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HomeMy WebLinkAboutRIVER VIEW ESTATES BLK 8 LT 11 Municipality of Anchorage · Development Services Department ..-__'--~--'-. -==-:~"'o t Building Safety Division {'~ ~, 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: SW030119 PID Number:. 050--792--42 H°me:MIKE MCGOUGH Wastewater System: · New [] Upgrade Address: 300 HIGHLAND DRIVE * EAGLE RIVER, AK 99577 ABSORPTION FIELD No, of Bedrooms: Ph°ne:(907) 244--0550 4 i-1 Deep Trench · Shallow Trench E3 Bed nMound 1'lather Soil Rating: Total Depth from original grads: LEGAL DESCRIPTION 1.2 oPD/s~.rc 7.0 (MAX) Block: Lot: Subdivision: Depth to pipe bottom fram arlglnol grade: Gravel depth beneath pipe: 8 11 RIVER VIEW ESTATES 4.25 (MAX) n. 2.77 Township: Range: Section: Fei added above odglnal grade: Grovel ~ength: - - - SEE DWG rt. 65 Grovel width: Number of Bnea: IOietoncs between lines: WELL: · New [] Upgrade 5 Ft. ' 1I -- Ck3e~lr~caflon (Private, A,B,C): Total Depth: Cooed To: Total absorption area: Pipe moterfl31: PRIVATE 200 rL 46 r~ 533 so.r~ D 5034/ F-810 Driller. Date Drilled: Static Water Level: Inetallen I~te Installed: CMM GENERAL 9/4/2005 SULLIVAN WATER WELLS 6/9/05 23 Yield: Pump Set At: Ic~sing Height Above Ground: 1.1 GP. UNKNOWN .., 2 ~ TANK SEPARATION DISTANCES =SepUc El Holding EiS.T.E.P. ElOther T_~_ To Septic Absorption Uft Holding Publ~c/Prlvate Manufacturer: C~paclty In gallons: Tank Reid Station Tank Sewer Unea PREMIER PLASTIC 1300 From-"--.., Mated<il: Number af compartmnent~: Well 100'+ 100'+ - - 25'+ PLASTIC 2 Su,face Water ~00'+ ~00'+ - - - LIFT STATION Lot Une 5'+ 10'+ -- -- -- Size in gall°ns:I FoundaUon 5'+ 10'+ _ _ _ .Pump an. level at: ~. at: iHigh later alarm at: Pump Make~l: JDeaUScal In~pecUon~ ~o,~,~ by:. Curtaln Drain - NONE KNOW~ I I Remarks: BENCH MARK Location and Deeadpflon: TOP OF GARAGE SLAB JAaeumed rdev~'don: 1 02.59 FL ENGINEER~F.~L \ Inspections performed by: AKWWC, INC, Dates: 1st 9/4/2003 ~,/~.?.~...{~...4.c, ._1.~{..~....1":'...'?*: Development Services Department Approval . I~. '., ;' ' ..' ~ Date: zl.J_/.j!,l/¢ ql~r.,.,, . ". I ........ ",~ ~.~.~,~,=, R(~viewed and approved by: ~t~ S~ FCO -- /~~, BEDROOM . .:-' .:.j:..:-:*- ,. -j f'. -~ -). :--:- .:.-..-. .... , ........... . .... / // ~2 73.29 91.38 // ' N ~N MT2 147.42 163.99 ~SI~ 55~TER & ~STE~TER ""<~ .............. - ........... CONSULTANTS, INC. · ................ SCLE: 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 09507 ' PHONE (q07)337-617~ · F~ (O07)338-5ZAO 1"=40' PR~ FOR: PHONE NUMBER: PAGE NUMBS: RIVER VIEW ESTATES SUBDIVISION; LOT 11 .......... BLOCK 8 ~.'"f. '~'"'- AS-BUILT DRAWING OF NEW SEPTIC SYSTEM 2' INSU~ON~ / 98.,, (A~) TOP Or T~K AT ~ ~1 / ~2 ..... T~K AT AT IN~= 94.10 I~ OF BUNG AT O~ ~ 93.80 ~ CO ~ R~ O~E - ~ ~ / 98.01 - 98.42 ' I~ OF PIPE t~~ - ~ (~vo) t -I - ~o.~7 (A~) R~ E~A~ON 8~.o7 ~ Ho~ D~- " ....... " ~2/5/2oo~ D~WN ~: 5701 E. TUDOR ROAD. SUITE 101 * ANCHORAGE. AK 09507 ' PHONE (qOT)557-blTg * FAX (q07)538-3~6 1" = 40' MIKE MCGOUGH (907) 244-0550 3 OF 3 vO~'~.. CE.