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RIVER VIEW ESTATES BLK 8 LT 5
River'view Estates Block 08 Lot 05 #050-702-35 t Municipality of Anchorage Development Services Department~.~:o'~ -=~_,o'- On-Site Water & Wastewater Program, 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 "~ ~' www. ci.anchorage.ak.us (907) 343-7904 Page 1 of ,.~ On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: 5W050125 PlD Number: 050-792-,35 GARY C0CKRELL Wastewater System: m New E] Upgrade Address: 11936 RAINBOW DR. 99516 ABSORPTION FIELD Phone: NO. of Bedrooms: (907) 266-5579 4 I~ Deep Trench · Shallow Trench Oeed I-I Mound t'lOther 8 5 RIVER VIEW ESTATES SEE DWG r~. 1.5 - - - SEE DWG rt. 120 (2@60') WELL: · New r-I Upgrode 5 rt. 2J 15 PRIVATE 400 rt. 60 rL 750 so. rt. D 3034/ F-810 SULLIVAN WATER WELLS 5/21/03 57 r,. OWNER 5/16-19/2003 0.83 cpu UNK r,. I 2 r,. TAN K SEPARATION DISTANCES .Septic a.o,d~n~ ass.c,. OOther 1o Septic Absorption Lift Holding Tank Field SIotlon Tank s~..~ u.. ANCHORAGE TANK 1250 Well 100'+ 100'+ - - 25'+ STEEL 2 - - - LIFT STATION Surface Water 100'+ 100'+ Remarks: * 5' LOT I. INI~ WAIVI~R SRANT[O. BENCH MARK WAIVER AMEND REQUESTED (SEE ATTACHED) NORTH WEST CO~NER OF HOLI~;~ FOUNDATION WALL ENGINEER'S SE~I. / Inspections performed by: ... ^KWWC, I~C. Dates: ~st 5/17/2003 .'"~/ "' 2nd 5/18/2003 3rd ~ ~s.: R~viewed(,.,. ,~/o,) and approved by:F ~ Dote: ~¢~J' '%~,~r,%~.4=.~'=~°reS'~°°°~'~ . 050-792-55 /-'--'ALTERNATE SITE WILL / REOUIRI~. THE USE OF' ~ ~ I ST1 171.95 40.25 ~ ~INST~LE~¢F~OW ST2 J79.43 47.37 / ~ FS J97.55 74.57 /~~__~ .... "~' ~/ ~.' MT1 i123.1 87.1'6 95.16 ~~-':~:.~ ~,.. ~..: ~ · - ,~'~:.' ~/~ ~,:".~ 0~?~ ".. ~ ." ~.~ ~ .~ · ........ "~ .................. ,., 71291200.3 DRAWN BY: .... B.S.G. ,AI.ASKA WATER & WASTEWATER , , CONSULTANT. S INC.- ' 1" 5701 E, TUDOR R~ SUITE I01 · ANCHORAGE. AK qqs07 PHONE (007 337-617<3 · FAX (q07)~38-SZ&6 PREPARED FOR: PHONE NUMBER: PAGE NUMB[R: GARY COCKRELL 266-5,:379 2 OF LECOM. DESCRIPTION: EIVERVIEW ESTATES SUBDIVISION; LOT 5, BLOCK 8 TYPE Og WORK: AS-BUILT OF NEW WELL AND SEPTIC SYSTEM A B ST1 71.95 40.25 5T2 79.43 47.37 OeL1 83.02 51.08 DBL2 85..36 53.48 FS 97,55 74.57 C01 122.23 85.65 M¥1 123.1 87.16 C02 69.71 61.52 MT2 70.57 63.25 c03 126.01 95.16 MT,.5 126.84 96.67 CO4 79.04 76.6 MT4 79.94 77.87 PERMIT NUMDER: swo30,25 AS- BUILT DRAWING FINAL C~E = 105.23 TOP OF T~K AT ~TOP INL~ ~ ~ OUTLET 102.33 2" INSU~TION '~[R' OF ~g~ NEW 1250 GALLON *T ~NL~ = 5 SEPTIC TANK ~RT OF BUNG AT OUTLET - IOI.47 , TRENCH ~RENCH REL~A~ EL~A~ION 80~OM OF TEST HOLE I ' OAT [: ~S~ WATER & W~TEWATER ~,: ~'s'°' ~.'4 , ~ .... : ................ :...:~[ GARY COCKRELL (907) 266-5379 3 OF 5 ; ; "~, mv[E v~rw ESTATES SUamV~S~ON; ~LOC[ S, LOT 5, ~..'~'-.l .... "'}~ PROFILE AS-DUILT OF SEPTIC SYSTE~ '~~ ALASIG WATER & WASTEWATER CONSULTANTS, INC. July 22, 2003 Municipality of Anchorage Development Service Department Building Safety Division On-Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Reft Lot Line Waiver for Lot 5, Block 8, Riverview Estates. To whom it may concern: We request that your department amend the existing 5 foot lot line waiver to 3 feet from the west property line to the existing drainfield. I am unaware of any adverse impacts this waiver would have on adjacent wells or septic systems. If you have any questions, please contact us at 337- 6179. Thank ~t for your assistance. ' Ga , P.E., M.S. 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com 01/01/1999 00:03 6002259 SULLIVAN PAGE 01/01 by DOC CO. db;~ SULLIVAN WATER WELLS P.O. BOX 670272, CHUGIAK, ALASKA 99567 * TELEPHONE 608-2750 OWNER OF LAND: BORE HOLE OATA .....' --- .....-- ¢r~,..~ b DEPTH LEGAL DESCRIPTION: ~I~&~ O,/.J~'4~J ~',~T"~"~' PERMIT NUUBER: ~ I~ Date of lssue ~- ]~-~ 7q T~ IDE~FICATION NUMBER:~- ~ -~ ~ Is well I~ated at appmv~ pe~it location? ~ ~ No Method of Dtilli~: ~a~ ~ cable tool ~pth of well: ~ e ~ C~ing Type ~Wall ~tckn~s ~lnches Oi~eter~/~ Inches, depth ~0 feet UnerType:~~ W~ /t ~- ._ Casing Stickup Above Ground= ~, fee' Static Water L~el: ~ feet R~over ~le: ~~ Meth~ofTCsting: ~)~~ Well Intake Opening Type: ~e~ Q open hole 'J Sc~n~; Sta~ feet Stopped feet u pedorations Sta~ __ , fee~top~a feet cHI ,, G~Type: ~;~T~; Vogue= ~ Depth: f~m _~ f~t, to ~ fe~t Well Disinf~ Upon Completion? ~ ~ ~o ' Commits: Driller's Name ATrENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation, MatSu Borough: Department of Environmental Conservation. MUNICIPALITY OF ANCHORA GE Deve/opment Services Depa~ment On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Initial Date Issued: May 12, 2003 Expiration Date: May 11, 2004 Permit Number: SW030125 Legal Description:[RiVER V!EW ESTATES BLK 8 LT 5 Design Engineer: 0041 AK Water & Wastewater Consultan' Owner Name: GARY COCKRELL Owner Address: NHN FALLING WATER DRIVE EAGLE RIVER, AK 99567- Parcel ID: 050-792-35 Site Address: Lot Size: 45240 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: [] Disposal Field [] Septic Tank [] Holding Tank r-~ Privy Private Well [] Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction dudng freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date:._~~.