. to Ft.
Ft. to Ft.
Ft. to Fl.
MISCL. INFORMATION:
I
go 4"
DRILLER'S NAME
April 28~ 1978
~!77229
1161
]3la~].~ R.ivar~ Alahha
99577
~qubj eot ~ Permit
~ permafit issued by thi:'; department for well and/or on-site
se~er tnst~llation on ~% 7 Block ,~ River View Estates
Subdivision has expire~! since the issue date excoeds one(l)
%n the event you still plan to install the well. and/or
on~,qite sewer system, a new pe×~mit is required° ~l'};ze ori~final
soil test ~aay b~; used to obtain a current permit.
the well ha~'~ been dril!ed~ a well log should be sent
this ~i~par~.m~¢,.n'l~ .~o d{ocu~aent the in.~.~tai].a't;ton date.
you have any question-q regard'ia/g the above matter~
please con'tact this office imine~q, ia'hely ~t. 26~I~4720.
Sincerely~
Les k~o Buchholz~ R,g~
,qenio.r Environmental Special
f'1].l',l.t.l'11Ji"1 t.:'].':':,lHi~',lh:l: I:::I:::.II.,.tE[:.I',I t'"1 I.,.l[:.l...L Ht',II... I'11',I'~' .'~I',I"~.:.:,].IL.
::t..l?~t;i) I:::'liii:[i(T I::'~i:)1:;'. t::I l:'l;;;::[',,,'l::l"i"l~i: I,.IEI.I. ~::~1::~'. ;i!:11!:.il;!!1 FLEET I:::~:)t:~'. Ff I:::'
I,It::~LL I....0(:~:~:; F:II;~ [~ :;; ~[I;: tJ :[ [~'.EI:) F~t",I[:' ~{"IIJST BE [;?.E'I'LII;?.I',I~::I::' "['0 THE
~::~:;' 'rH~: ~,.1~:~ .L ~:::~:::,~',~l::'[..l~:'~" :l: ~::~-,~ ~
~; ::' ~ (: ]: F :i: CI::I"i" :J: 01",t:~; I::ff',l[::' I::::l::li'.,l:~;"['l:;~:l...ll~::"l" :[ (:)1",1 D :[ FII]i:~:I:::II'I'.~; I::l~q',lE I~ ,/t::1 ~t :IE',i...E
]~ I'"1S'T'I;;:II" '1'" I:i"1 ' ]: 0 I~"!' , ~ ~
): (];1:~;1:;?.'i" .l. F ~ TIIFI'f ',
::t.' ;i; t:;1t"1 F:I::tI"'I];I...]~I:::it:;'. I,.t]:-H"I TI'-t~] ~;i:~;I];~I.J;[~;?.EHI:~;NT~; I::'0~?. ON'"~ SEI,.II~[I:i;~; 1::~I"4D I,.I1~;I.I..1:~; t:::1':.~; :~:~;1~]"1"
[,l '[ ~1"1"1 TI'"I~ (;]:ODES.
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. o~o-72~-o4
Expiration Date:
GENERAL INFORMATION
Complete legal description Riverview Estates Block 4 Lot 2
Location (site address) 2~2oo Running Brook Circle, Eagle River, AK 99_~77
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
unless otherwise., requested, COSA will be held by DSD for pickup.
NUMBER OF BEDROOMS:
TYPE OF WATER SUPPLY:
individual W~ll
Individual Water Storage
CommunitY Class __
Public Water System
Michael & Yvonne Edmunson Day phone 862-797z
2zzoo Running Brook Circle, Eagle River, AK qqs77
Day phone
Day phone
TYPE OF WASTEWATER DISPOSAL:
[] Individual On-site E~
[] Individual Holding Tank E]
Well [] Community On-site F-1
[] Public Sewer E~]
The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On-Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems Approval
are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued
with new water sample results. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. 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 Pannone Engineering Services, LLC
Phone 272-82~-8
Address P.O. Box,oo2~7, Anchorage, AK 9q~;zo
Engineer's Printed Name Steven R. Pannone, P.E. Date
Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in
accordance with MOA DSD Guidelines & Regulations. The reported results describe the performance of the system under the conditions
encountered at the time of the test, and separation distances measured to readily identifiable features.