-7~ ..".,~ ~G~ D~CRI~ON: .~VE. V~EW ESTATES SU~D~V~S~O.; LOT 11 ~LOCK ~ PROFILE AS-BUILT DRAWING OF NEW SEPTIC SYSTEM 02?02/2004 08:29 9076942141 HC@ CONTRACTING PAGE 02 by DOC CO. ,~ea SULLIVAN WATER WELLS p.o. BOX 670272, CHUGIAK, ALASKA 99567 · TELEPHONE 688-2750 ,'.WHIR OF LAND: ar')f3RFSS: nATF: .. OF. NT RaATIO NUUnEn: P; well located at approved permit Iocation'~ ~ .1 No M~'~thod of Drifting: .~i~'~r rotary -1 cable tool .%npth of well: r~ "=~ing Type ~Wall Thickness ,~ ~'0 inches :'~,ameter inches, depm '~ ' [eet I Inet Type: ~ ~ ~ ~$ing Stickup Above Ground;- C~- feet .~tatic Water Level: '~ ~' feet Recover Rate: ~ , ~ gpm Method of Testing: Well Intake Opening Type: ~-1 open end ~5'~en hole ..J Screened; Start feet Stopped feet .J Perforations Start , feff. t Stopped feet ~rout Type: ~_~.7~."'r'~' volume /')~/-.~-,~ I",e. pth: from ~_O _ leer, to ~'~ ~' .. feet Well Disinfected Upon Completion? ~s J No Method of Disinfection: BORE HOLE DATA DEPTH I'n)m 'Jo .! Comments: Driller's Name ATTFNTION: It is the responsibility of the properly 'owner to submil a copy of the well log to Ihe proper authority. Municipality n{ Anchorage: Department of Health & Human Services and/or Department of Environmental Con-4ervation. MalSu Borough: Department of Environmental Conservation. MUNICIPALITY OF ANCHORAGE Development Services Department 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 08, 2003 Expiration Date: May 07, 2004 Permit Number: SW0301'19 Legal Description: ~I~[~-E'R'~IEW ESTATES'BLK ' 8 LT 11 Design Engineer: 0041 AK Water & Wastewater Consultan' Owner Name: MIKE McGOUGH Owner Address: NHN WHITE WATER CIRCLE EAGLE RIVER, AK 99577-0000 Parcel ID: 050-792-42 Site Address: Lot Size: 40020 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: [] Disposal Field I-~ Septic Tank Holding Tank E~ Privy [~] Private Well r-I 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 during 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: ~'-)~:4/ i{~- Municipality of Anchorage Development Services Department Building Safety Division 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 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 050-792-42 Permit Number Property owner(s) MIKE McGOUGH Mailing address (1) 300 HILAND DRIVE * Mailing address (2) Legal description (Lot, Block & Sub'd.) LOT Legal description (Section, Township & Range) Lot Size 4 O/O Z O Acre,S) THIS APPLICATION IS FOR: Sewer Only D Sewer and Well · Sewer Upgrade [--] THIS PROPERTY CONTAINS: Hot Tub [~ Swimming Pool [-'] Therapy Pool D EAGLE RIVER. AK 11. BLOCK 8: Day phone 244-0350 Zip Code 99577 RIVER ~EW ESTATES SUBDWISION Number of Bedrooms Well Only Water Storage Jacuzzi D Water Softening Unit D 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 CONSULTANTSr INC. Waiver Fees; Date of Payment: Receipt Number: ALASI WATER & WASTEWATER ~,.~ ~.,,~__..