~ Date:~ ill-America Ci~ · ll'~terch, Mayor 2002 5113~2003 Jeffrey A. Gamess Alaska Water & Wastewater Consultants Inc. 6901 DeBarr Rd, Suite 2B Anchorage, AK 99504 Subject: Waiver Request for River View Estates Block 8 Lot 5 Waiver Request #WR030035 Parcel ID #050-792-35 Permit #SW030125 Dear Mr. Gamess: Your request for a waiver of the required 10 feet hOrizontal separation from the absorption field to property line has been approved. The approved separation distance is _5~ feet. This waiver approval applies to the existing absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Daniel J. Roth Civil Engineer On-Site Water & Wastewater Program P.O. Box 196650 ·Anchoragc, Alaska 99519-6650 · Tclcphonc: (907) 343-8301 ° F.'~x: (907) 343-8200 4700 South Bragaw Strcct ° Anchoragc, Alaska 99507 h ttp://~x'ww.ci,anchoragc.al¢.us 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. ci.anchorag¢.ak.us (907) 343-7904 Waiver Review Worksheet WR#: WR030035 PID~: 050-702-35 HAft: Date Received: ~i112/05 Legal Description: River VieW Esta~e~ IBI0~k 0 !-o~ ~5 Engineer: Jeffrey A. Garness. PE Alaska Water & Wastewater Consultants. Inc. Applicant: Gary Cockrell Waiver Requested'_.~et from dralnfleld to west lot line Criteria: Geology A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Permit~: SW030125 Points: Total: Waiver is Granted: .~. Waiver is not Granted: List Conditions or Reasons for above: ,~' E Date: F~/O ~ By:, P~J~ t Name of Reviewer Rec~: :~i217 Amount: $150,00 Date Paid: 5/12/03 Parcel I.D. Municipality of Anchorage Development Services Department Building Safety Division ' On-Site Water & Wastewater Program ~O~/~ 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERHIT APPLICATION FOR A SINGLE FAMILY DWELLING 0 o-7qZ-3 Permit Number, ~ ~.~0125' Property owner(s) Mailing address (1) Mailing address (2) Legal description (Lot, Block & Sub'd.) LOT 5. Legal description (Section, Township & Range) GARY COCKRELL 11936._RAINBOW DRIVE * ANCHORAGE. AK LotSize 4~ 2.~0 Acre~ THIS APPLICATION IS FOR: Sewer Only ~= Sewer and Well Sewer Upgrade [] THIS PROPERTY CONTAINS: Hot Tub [] Swimming Pool r-~ Therapy Pool [] Day phone 266.3379 Zip Code 99516 BLOCK 8: RIVERV1EW ESTATES SUBDIVISION N/^ Number of Bedrooms 4 Well Only Water Storage Jacuzzi N Water Softening Unit r-~ 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. ALASKA WATER &: WASTEWATER CONSULTANTS, INC. Permit Fees:.~55~) lt' 150 ~"'~00 Waiver Fees: Date of Payment: Receipt Number: _'~ 5! r7/~' i~, Date of Payment: Receipt Number: /,5-'O. ALASIG WATER & WASTEWATER CONSULTANTS, INC. May 8, 2003 Municipality of Anchorage Development Service Department Building Safety Division On-Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Proposed Well & Septic System for Lot 5, Block 8; Riverview Estates Subdivision To whom it may concern: The proposed 4 bedroom house will be served by a private well and septic system. Two test holes were excavated on the property. The drainfield will be designed around the 30 foot radii of these testholes. We are proposing that a new 1250 gallon septic tank and dual 5-wide type drainfields be installed. Comments regarding the design are summarized as follows: 1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and the percolation test results. It is our opinion that a combined application rate of 0.8 gallons/day/ft2 should be used. 2. TRENCH DESIGN: a. Percolation Rate: 4 & 24 minutes/inch b. Combined Application Rate: 0.8 gallons/day/ft2 c. Number ofBedrooms: 4 d. Design Flow: 600 gallons per day e. Minimum Absorption Area: 750 ft2 f. Total Depth: 3.0 feet (max.) g. Effective Depth: 1.5 h. Width: 5 feet i. Reduction Factor: 0.78 j. Minimum Length: 2 @ 60 feet long each (120 feet total length) k Effective absorption area = 750 ft' 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system. 