The operational life of all wells and septic systems depend on the local soil condition, ground water
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 system. All systems eventually fail and
satisfactory test results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. PES can therefore not provide any warranty for future
performance nor give any estimate of how tong the system will continue to meet the operational
requirements of the MOA DSD. The content of this report is for the sole benefit of the owner listed
above. Any reliance upon or use of this report by any other person or party is not authorized nor will it
confer any legal right whatsoever.
5. DSD SIGNATURE
V"'" Approved for ~.~ bedrooms.
Disapproved~--
Conditional approval for
bedrooms, with the following stipulations:
Attachments:
COSA Checklist X
Septic System Advisory
Well Flow Advisory ,~
Nitrate Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
Original Certificate Date:
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www. muni,org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: Riverview Estates Block4 Lot 7
Parcel ID: o5o-7aa-o4
A. WELL DATA
Well type _P
Date completed nlanlanSa
Total depth ~.ee ft.
If A, B, or C provide PWSID # __
Sanitary seal (Y/N) Y
Cased to 2o ft.
FROM WELL LoG
Well Log (Y/N) Y
Wires properly protected (Y/N) Y
Casing height (above ground) aa
AT INSPECTION
in.
Date of test
nh~Jaoao
Static water level
Well production
wATER SAMPLE RESULTS:
ff.
g.p.m.
ff.
g.p.m.
Coliform o colonies/100 mL
Arsenic: ND ug/I
B. SEPTIC/HOLDING TANK DATA
Nitrate ND mg/L
Date of sample:
Other bacteria o colonies/100 mL
Collected by: Steve Pannone
Tank Type/Material Anchorage Tank Steel-
Date installed 7hl2o',o
Tank size aooo gal. Number of Compartments
Foundation cleanout (Y/N) Y Depression over tank (Y/N)
Date of pumping J~ ~ Pumper
C. ABSORPTION FIELDDATA
Cleanouts (Y/N) a
High water alarm (Y/N) N
Date installed ?hlam. o
Length 4.8 ft.
Total depth _6 ft. Eft. absorption area :~Tn fta Monitoring tube Y
Date of adequacy test ~ ResultS (Pass/Fail) Pass
Fluid depth in absorption field before test __ in. Water added .
Elapsed Time: __ min. Final fluid depth __ in.
Any rejuvenation treatment (past 12 mo.) (YiN & type)
Soil rating (g.p.d./ft2 or ft2/bdrm) a.a System t~pe Shallow Trench
Width 5.0 ff. Gravel below pipe 2.5
Depression over field N
For 3 bedrooms
~ gal. New depth~
AbsorPtion rate
ff yes, give date
in.
g,p.d.
LIFT STATION ze in~l
Date installed Si
"Pump on" level at ~ in. "Pump off.
Datum Cycl~
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot
Absorption field on'lot ~.oe+
Public sewer main N/A
Sewer/septic service line
Building foundation ~.o+
Water main N/A
Wells on adjacent lots =oo+
Manhole/Access (Y/N)
High water alarm level at
Meets alarm.& circuit requirements?
On adjacent lots ~oo+
On adjacent lots ~.oo+
Public sewer manhole/cleanout NIA
Holding tank ~.oo+
Animal containment areas ~ .~"0" ,,~-,v'
~ R. 1° Manure/animal excrete storage areas :~oo+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Property line . ~o+ Absorption field 5+
Water service line 2~+ Surface water 1oo+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Water main. N/A
Driveway, parking/vehicle storage
Property line ~o+
Water Service line.. ~+
Curtain drain None Known
COMMENTS
Building fOundation ~o+
Surface water ~oo+
Wells on adjacent lots ~o0+
in.
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.
Engineer's Printed Nam. e Steven R. Pannone~ P.E.
Date
COSA Fee $ ~ ~' 0
Date of Payment .. g -' ,~ ~ - ,/ 0
Receipt Number ~ ~ .'7 //~ O/ '_"_~
(Rev. 11/05)
Waiver Fee $
Date of Payment
Receipt Number
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www. ci. an chorage, ak. us
(907) 343-7904
Water Well Advisory
Certificate of On-Site Systems Approval (COSA) # 101177
During a recent COSA on-site inspection and test of the potable water
supply well on Block 4, Lot 2 of Riverview subdivision, the well's
productivity was determined to be 0.5 gallons per minute. The minimum
well productivity required by this Department (AMC 15.55) for a 3-bedroom
residence is 0.31 gallons per minute. Although the subject well currently
exceeds this minimum requirement, all parties concerned are advised that the
production capacity of the well may fluctuate. Restriction of non-critical
water uses such as washing cars and watering lawns and gardens may be
required.