~d,,~- ...... CONSULTANTS. INC. May 2, 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 Septic System for Lot 11, Block 8; River View Estates Subdivision To whom it may concern: The proposed ~4 bedroom house will be is served by a private well and septic system. Two test holes were excavated on the property in the area of the proposed drainfield. We are proposing that a new 1250 gallon septic tank and a 5-wide drainfield be installed. Comments regarding the 'design are summarized as follows: l. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and the percolation test results. The insitu sandy soils will act as a sand filter. 2. TRENCH DESIGN: a. Percolation Rate: <1 minutes/inch b. Proposed Application Rate: 1.0 gallons/day/ft2 c. Number of Bedrooms: 4 d. Design Flow: 600 gallons per day e. Minimum Absorption Area: 600 fi2 f. Total Depth: 7 feet (max.) g. Effective Depth: 4 h. Width: 5 feet i. Reduction Factor: 0.5 j. Minimum Length: 60 feet long k Effective absorption area = 600 fi2 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system. 4. TOPOGRAPHY: The area for the proposed drainfields is a 15-20 percent slope running approximately southwest to northeast; in short, there are no slope concerns. We are unaware of any adverse impacts this installation would have on adjacent wells or septic 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com systems. assistance. Sincerely1 Presi [e~l If you have any questions, please contact us at 337-6179. , P.E., M.S. Thank you for your NOTE: A site plan drawing, a design drawing, two soils logs, and a 7 page constntction 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 RNERV1EW ESTATES S/D; RNERVIL:'W ESTATES S/D; RIVER~EW ESTATES S/D; RIVERVlEW ESTATES S/D; LOT 10, BLOCK 10 LOT 11, BLOCK 10 LOT 12, BLOCK 10 LOT 13, BLOCK 10 RIVER PARK DRIVE ,' /-- --h" I ~ ~=.~ .... I RIVERV1EW ESTATES S/D; RIVERVIEW ESTATES S/D; I ~ I LOT 12, BLOCK 8 LOT 1~, BLOCK 8 Il I ' I ~ x/'~ \, I I I [.~/ ',.~. '~l~& L.,'~''" LOT 14. BLOCK B ' ~ \ V \ k '~."-,, ~_ // (s~ .~S~ON PAGE 2 or 2) '--~_~c. .'~_~.. ~-~. ~,.. - / X I \ " ~' / -~i '~,'.-..~. ' -.... -... ,' x _o~P X -----~ RNER~L'W ESTATES S/D;'~..~ ~'X.. '~? ,~ I N ~ ,~"~' ' / ~. ~ / .,'~:..~ _3) P'~. "%. ~- ~ /.-~---:~ / ,/~_~ ~,_,~;.,'., ,/ -. ~~ .~__~._ ~_.~ ~_/o: /, ........ -"' ,~ ~ ~ / \ L-..-' ~ I "~ "~'..'C'/,. ~'.._ I ./ RIVERVIE'W ESTATES S/D; / [-S._EI~TI_.C / -~%?,,.,. '"~, '"'"-~M.~ ,--.. ~'~,,.. i / ...-----...-' / '~-.._._-~_:=<: '-~_...;'._ ~"-~.. // / /' LOT ~Y-'3.-BLOCK 5~ '~,,_~./ .............. , . , ~ c.~.o. · ~~4o,__~/..,,~ '"~ '~ 6qOl DEBARR ROAD, SUITE 2B ANCHORAGE. AK OqSO/, PHO E ( )5 - ~l ~ I I I /] ' va PREPARED FOR PHONE NUMBER: PAGE NUMB.: ~.~,.[~...~'._._.~ ....~,~_ ...,.~ MIKE McGOUGH 244-0550 1 OF 1 '~, _ '.{leffr~yJ~. Go. ss: R~VERWEW ESTATES SU~D~WS~ON= LOT ~, ~OCK S ~fo~ "~."