4. TOPOGRAPIIY: The area for the proposed drainfields is a 10-15 percent slope running approximately south to north; in short, there are no slope concerns. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: a~vxvc.com 5. LOT LINE WAIVER. We request a 5 foot lot line waiver from the proposed drainfields to the west lot line. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If u have any questions, please contact us at 337-6179. Thank you for your assistance. P.E., M.S. NOTE: A site plan drawing, a design drawing, two soils logs, and a 7 page construction specification letter which are all part of the design package for this septic system. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com x R~ ~ ~. S/D; - ". ~ '.. ~ t . · .~, ~, ~ ,~.~,~ ~ 1 100 PR~ ~R PHONE NUMBS: 'P~ NUMBS: GARY COCKRELL 266-5579 1 OF 2 ~E OF ~RK: SI E 0 0 T P~N F R PR POSED WELL AND SEPTIC SYSTEM ~ ~ / / ~ ~/' CONSULTANTS INC. "-- ' ~.[ t~,:.:..~ ...........~ :....~ 6~01 OEBARR ROAD SUITE ~B · ANCHORflG~ AK ~qS~ ' PHONE (q07)357~17~ ~ FAX (q07~38-~Z~6 ~ ~ 40 ~ ~c.~o.= ~'~. '.~ ,7~ .."~ ,~vERv~Ew ESTATES SU~D~V~S~O,= LOT S. ~LOCK S "~?Z,'"-~:~., ~./ ..-"~L~ PROPOSED WELL AND SEPTIC SYSTEM LOCATION AI SKA WATER & WASTI '.WATER ! ISOIL LOG - PERCOLATION TESTI .¥.. IFGAL DESCRIPTION: RIVER ViEW ESTATES SUBDMSION; LOT 5, BLOCK B, PERPORVED FOR: c~ Coc~ D^T~: ~/~/=o0~ :~,!~.::~. TEST HOLE #1 ,.:~!,~[~ SOIL CLASSIFICATIONS ~ '~:~:": ~iGM CL I ~,!~¥ IGC OL ~!~¥ , SW i HH '~*!~¥ SP ~CH '~;~ SM I OH ~:':' GP-GM :~':~ ' DEPTH TO ~.._ 7---==~: DATE ~:~ GROUNDWATER ~._ / 8 --.~ 9.0' 4/19/2003 ~F¥ 8.5' ~i~ 8.5' 4/28/2003 :~::~ DATE READING CLOCK NET TIME WATER LEVEL NET DROP ~:~¥ TIME (MINUTES) READING (INCHES) 12 ~ "~= 4/21/2005 1 2:50 - 6- - 2 5:00 10 15-- 5 5:00 - 6- - 4 3:10 10 3 1/2' 2 1/2" 14~ 5 3:10 - 6' - 6 3:20 ~0 3 1/2' 2 ~/2' 15-- 7 3:20 - 6. - ~s_ a ~:30 10 3 ~/2' ~ ~/2' 9 3:30 - 6- - 17~ 10 3:40 10 3, 1/2" 2 1/2' 11 3:40 - 6- - is-- ~2 3:50 ~0 3 ~/2' 2 ~/2' 19-- PERCOLATION RATE. 4 (HIN./INCH) PERC, HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 3.5 FT. ~D 4.5 FT. 20--~ A FOUR HOUR PRESOAK WAS PERFORHED: ~ YES ~ NO SOILS LOGGED BY: ~B ~L PERCOLATION TEST PERFORMED BY: ~EB (;ALL COMMENTS: PERFORMED BY AK~C, INC. I. JEF~ ~ GARNESS, CERTI~ T~T THIS W~ P~RFORMED IN ACCORD~CE W~ A~ ~ATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: DEPTH TO GROUNDWATER DATE 9.0' 4/19/2005 8.5' 4/25/2003 8.5' 4/28/2003 ALASKA WATER & WASTEWATER ~.~....'." ;'4~Ji' '"'r-dOt.. ........ CONSULTANTS. INC.' ..... 419 I .... y,;.- ....... ~G~ D~CRIP~ON: SUBD~SION:,LOT 5,,BLOCK 8. PERFORMED FOR: ~ COCKR~ DA~: 4/19/2~5 ~ ORig.,CS ITEST HOLE SOIL C~SSIFICATIONS ~ GH CL GC OL SW MH SP CH SC DEPTH TO DATE ~'-~_ GROUNDWATER ~...._ SEEP 0 6,0' 4/19/2003 ~._ 7.5' ~/~/~oo~ '~-~ 7.5' 4/28/2003 ~ 11 DATE READING CLOCK NET TIME WATER LEVEL NET DROP TIME (HINUTES) READING (INCHES) 12 4/21/2003 1 2:50 - 6- _ 2 3:20 30 4 3/4" 1 1/4' 13 3 3:20 - 6- _ ~ 3:~o 3o 4 3/4' ~ 1/4' 14 5 3:50 - 6- _ 6 4:20 30 4 3/4' 1 1/4' 15 ' 16 17 19 PERCOLATION RATE 24 (HIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 3.0 FT, AND 4.0 FT, 20 A FOUR HOUR PRESOAK WAS PERFORHED: ~ YES ~ NO SOILS LOGGED BY: ~B G~ PERCOLATION TEST PERFORMED BY: COHHENTS: PERFORMED ~ ~C, INC. I, JE~ ~ GARNESS. CE~ T~T THIS W~ P~RFORMED IN ACCORDANCE W~ A~ ~A~ ~D MUNICIPAL GUIDELINES IN EF~CT ON ~lS DATE: DEPTH TO DATE GROUNDWATER SEEP 0 6.0' 4/19/2003 7.5' 4/25/2003 7.5' 4/28/2003 TO WHOM IT MAY CONCERN I }lAVE OPERATED BACK HOES TO EXCAVATE FOR INSTALLING A SEPTIC TANK, A DITCH FOR LAYING CABLE AND DITCHES FOP. WATER LINES AND GAS LINES. I HELPED BRAD KRUGER, OF PREMIER ALASKA EXCAVATING, TO INSTALL HIS SEPTIC A COUPLE OF YEARS AGO. I AM FAMILIAR WITH TIlE CODES ON INSTALLING A SEPTIC SYSTEM. BRAD KRUGER OF PREMIER ALASKA EXCAVATING, WILL ASSIST ME I1;q INSTALLING THIS SYSTEM. LL PERMIT NO. I}EF:'RF.:TMEN]" [ HEFIL. TI-I RND ENVIRONMENTFIL ]TECTION 025 "L'" STREET., RNCHORRGE., RK. 9'9.50± ,:: 8]:0008 ::, FIF'F'L I F:RNT LOCflT I OI',t I,~EGRL .]'OHN GF.:OSS REI",IEI.4FII,~. F'ERMIT .~t, 82078t LSB8 RIVER',,,'IEI.4 ESTRTES F'O BOM ±'16± 9205'?7 LOT SIZE T'¢PE OF SOIL FIBSORPTIOI'.4 SYSTEM IS: E:,RFIINFIELD I','IFt:=.,',IMI..II'd NLII'"IE~ER OF BEDROOMS = 3 694 9±38 999999 SQl Jr;IRE FEE'F SOIL RFf'I"ING ,::SQ FT,.,'BR)= ±25 THE' REQUIRE[:, SIZE OF TFIE SOIl,.. FIBSORPTION S'¢STEM IS: THE LENGTH B',II"IEI'.4SIOI'.4 IS THE LENGTH (IN FEET) OF' THE TRENCH OR DRFIINFIEL.