This advisory must be attached to all copies of the subject Certificate of On-
Site Systems Approval.
............ :SG_S
SGS ReL# 1103300001
Client Name Pannone Eng. Srv. Printed Date/Time 07/20/2010 15:29
Project Name/# Bk 4 Lt 7 River View Est Collected Date/Time 07/07/2010 9:15
Client Sample ID Bk 4 Lt 7 River View Est Received Date/Time 07/07/2010 14:50
Matrix Drinking Water Technical Director Stephen C. Ede
PWSID 0
Sample Remarks:
4500NO3 - Total Nitrate/Nitrite - MS did not meet QC criteria, biased low. LCS meets QC criteria.
Allowable Prep Analysis
Parameter Results LOQ Units Method Container ID Limits . Date Date Init
Metals by ICP/MS
Arsenic
ND 5.00 ug/L EP200.8 C (<10) 07/07/10 07/19/10 KDC
Waters Department
TotalNitrate/Nitrite-N ND 0.100 mg/L SM20 4500NO3-F B (<10) 07/08/10 AYC
Microbiolo97f Laboratory
E. C01i
Total Coliform
Negative 1 100mL SM20 9223B A 07/07/10 DLC
Negative 1 100mL SM20 9223B A 07/07/10 DLC
lO' UTILITY EAS;
Lot 8
CHAIN UNK
PLOT PLAN
WOODEN FEN
1 STORY
RESIDENCE
42.1'
Lof 7
- 66,587 s.f.
:-bRg;~v^.':..'
-SEPTIC CLEANOUTS
/
~ ~ ---'" N 88' 372.00'
Lot 1
20' UTIUTY EASEMENT &:--~
~WALKWAY EASEMENT~~ __
Lot 2
AS BUILT X SCALE 1" = 50' GRID SW 0357 Project No. 10-163
Lot 5
\ Lot 5
La n g (907) 522-6476
Registered Land Surveyors (907) 522-4625
kglanglsOalaska.nef / JclanglsOalaska.nef
& Associates, inc. 11500 Daryl Avenue, Anchorage, Alaska 99515-5049
Phone
Fax
I hereby certify that I have surveyed the following described properly:
Lot 7, Block 4, River View Esfofes (Plot No. 75-151)
Anchoroge Recording Disfrlcf, Alaska, ond fhof the Improvements sifuofed thereon are
within the properly lines ond do not encrooch onto the properly adJocenf thereto, fhaf
no Improvements on the properb/ lying adJocenf thereto encroach on the surveyed
premises ond fhaf there are no roedwoys, fronsmlsslon lines or other vislble
easements on said property except os Indicated hereon.
Dated this the ~'~) Day of ~<JF.~-~<~T ,
~,~ , at Anchorage. Alaska
It Is the responslblllty of the owner fo determlne the existence of any easements,
covenants, or resfrlcflone which do not appear on the recorded subdivision plat.
MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
DIVISION OF ENVIRONMENTAL SERVICES
343-4744
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
Parcel I.D. # ~) L~) ' "~ ~' \" L~"'Jl"~ HAA# ¥-~ ¢', ~C~C-''5'~ '9'~ ~
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include lot, block, subdivision, section, township, range)
LOT 7, BLOCK 4 RIVERVIEW ESTATES
Location (address or directions)
(b) Property owner AHFC # $2295
Mailing Address 520
(c) Lending Institution
Mailing Address
East 34th. Av~.nu.~.
Telephone:(home)
An6horag~, Alaska 99503
TeLephone
Business
(d) Real Estate Company and Agent RE/MAX of Ea~le River ATTN: Eva Loken
Addres~ 16600 Centerfield Dr. Suite #201, Eagle River, AK 99577
Telephone 694-4g00
(e) Mail the HAA to the following address: (or check here'S, if hold for pick up.)
List contact person and day phone number below:
$ & S ENGINEERING
Eagle River, Alaska 99577
2, TYPE OF RESIDENCE
Single-Family~:~ Number of bedrooms
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 th legality and status.