~.o~' SITE PLAN FOR PROPOSED WELL LOCATION AND SEPTIC SYSTEM I NOTE: THE CONTRACTOR SHALL HAVE I J THE PROPOSED 100 FOOT,WELL RADIUS J AND THE NORTH AND WEST LOT UNE J /~ FLAGGED BY A REGISTERED LAND  SURVEYOR PRIOR TO CONSTRUCTION. ~ ~PROPOSED DRNNFIELD. EXCAVATE A TRENCH '11[ /THAT IS 7 FEET DEEP MAXIMUM BY 5 FELT (,'j / w~E in' so ~ LON~..~D 4- ~ OF I ' /CLEAN WASHED SEWER DRNNROCK. INSTALL  -~R~CH PAR~LL~: TO SU3PE CO~OURS. ~ ~. J ...1~ ~ ~PROPOSED 1250 GALLON ~ _ ~ ~'%~..\ / _ .~,~r / ~ SEPTIC TANK I ~ FOUNDAllON \ CLEANOUT \ I -,m~:,,,,~,.,,~,-'~.~.~-~----~J.:~'~. '. DP, AWN "',': ~'~.~...l" ' "' "' !6'."~' ........ C.a.e~. , '": l-;R -~-~ CONSULTANTS, INC.- . '" , 1" -- 40' 6901 DEBARR ROAD. SUITE 28 ' ANCHORAGE. AK qqSO/, ' PHONE (q07)537-~179 FAX (q07)558-3Z~.6 I ~ PREPARED FOR, PHONE NUMBER: iPAGE NUMBER= R~V£R____...WEW ESTATES SUbDiViSiON= LOT ~, ~LOCK S, ~(o,"~.1:~.~_~ . __~'""[°£~ T~P~D~Sr~' OF PROPOSED WELL LOCATION AND SEPTIC SYSTEM ~SK~ WATER & WASTEWATER f~l.',.I ~.,1~ ..?..~.,..~, _ CONSULTANTS, INC. ' 6901 DEaARR RO,~, SUfl'[ 2B * ~ ~ ~ * ~N~ (~7~-6179 * F~ (~7)~2~ * ~ ~--~,,, ..... ISOIL LOG - PERCO~TION TESTI ..~;;. ~... PERFORMED FOR: MIKE McO0U~H DA~: 4/11/2003 E " }~[ ~ORGANICS ITEST HOLE ~1I '":"" ~ GP ML ,'.'~'.,~ GC OL ~ SM OH . P-SP sc GROUNDWATER F2~di' ~i DRY ~ 4/11/2003 ~2:d~' ~i 4/25/2003 [~ i~ ~ DRY 11 DATE READING CLOCK NET TINE WATER LEVELI NET DROP TIHE (HINUTES) READING (INCHES) 4/14/~oo3 ~ - - s" - ~2 GM/SM 2 - <1 o' 13 3 - - 6' - 4 - <1 O" 6" 14 5 - - 6' - 6 - <1 O" 6" 17- PERCOLATION RATE <1 (HIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 4.0 FT. AND 5.0 FT. 20 ~ A FOUR HOUR PRESOAK WAS PERFORHED: ~ YES '~ NO SOILS LOGGED BY: JODY ~US PERCOLATION TEST PERFORHED BY: C~B GALL COHHENTS: ~E INS~ ~NDY SOILS WILL ACT AS A SAND RL~R PERFORMED BY ~C, INC. I, JE~R~ A. GARNESS, CERTI~ THAT ~IS ~ERFORMED IN ACCORDANCE WEH ALL ~A~ AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: DEPTH TO DATE GROUNDWATER DRY 4/11/2003 DRY 4/25/2003 · i, O, 'ALASKA WATER & WASTEWATER ....... _ . . LEGAL DESCRIP~ON' R~ ~ ~A~S SUBD~SION: LOT 11, BroCK 8. PERFORMED FOR: MIKE McGOUGH DATE: 4/11/2~3 '~e~" .... , ......... "¢~ EPTH~ feet)~l .... ORGANICSLoAM [TEST HOLE ~2[ t~'i~'~ ~OIL C~IFICATIONS, 2 ~:, ~, GW ~ ORG [~Td;a ~ GP ~ HL ' 1~2X4' G M CL . -... ~. ~'., SP ~ CH s q~4~:: ~P-SP I~,;,;, SM OH 1~2~i, DEPTH TO '--.. 7 ~ ~, DATE ... -J~ilt~":~*' GROUNDWATER -~. ~.... 8~J;~:<" DRY 4/11/200~ ~ ~. ~. ' // DATE READING CLOCK NET TIHE WATER LEVEL NET DROP TIHE (HINUTES) READING (INCHES) 11--,~,. GM-SM ,4/11/2005 I - _ 6- - 13~ ~ - _ 6' - 4 - <1 O" 6' 14~~'u'' 5 - - 6' - 6 - <1 O' 6" 15 16 17 18 PERCOLATION RATE <1 (NIN./INCH) PERC. HOLE DIA. 6 (INCHES) 19 -. TEST RUN BETWEEN 5.0 FT. AND 6.0 FT. 2 A FOUR HOUR PRESOAK WAS PERFORNED: ~ YES ~ NO SOILS LOGGED BY: dODY MAUS PERCOLATION TEST PERFORHED BY: O~EB GALL CO~HENTS: ~E INS~U ~NDY SOILS WILL AOT ~ A ~ND ~LTER PERFORMED BY AK~O, INO. I, dEFFR~ ~ OARNESS, CERTI~ T~T THIS WA~ ~RFORMED IN ACCORDANCE WITH A~ ~ATE AND MUNICIPAL GUIDEUNES IN EF~CT ON THIS DATE: DEPTH TO DATE