[:,. '['HE [:,EF']"H OF FI TRENCH OR F'IT IS '['HE DIS"rFtNCE BE"FI.4EEN THE SURFRCE OF THE GROI.jt'.,ID RN[:, THE E:OTTOM OF THE EXCFt',,,'FITZON (IN FEE'r). TFIIE GRFtVEL DEPTH IS THE MINIMLIM [:,EPTH OF GRR',,,'EL BETBIEEN THE OU]"FRL..I,_ PIPE FINE;, THE BOTTOM OF THE EXCWFRTION (IN FEET). ~;-'.: E: (.:.':Lu L.~ :E ~'~: E £:, "-2] E: F' T Z C: 3F F~t 1'-48-::: % Z Z E == :L ~£"~ ~Zu u:-'E-~ E3 ¢-'~ [_ b. ,::3 ~'-,~ ~; F:'ERMI T RPPL IC:FINT HFIS THE RESF'ONSIE:IL.I T'¢ TO INFORM TFII'.5 [:,EPFIRTMENT [:,LIR I NG THE INSTRI._LRTION ZI'4SF'ECTIONS OF RN'¢ HELLS RD..TRCENT TO TH~S PF.'.'OPERT'¢ FIND THE NUME',ER OF' RESIDENCES THRT THE HELl.. [,.IZLL. SEF..",,,'E. ............... 'T t-.~ () ( ~:~; ]:, ][ ~"-.~ ~:; F' E ,2: ]-' Z ~]l U'...i S F~ ~;:~: E Fu': EE (~ ~_..~ ]:: ~:L:: E; E: ........................ E:RCKFILLING OF RN'¢ S'.,.'STEM klITHOUT FINRL INSPECTION RN[:, FIF'PROVIqL E:'¢ THIS [:,EPRRTMENT HIL.L. BE SUBJECT TO PROSECUTION. MINIMUM [:,ISTFINCE BETHEEN Fl WELL FIND Rl"J¥ OBI-SI"FE SEI.,IFIGE [:,ISPO:~;~L. S"r".':q'TEM IS :~.00 FEET FOR R PR.I'v'FFFE HELL OR ±50 TO 200 FEET FROM R PUBI...IC HELL DEF'ENE:,ZNG UPON THE -r'¢PE OF' F'UBLZC HELL MINIMUM B, IL=;TRNCE FROM R F'RI'¢FtTE HELL TO R F'R~VFtTE SEHER LIt'.,IE IrE; 25 FEET FINE:, TO Ft COI','IMUNI'T'¢ SEHEF.'. LINE ZS 75 FEET. HELL LOGS RRE F.:Eg!IJIREE:, FINE:, MUST BE RETLIRNEE:, TO OF THE 1.4ELL COMPLETION. OTHER REQtJZREMENTS I"IF4'¢ RPF'L.'¢. SPEE:IF~CRTIOI'.4S FIN[:, CON~,TRLICTTON B, ZFIGRFIMS F~RE FI',,,'Fi I I...RBI...E TO T NSUF.'.'E F'ROPER I N':';TRLLFtT I ON. I C[:RTIF"r' TNRT ±: I Rl'd FFtMILIRR HITH THE REQUIREMENTS FO[;.: ON-SITE SEHERS RND HELLS FIE; SET FORTH B"r' THE MUNICIPFILIT"r' OF RNCHOF.:I:]GE. 2: I 1.4II_L INSTF~L.L TNE S'¢STEM IN RCCORB"flNCE klITH THE E:ODES. ~:: I UN[:'ERSTRN[:' THRT THE ON-SITE SEWER SYSTEM I"IRY I';.".EQUIRE ENLFIRGEMENT IF THE RESIDENCE IS REMO[:'EL. ED TO INCLI.J[:'E MORE THFIN ."~: E.:EDROOMS. RF'F'[ .~:FtNT ..10Hi'~-GROSS PERMIT NO. ,' n ,' '- DEF'flRTMENT P~ HEflLTH RND EN¢IR_NI'IEN]RL '"ROTECTION ,_,;~,_, STREET., RNI_.HORFIGE., AK. La:. 242 1.4ELI ...... RI"-.,tE:, Oi",,I _ T -rE 2~.";EL,,IE~: F"EERI"d ]E T ~' ~,.-,t..-1"2 ,-, 4 IRPPL I E:FtNT LOC:BT I ON LEGflL ,.TOHN L GRU.~_, L5C,,¢:, , ',' ~, ,- ~ ..... RI ~EtR ',/IEW E=,TRTE-, F'0 B0~'.: 116t E.R. _.~,._,, LOT SIZE 694-9t3:8 999999 SQ.RRE FEET T'T'PE OF ~nlL HE.=,LRFIIEN =,r=,TErl IS: DRRINFIELD MAXIMUM HUME, ER OF E, EE.,RuOM_, = ~ ,-n ,..~. FT/'BR) = t25 =,L I L RRT 11'46 ,' ~¢,; THE REQUIRED SIZE OF THE SOIL~,~.~.=,_,,..,-..~.r~c'~"~n~'~'~r'rr'l' bT -,TEM-' "-IS : E:, E P T H = ~_-;. L E I'-,I ~-]i T H = .~_; 2.-~ Iii R R "...' F L E:, E F' -r" 14 2 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRF~INF:IELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTF~NCE BETWEEN THE SURFRCE OF THE GROUND FiND THE BOTTOM OF THE EXC8VRTION (IN FEET). "I-HE TF-."E"NC:H L..I T E:,31-H I S 5. #~J0~4 FEE-IF. THE GF.'.RVEL r:,EPTH TS THE MINIMLIM [:,EPTH OF GRRVEL BETWEEN THE OUTFRLL PIPE RND THE BOTTOM OF THE EXCRVRTION ,::IN FEET::'. R EL~--.!bI ,'[ F-."EE:, S;EF"-r I C: TRI'-.II<; '_--; I ZE= :]Ll-]-~OEl .-RLLOI'-.~.=. PERMIT RPPLICRNT HRS THE RESF'ONSIBILIT'?' TO INFORM THIS DEPBRTMENT DJRING ]'HE INSTRLLRTION INSF"EC:TIONS OF BNV WELLS RDJRCENT TO THIS PROPERT'¢ RND THE NLIMBER. OF RES IDENC:ES THRT THE WELL WILL _,EF..¢E. -F ~,,I r.]i ,:'. ~'-:-' .':, I F.~ _. F"-':' ' EL-T-" I cIr-.l'--; RRE REQI_I IRE[) BRCKFILLING OF RN'¥' S'?'STEM WITHOI_IT FINBL INSPECTION RND RPF'ROVRL B~r' THIS [:,EPBRTF1ENT WILL BE _,UB..rECT TeD F'ROSECUTION. MINIMUM DISTRNC:E BETWEEN FI [dELL RND RNY ON-SITE SEWRGE DISPOSRL SYSTEM IS t00 FEE'r FOR Ft PRIVRTE WELL OR t50 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTRNCE FROM B F'RIVRTE WELL TO R PRIVRTE SEWER LINE IS 25 FEET BND TO R COMMUNIT'¢ SEWER LINE IS 75 FEET. HELL LOGS RRE REQUIRED RND MUST BE RETURNED TO THE DEPFIRTMENT WITHIN 7~0 DR'CS OF THE WELL COMPLETION. OTHER REQUIREMENTS I'1R'¢ BPPLM. SPECIFICRTIONS RND CONSTRUCTION DIRGRRMS RRE R'¥'RILRBLE TO INSURE PROPER INSTBLLRTION. PE~:I',I I T E::<-,F" :r RE_.9_'; L':,ECEME:EF~: _:--t., - -:~ I CERTIF9 THRT 1: I RM FBP'IILI~R WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET FORTH BY THE MUNICIPRLIT~¢ OF RNCHORBGE. 2: I WILL INSTRLL THE Sb'STEM IN RCCORDRNCE WITH THE CODES. ~: I UNDERSTBND THBT THE ON-SITE SEWER S9STEM MR9 REQUIRE ENLBRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THBN ~ BEDROOMS. =,I LJNE[: _¢¢.-Z..~ L ...... · RF'F'L I CFINT V4. 