4. SEWAGE DISPOSAL
On-site [~ Public [] Community [] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legality and status.
Page 1 of 2
5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION"
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this
Health Authority Approval shows that the on-site water supply and/or wastewater disposa~ 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.
Telephone ,, ;..:} .~,/~, .~....m~.~. ~ ~:~
S & S ENGINEERING
17034 Eagle River Loop Road No. 204
Eagle River~ Alaska 99577
Name of Firm
Address
Date
6. DHHS APPROVAL
Approved for J bedrooms
Approved __/~'""~'~_~ Disapproved Conditional
Terms of Conditional Approva
The Municipality of Anchorage Department of Health and Human Services(DHHS) issues Health Authority Approval
cerificated based only upon the representations given in paragraph S above byan independent professional engineer
registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their Pending
institutions in order to satisfy certain federal and state requirements. Employees of DHHSdo not conduct inspections
or analyze data before a certificate is issued. The Municipality of Anchorage is not responsibleforerrorsoromissions
in the professional engineer's work.
72-025 (Rev. 7/88)Back Page 2 of 2
MUNICIPALI [Y OF ANCh~,qAGE
ENViRONMEixllAL SERVICES DIVISION
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
!U i\-] 2 c~ 1,9~(~)CHECKLIST- FEBRUARY 1984
264-4744
RECEIVED Legal Description:
WELL DATA
Well Classification '~1~\~/~,'~-~ If A, B, C, D.E.C. Approved (Y/N)
Well Log Present ~N) Date Completed _ ~/~51 / Yield
~ , u :F--~Dept h ~
Total Depth ~ / Cased to ~ ,4 of Grouting
Static Water Level '7~L~/ '-' Pump Set At "¢~¢'¢"¢)~"
Casing Height Above Ground
Electrical Wiring in Conduit~)'N):
Sanitary Seal on CasingFJ.--~N)
Depression Around Wellhead (Y~)
Separation Distances from Well: I
To Septic/l~ld~ctg Tank on Lot
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line ,
Cleanout/Manhole ~'~/~ To Nearest Sewer Service Line on
Water Sample Collected by
Water Sample Test Results ~1
Comments
SEPTIC/F~ TANK DATA
Date Installed
No. of Compartments
Foundation Cleanout (Y/I~)
Date Last Pumped
;for ....
Temporary Holding Tank Permit (Y/N) /%'
Standpipes ~-¢~/N) Air-tight Caps~N)
Depression over Tank (Y(~
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/14el~mg Tank:
tA_
I
To Building Foundation
To Disposal Field
To Stream, Pond, Lake, or Major Drainage
To Water-Supply Well .
To Property Line
To Water Main/Service Line
Course
Comments '~
Page 1 of 2
72 026fRev ~861 Fronl
ABSORPTION FIELD DATA ~
Soils Rating in Absorption Strata I"~'~y'~_~C-~,...---
Type
of
System
Design
Date Installed ~'-~-'L...-¢2- ~,~ Length of Field ,--2~.¢~.
Width of Field "~ ~ /-
Depth of Field t c:~
Gravel Bed Thickness
Square Feet of Absorption Area '¢~¢O~'~;2 Standpipes Present ¢~:;N)
Depression over Field (Y/~- -/ Date of Last Adequacy Test (
Results of Last Adequacy Test ~¢~~1 ~ ~ ~, -
Separation Distance from Absorption Field: '"-' ..... ?' ~,~, ..d~;.u.,~Z f' "'
To Water-Supply Well ~ To Prope~y Line
To Building Foundation ~ I ~
To Existing or Abandoned System on
Lot ¢//%
To Water Main/Service Line ~, ,::, ~ ~
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
; On Adjoining Lots ~
To Cutbank (if present)
!
LIFT STATION
_D~ Dimensions
Size in Gallons ~ Manhole/Access (Y/N)
"Pump On" Level at ~ "Pump Off" Level at
High Water Alarm Level at ~ Vent (Y/N)
Tested for
Cycles during Adequacy Test. Meets MOA
Electrica'l Codes (Y/N)'
Comments. -~"'--..~ ~.~
** Check Permitted' B Rating Against HAA Request **
I certify tha. t.~l~.Cve~czer~eonformed to all MOA and. HA~ gc~idelines in effect on the date of this inspection.
