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HomeMy WebLinkAboutRIVER VIEW ESTATES BLK 8 LT 5River'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. ~