0 · d~"~so ILS LOG MUNICIF ~' OF ANCHORAGE MUNICIPALITY OF ANCHORAGE r'?T C~ ::r';.: ~ ~ DEPARTMENT OF HEALTH AND ENVIRONMENT~AI~I~I~'(~'T~CL~ION© F ;El I PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720/~ .JU''~ ~.") ~190~2c r~ SOILS LOG - PERCOLATION TEST 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17, 18- 1g- 2O ¢? SLOPE SITE PLAN / l I WAS GROUND WATER ENCOUNTERED? IF YES, ATWHAT DEPTH? Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE TEST RUN BETWEEN (minutes/inch) FT AND · FT PERFORMED 8Y:~~~~/~~ CERTIFIED DATE: 72-008 (6/79) 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. 050-792-35 1. GENERAL INFORMATION Complete legal description COSA # O"DC \ \\ ~0i ~ Expiration Date: Riverview Estates Block 8 Lot 5 Location (site address) 21439 Falling Water Circle, Eagle River, AK 99577 Current Property owner(s) Robicheau, Michael Mailing address same Day phone 223-3108 Lending agency Day phone Mailing address Real Estate Agent Jan Deerin,q Mailing Address RE/MAX, Eagle River Unless: otherwise requested, COSA will be held by DSD for pickup. NuMBER:OF BEDROOMS: 4 Day phone 240-4258 TYPE OF WATER SUPPLY: IndividUal Well Individual Water Storage Community Class __ Public Water System Well TYPE OF WASTEWATER DISPOSAL: [] Individual On-site [] [] Individual Holding Tank [] [] Community On-site [] [] Public Sewer [] 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 NorthRim Engineering Phone 694-7028 Address PO Box 770724, Eagle River Engineer's Printed Name Steve Eng Date 10/17/2011 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. 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 inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and~~ems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and se tic s stem --'~-~ DSD SIGNATURE ~/ Approved for ~ bedrooms. '~2~% Cond~bonal approval for bedrooms, w~th the following sbpulatioffsT ON-SITE ,,%... ..- By: (Rev. 11/05) Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: //0-~- /-// Municipality of Anchorage Oeveloprnent 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 Block 8 Lot 5 A. WELL DATA - Public Water Well type P If A, B, or C provide PWSID # Well Log (Y/N)~ Date completed 5/2//03 Sanitary seal (Y/N) Y__ Total depth 400 ff. Cased to 80 ff. ~: '~' *FROM WELL LOG 5/z//o3 57 ft. 0.83 g.p.m. Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform lass colonieS/100mL Nitrate 1.10 .mg/L Arsenic: 0.6?0 u~t mg/I Date of sample: 9/28/11 B, SEPTIC/HOLDING TANK DATA Parcel ID: 050-?92-35 Wires properly protected (Y/N) Casing height (above ground) 30 in. AT INSPECTION 9/711 t 81.4 ft. 0.8 g.p.m. Collected by: NRim ling Tank Type/Material Sept'iq'Steel Date installed 5/18/03 Tank size 1250 gal. Number of Compartmer~ts _2 Cleanouts (Y/N) ___ Foundation cleanout (Y/N) Y Depression over tank (Y/N) N__ High water alarm (Y/N) N Date of pumPing ~...~._~/l~'~mper ~/"~., {~ ABSORPTION FIELD DATA Date installed 5/1_8/03 Soil rating Length 2@60 ff. Width --5 ff. Eft. absorption, area 750 ,ft2 (g.p.d./ft2 or ff2/bdrm) 0.8 System type Trenches Gravel below pipe 1.5 ft. Total depth 5.5 & 4 ft. Date of adequacy test 9/7/11 ,. Fluid depth in absorption field before test, Elapsed Time: 30 min. Final fluid depth Results (Pass/Fail) Pass For ~__ bedrooms 0 in. Water added 600 gal. New depth 0 in. 0 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.)(YIN & type) N__lf yes, give date.--- Monitoring tube Y Depression over field __N D. LIFT STATION Date installed na "Pump on" level at na in. Datum na E. SEPARATION DISTANCES Size in gallons na "Pump off" level at na in. Cycles tested na Manhole/Access (Y/N) n_~a High water alarm level at na in. Meets alarm & circuit requirements? na SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 1.00+ Absorption field on lot 1.00+ Public sewer main NA Sewer/septic service tine 25+ Animal containment areas 1-00'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Water main NA Wells on adjacent lots 1-00'+ Property line 1-0'+ Water service line On adjacent lots 1_00+ On adjacent lots 1-00+ Public sewer manhole/cleanout NA Holding t~nk aa Manure/animal ~xcrete storage areas Absorption field 5'+ Surface water 1-00'+ 1-0'+ Water main NA Driveway, parking/vehicle storage Property line 3'+ Water Service line Curtain drain ~a F. COMMENTS 3' Property Line Waiver SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation 1.0'+ 25'+ Surface water 1_00'+ Wells on adjacent lots 100'+ 10'+ G. ENGINEER'S CERTIFICATION I ce~ that I have ~ined through field ins~ctions and review of Mun~al ~s that the a~ve systems are'in conformance with MOA ~COSA guid~es in effect on this date. Engineers Printed Name Steve Eng , COSA Fee $490.00 Date of Payment Receipt Number (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number ANALYTICA GROUP NorthRim Eng Attn: Steve Eng 17237 Bear Paw Circle Eagle River, AK 99577 907-694-7028 Fax: 907-694-7026 Client SampleID: E.R2Iq3~ Sampling Location: E.R21 t.4 Client Project: EP~ Sample Matrix: Drinking Water COC #: PWS#: Residual Chlorine: Comments: SP-Analytica, Inc.