Sign~e~d ,~! /~-~ Date
Rece~ Eaale River, Alaska 995~ -/ - /
Date of Payment ~ - ~ fl'-~F --
Page 2 of 2
72 026 IRev 8/861
CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
FEDERAL TAX ID # 92-0040440
ANALYSIS REPORT BY SAMPLE for Work Order 8 1~262
Date Report Printed: JOtl 26 89 ~ 14:55
Client Sample ID:L7 B4 RIVERVIEW
PWSID :UA
Collected JUN 20 89 ~ 16:45 }us.
Received JUN 21 89 @ l?:O0 hfs,
Preserved with :AS REQUIRED
Client Name : S & S ENGR
Client Acct: SNSENGP
?.O,tl NONE REC'D
Req I~
Ordered By :
Analysis Completed :JUN 23 89 Send Reports to:
Laboratory Supervisor.:gTEPNEN C. EDE I)S & S ENGR
Special
Instruct:
Chemlab Roi ~I: 5881 Lab Smpl ID: 3 Matrix: WATER
Allowable
Parameter Tested Result/Units Nethod Limits
NITRATE-N 0.12 mg/l EPA 353.2 lO
Saraple ROUTINE SAMPLE
Remarks: SAMPLE COLLECTED BY RJS.
1 Tests Performed ' See Special Instructions Above UA=Unavailable
ND= Hone Detected '* See Sample Remarks Above
NA= Not Analyzed LT=Loss Than, GT-Greater Than
DATE
,NS.ECTOR
DATE
MUNICIPA'/I,ITY OF ANCHORAGE
DEPARTMENT OF HEALTH B~ ENVIRONMENTAL PROTECTION DEPT. OF HEALTH &
825 L Street - AuchorafJe, Alaska 99501 ENVIRONM[!N1AL PF;OTECTION
ENVIRONMENTAL SANITATION DIVISION AUG ? i981
Telephone 264-4720
.EOUEST FOR APPROVAL OF INDIVIDUAL ~ATEFI AND 8E~EI~LN~,~8~ D
DIRECTIONS: Complete all parts on page 1. tncolnplete requests will not be processed. Please allow ter (10) days for processing.
1. PR~O~_PERTY OWNER PHONE
MAILING ADDRESS
PROPERTY RESIDENT If different fromabov61 [
2, BUYE~t ---
MAILING ADDRESS
PRONE
PHONE
3, LENDING INSTITUTION
_A A x'c/~Z
MAILING ADDRESS
PHONE
4. REALTOR/AGENT
- PHONE-
MAILING ADDRESS
5, LEGAL DESCRIPTION
STREET LOCA'I ON
6. TYPE OF RESIDENCE
I~" SINGLE FAMILY
[~] MULTIPLE FAMILY
NUMBER OF BEDROOMS
I~ One L~ Four
~ Two [] Five
b~ T ql-ee [] Six
Other
7, WATER SUPPLY
INDIVIDUAl_'
COMMUNITY
PUBLIC UTILITY
ATTACI4 WELL LOG. A well log is reauired for all wells drilleo
since June 1975. For wells drilled orior to that (late. give well
depth (attaclr log if available,)
8. SEWAGE DISPOSAL SYSTEM
..~" INDIVIDUAL/ON-SITE*~
~ PUBLIC UTILITY
YEAR ON-SITE SYSTEM WAS INSTALLED
Cq ~Z~ I)
NOTE: 'rile INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING (;AN BE NITIATED.
~.ote~.e~.e/~ 11.-~--4'~ '~f,~ ~ a.._~ c~,..,,.~.~../rr_.~~ ' '
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NSMBER
2. WATER SUPPLY
[~ INDIVIDUAL DEPTH OF WELL
[] COMMUNITY DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
PERMIT NUMBER
3, SEWAGE DISPOSAL SYSTEM
~ INDIVI DUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY
Connection Verified INSTALLER
[~]Septic Tank or [~ Holding Tank
Size:_ If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCES Septic/Holding Tank IA'bsorption Area Sewer Line I Nearest Lot Line
WELL TO:
I
I
Absorption Area to nearest Lot Line
5, COMMENTS
[~'~ APPROV ED FOR ~ BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificatel
[] DISAPPROVED
DATE BY