-Anchorage 4307 Arctic Blvd. Anchorage, AK 99503 Phone: 907-258-2155 Fax: 907-258-6634 Report Date: 10/13/2011 Receipt Date: 9/29/2011 Sample Date: 9/28/2011 Sample Time: 4:00:00PM Collected By: Unknown Flag Definitions: MRL = Method Reporting Limit MCL = Maximum Contaminant Limit B = Present also in Method Blank H = Exceeds Regulatory Limit M = Matrix Interference J = Estimated Value D = Lost to Dilution ** = RL higher than MCL; target not detected TNC = Too Numerous to Count - result rejected CF = Confluent Growth - result rejected TCNG = Turbid Culture No Growth - rejected Lab#: A1110013-0IA Analysis Method Prep Prep Analysis Parameter Result Units Flags MRL MCL Method Date Date Analyst 4500-NO3E (Aqueous) - Nitrate+Nitrite pres Test was conducted by: Analytica - Anchorage Nitrate-Nitrite as Nitrogen 1.10 mgFL 0.50 10 10/10/201110/10/201 IMC Lab#: A1110013-0lB Analysis Method Prep Prep Analysis Parameter Result Units Flags MRL MCL Method Date Date Analyst 9223B-PA (Aqueous) - Coliforms in DW E. Coli Pass PASS/FAIL 1.0 Total Coliform Pass PASS/FAIL 1.0 Lab#: All 10013-01C Test was conducted by: Analytica - Anchorage 1 9/29/2011 9/29/2011 KM 1 9/29/2011 9/29/2011 KM Analysis Method Prep Prep Analysis Parameter Result Units Flags MRL MCL Method Date Date Analyst 200.8/200.8 (Aqueous) - Family Well Water I Arsenic 0.670 ug/L 0.15 Test was conducted by: Analytica - Thornton 10 200.8 10/10/201110/10/201RM Page 3 of 3 Mnnicipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmor¢ Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Water Well Advisory Certificate of On-Site Systems Approval (COSA) # oscl 11396 During a recent COSA on-site inspection and test of the potable water supply well on Block 8, Lot 5 of Riverview Estates subdivision, the well's productivity was determined to be 0.8 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 4-bedroom residence is 0.41 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. 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.orglonsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. t") oc"O-, 7 ~ 2 - 3 .~'"" 1. GENERAL INFORMATION ', Co'replete legal description, Location (site address) Current Propedy owner(s) Mailing address Lending agency COSA# 0 '2 Expiration Date: Day phone Day phone Mailing address Real Estate Agent Mailing Address Day phone ,~-,~ I-- ~.o.,~._ Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: dr 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site ~ Individual Holding Tank [] Community On-site [] Public Sewer [] 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 ere 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 emissions 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 flies 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 Eagle River Engineering Services Phone ~'~ 1042.1 Vr%V Rd., Suite Address Eaqle River. AK .~577 Engineer's Printed Name L~riS-{c,~Bt( ~- ~',J00d Date 5. DSD SIGNATURE ~ Approved for /-7/- bedrooms. Disapproved. Conditional approval for . bedrooms, with the following sbp~ns By: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other ~ ~/~Original Certificate Date: Municipality of Anchorage Development Services Department Building Safely Division On-Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.erg/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legel Description: }~'V.t~t Vi.~iA) ~ ~t~'~l..CJ-- I..5 l¢ ~' Parcel IO:_~...~._~' 3.7~'~ WELL DATA Well type'~ri va Date completed ~/ Total depth 0~0(3 ft. Date of test Static water level Well production IfA, B, or C provide PWSID # Sanitary seal {~1) Cased to ~'0 ft. FROM WELL LOG 61 ft. 0 .~'~ g.p.m. Well Log ~'/N) Wires properly protected (~1) v Casing height (above ground) ~O in. AT INSPECTION ~1 ft. g.p.m. Bo WATER SAMPLE RESULTS: Coliform .,¢¢ colonies/100 mL Arsenic: ^]~) mg/I SEPTIC/HOLDING TANK DATA Nitrate /' ~'! mg/L Date of sample: Other bacteria /~Y colonies/100 mL Co,,ected Tank Typ~M~teriel Tank size 1; EDuCation ~nout Date of ~mpi~ C. ~SOR~ION FIELD DATA " Date I~tall~ Date installed Cleanouts {~) High water alarm Length fcc/~,f2 ff. ' Width E,/,3 ff. Gravel below pipe 1,5 ft. ToteldepthC'y? ft. Eff. absorptionarea-150 ft2 Monitoring tube ~[.-._ Depression 0ver field I~0 Date of adequacy test -/ !1.3. ,/ 0"'1 Results~ail) ~ For ~L- bedrooms Fluid depth in abserption field befoce test C/g, in. Water added_[~.Cgal. New depth ~/11 in. Elapsed Time: ID min. Final fluid depth'C/0 in. Absorption rate >= L~oo g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/I~I'"& type) . .¢~xr,~ ~u,~n If yes, give date ,,~/~- System type'T'¢~ ~'~a£&~J D. LIFT STATION Date installed Size in gallons ,., Manhole/Access (Y/NJ _-----------' off level~l at in. 'Pump on' level at in. 'Pump __ ~/~ ~ ~ Meets alarm & circuit requirements? SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tanldlift station on lot -t I oO ~ Absorption field on lot Public sewer main Sewer/septic service line Animal containment areas On adjacent lots i' t 0 0 ' On adjacent lots --I- I O0 ~ Public sewer manhole/cleanout .~ Ioo ' Holding tank ~ -1~ ~ Manure/animal excrele storage areas -I- lOC) ' SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation Water main t Wells on adjacenl lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Water service line Property line '-A -~ ~ Building foundation Water Service line ~- I ~,~ Surface water '~ I Curtain drain 4 ~o ' Wells on adjacent lots F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through t'~eid 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 Date COSA c150 Date of Payment O[/~ ~/0'7 Receipt Number / ~){~'9 '?~ (Rev. 11105) Absorption field Surface water Water main t I(~ ' Driveway. parking/vehicle storage qfC' ~ Waiver Fee $ Date of Payment Receipt Number SGS Ref.# Client Name Project Name/# Client Sample ID 1074439001 Eagle River Engineering River View Estates Lot 5 Blk 8 River View Estates Lot 5 Blk 8 Drinking Water All Datt'~l'lmes are Alaska Standard Time Printed Datefl'lme 09/11/2007 16:01 Coil.ted Date/Time 08/29/2007 12:10 Received Date/Time 08/'29/2007 12:38 Technical Director Stephen C. Ede PWSID 0 Semitic Remarks: Allowable Prep Analys~ P~'amet~ Results PQL Units ht~hod Container ID Limits D~le Date Init ~let~ls ~ ICP/MS Arsenic ND $.00 ug/L EP200.8 C (<10) 09/05/07 09/10/07 TK Waters Department Total Nitrate/Ni~te-N 1.51 0.100 mg/L SM204500NO3-F B (<10) 09/05/07 JDS Htcrobiolo!r~ Laboratory Total Coliform ¢ol/lOOmL SM20 9222B A ¢<1) 08/29/07 SDP 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.ci.anchorage.ak.us (907) 343-7904 Water Well Advisory. Health Authority Approval # 070382 During a recent Health Authority Approval on-site inspection and test of the potable water supply well on Block 8, I~t 5 of Riverview Estates subdivision, the well's productivity was determined to be 0.7 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 4-bedroom residence is 0.4 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 ofthe subject Health Authority Approval. Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw St. www.cl.anchorage.ak.us CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 050-792-35 1. GENERAL INFORMATION Complete legal description R~rr_~v~.w Location (site address or directions) Expiration Date: ESTATES SUBDMSION; LOT 5, BLOCK 8 21439 FALUNG WATER CIRCLE * EAGLE RIVER, AK 99577 Current Property owner(s) Mailing address Lending agency GARY COCKRELL Dayphone 440-5205 21439 FALUNO WATER CIRCLE * EACLE RIVER, AK 99577 Day phone ' Mailing address Real Estate Agent Day phone Mailing address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well Itl Individual Water Storage Community Class Well E] Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site Il.I_I Individual Holding tank Community On-site B Public Sewer The Municipality of Anchorage Development Sen/ices Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given In paragraph 4 by an Independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties sen/ed by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority 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 samples. (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 vedfy that my · investigation, based on procedures outlined in the Health Authority Approval Guidelines forthis application, shows that the on-site water supply and/or wastowater disposal system is(am) safe, functional and adequate for tho 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(am) in compliance with all applicable Municipal and State codes, ordinances, and rogulations in effect at tho time of installation. Name of Firm CARNESS ENGINEERINO CROUP, Ltd. Address ,3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. CARNESS, P.E. Phone 337-6179 Date Engineer's Comments: In conducting this evaluation, GEG, Ltd. attempted to provide a thorough, c~scientious engineering analysis of the system in accordance with ADEC end MOA DSD Guidelines & Regulations. The reported results described 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 soils condition, groundwater levels that may Euctuate during the year, end the water usage of the family being sen/ed by the system. These conditions are outside the control of the evaluator of the system. Satisfacteq, test results do not guarantee future performance of the system, nor do they guarantee that there ara no hidden defects or encroachments. GEG, Ltd. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or 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 pan), is not authortzed, nor will it confer any legal #ght whatsoever. 5. DSD SIGNATURE I'"/ Approved for bedrooms. Disapproved. Conditional approval for __ bedrooms, with the fllowing stipulations: k.',' ~" ,,,,,"'C.' ~'~ Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Manitenance Agreements Supplemental Engineer's Reort Other (ReY. 12J01) Original Certificate Date: ~' ' ~ 3 "0/74 Municipality of Anchorage Development Services Department Building Safety DNbkm On-Site Water & Wastewatar Program 4100 South Bmgaw St. P.O. Box 196650 Andtmage, AK 99519-6650 www,cLancflorage~k.u~ (;07) Legal Description: W~II DATA Well type pt~xT[ HEALTH AUTHORITY APPROVAL CHECKLIST RIVERV1EW ESTATES SUBDMSIONi LOT 5~ BLOCK 8 Parcel ID: 050-792-35 If A, B, or C provide PWSID~ N/A Date completed 5/21/2003 Sanitary seal (Y/N) YES Totaldep~ 400 ff. Casedto 80 ff. FROM WELL LOG Date of ~., ~/2'~/2oo3 Static water level 57 fl. Well production 0.85 .g.p.m. WATER SAMPLE RESULTS: Wetl Log (Y/N) YES V~res property protected (Y/N) YES Casing height (above ground) 24 ATINSPECTION Coliform ~) c~lonies/100 nd. Arsani~ N/A mgJl.. B. SEPTIC/HOLDING TANK DATA Nltmte .~._~mgJL., Other bacteria O colonies/100 nd. Date of sample: 8/6/2004 Coltectad by: GEG~ Ltd. Tank Type/Mateifal Tank size 1250 gal. Foundation deanout (Y/N) YES Date of pumping NEW C. ABSORPTION FIELD DATA SE~C/S~.L Number of Compartments 2 Depression over tank (Y/N) NO Pumper Datelnstalled 5/18/2003 Sollratino(~rftaredrm) 0.8 Length 2 O 60 (120 TOTAL)E. Width 5 .ft. Dateinstefied 5/17/2003 ~eanouts(Y/N) YES H~hwateratarm(Y/N) N/A System type 5-WIDE TRENCH Gravel below pipe 1,5 ft. Total depth 5.88/4.6 ft. Eft, absorption ama 750 fl2 Monitoring tube YES Depression over field NO Date of adequacy test NEW SYSTEM Results (Pass/Fail) - For 4 bedrooms Fluid depth in absmption field before test in. Water ed~ atment (past 12 mo.) (Y/N & type) If yes. give date D. UFT STATION Date instal]ed Size in gallons 'Pump on" level at in. 'Pump off' . High water alarm level st in. ~ Cycles tested Meets alarm & circuit requirements?. E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lilt station on lot100'+ Absorption field on lot 100'+ Public sewer main N/A Sewer/septic service line 25'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cteanout Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line Water main N/A Water service line 10'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line *3' Building foundation 10'+ Water service line 10'+ . SuK'ace water 100'+ NONE KNOWN Wells on adjacent lots *WANER GRANTED Curtain drain COMMENTS G, ENGINEER'S CERTIFICATION I cen~/that I have determined through field inspectfons and review of Municipal mcerds that the above systems ere in conformance with MOA HAA guidelines in effect on this date. Absorption field 5'+ Surface water, 100'+ Water main N//A Driveway, parkinghmhicie storage 10'+ Engineer's Printed Name JEFFREY A, GARNESS HAA Fee $ Date of Payment Receipt Number (Rev. 12/01 Waiver Fee $ Date of Payment Receipt Number ASBUILT SEWARD & ASSOCIATES LAND SURVEYING I HEREBY CERTIFY .THAT I HAVE SURVEYED THE SCALE> /~/~ '~ n'"///',."a z- '~ ..r "~-,~ ~T~ ~ ~ INDICA~. IT IS THE RES~SIBILI~ OF THE ~ ~ D~ERMINE T~ ~ISTEN~ OF ANY GRID: WHI~ ~ NOT ~EAR ~ THE RE~ ~DI- VISION P~T. UND~ NO CIRCUMSTANCES S~ F~ ~Y DATA H~N BE US~ FOR CONS~U~ION ARY LINES. ~