GROUNDWATER DRY 4/11/200~ DRY 4/25/2003 ~Permit ~: 820025 January 31, 1.983 TO: Permit ApplJ.cant Subject: Lot. 11 Block 8 River View Estates Subdivision A permit issued by this department for' an individual well and/or on--.site sewer system has expired as of December 31, 1982. Permiks are issued on a calendar year basis, as stated on the permit, hy authority of Municipal Ordinance. If you have drilled the well, a well log needs to be sent to 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 documentation° If there are any further questions, please call this office at 264~.4720. Sincerel~ Robert C~ Pratt, R.S. Acting Pregram Manager Sewer and Water Program RCP/ljw enc: Copy of Permit SWP/057 MUNICIPALITY OF ANCHORAGE Department Health and Environmental rotection 825 L Street, Anchorage, AK. 99501 ¢~ 264-4720 ~¢~'~ '~<~}& * ~ * HANDWRITTEN PERMIT -x. W~'L~I~D~6d~- ON-S I TE SEWER PERM I T Type of Soil ~sorption System Trench: ~ Drainfield: Seepage Bed: Holding Tank: Maximum Number of Bedrooms: ~ ~' Soil Rating(sq.ft/br)~ The R~quired Szze of the Soil Absorpuion ~ys~s: DEPTH_ ~ ]Z' LENGTH ~-~ GRAVEL DEPTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance be%ween 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 = ~-00 GALLONS Permit applicant has the responsibility to inform 'this department during the installation inspections ef any wells adjacent to this p~operty 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 subjecb to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. 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~ 1 9 82 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. '-~tem~ (3) I understand that the on-site sewer system may require enlarg if the res idence~is remodeled to include raore tp3 ~roo~,~?/ Signe~: :- /6.>-./~:, '~¢ L~/4.~-,., Issued by: Date: [] SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST [] PERCOLATION TEST SLOPE 10 11 12 13 WAS GROUND WATER g/_. S ENCOUNTERED? /~¢',~.~, ~ P E IF YES, AT WHAT DEPTH? DATE PERFORMED: ¢~ff/'~'"~¢~ / ~.~rgs. 'T~ /' SITE PLaN 14 15 16 17 18 19- 20- Gross Net Depth to Net Reading Date Time Time Water Drop ,~ OF' ...... ,..m~d. .T: j, PERCOLATION RATE (minut~ ~ TEST RUN BETWEEN FT AND FT / DATE: 72-008 (6/79) J G ` • Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval Parcel I.D. 050-79242 Expiration Date: _ ® -31 — 2 C20 1. GENERAL INFORMATION: Complete legal description RIVER VIEW ESTATES: BLOCK 8, LOT 11 Location (site address) 21323 WHITE WATER CIRCLE, EAGLE RIVER, AK 99577 Current Property owner(s) CHARLES LEE Day phone 223-7321 Mailing address 21323 WHITE WATER CIRCLE, EAGLE RIVER AK 99577 Real Estate Agent MELINDA PEDERSON W/ CENTURY 21 Day phone 338-2868 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community El Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ tl 12. SU Covio Waiver Fee $ Date of Payment 7 15 U Date -of Payment Receipt Number 0 38 9ZC Receipt Number COSA # 0.6 W P5 Z9 Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm: Gamess Engineerinq Group, Ltd (GEG) Phone: 907-337-6179 Address, 3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: / In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 6. DSD SIGNATURE System #1 Approved for __y__ bedrooms System #2 Approved for Disapproved Conditional approval for bedrooms bedrooms, with the foll �'�13\ 01 � I ' A! ....... ..... ... ...... ....... i... . ..... ..... (� A. sur • e s 19 - G ro r ess�o� c ' #AECC884 T Yt 0F(r������ri Is �Gy0 /rir ON-SITE �v LW'sti FORsAN m :�Rr)n—, _ - WASTEWATER z J' mvr It Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet_10-10-12.doc �� i '1 Legal Description: RIVER VIEW ESTATES; BLOCK 8, LOT 11 If more than 1 septic system on lot: COSA Checklist # 1 of 1 A. WELL DATA Al Well log is filed with Onsite (or attached) Date drilled 6/9/03 Total depth 200 ft Cased to 46 ft ❑ Sanitary seal is functioning correctly X Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 7/8/20 Static water level at beginning of test 31.3 .f{. Comments Parcel ID: 050-792-42 Structure served by this system I Well production at time of test 1 5 qpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes Al No FlColiform bacteria is Negative Nitrate mg/L 061 "Nitrate less than MRL (ND) . Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by GEG,LTD. Date of Sample 7/8120 B. TANK DATAT STATION Age of tank(s) <17 years ❑ Require tenance comple Tank type/material PLASTICReq of lift station rs Measured operating fluid level in septic tank * Lift station al FE -1 Standpipes/foundation cleanout per record drawing C ents: Date of pumping 7/8/20 *TANK PUMPED ON DAY OF TEST. PER PUMPER, TANK OPERATION AT NORMAL OPERATIONAL LEVELS. D. ABSORPTION FIELD DATA 5 -WIDE Which system tested (date installed) 9i4-8/03 Adequacy test date 7/8/20 ❑ ALL standpipes present per record drawing Results OPass For 4 bedrooms Total measured depth from grade 7.1 ft (max) Fluid depth prior to test *5.75 in Measured depth to pipe invert from grade 4.3 ft (min) Water added 780 gal ❑ N/A — pressurized field New depth `11.5 in ❑ Monitor tubes go to bottom of effective. If not, state 1161 depth into effective Ela sed time min p X Code -required soil cover over field Final fluid depth 4 in ❑ System presoaked Absorption rate 600+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) NONE date of test) Gallons introduced gallons If yes, enter date Comments/Deficiencies: *IN MT1 (EAST END) MEASUREMENT TO SLUDGE. MT2 (WEST END) REMAINED DRY THROUGH ENTIRE TEST. COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' 0 Yes Community Sewer Manhole/Cleanout > 100' ❑✓ Yes if No ft M Yes if No ft Neighboring Tank > 100' ❑✓ Yes if No ft Private Sewer/Septic Line > 25' 7 Yes if No ft Absorption Field on Lot > 100' 0 Yes if No ft Holding Tank > 100' ❑✓ Yes if No ft Neighboring Absorption Fields > 100' M✓ Yes if No ft Water Main > 10' Animal Containment > 50' ❑7 Yes if No ft ✓� Yes if No ft 0 Yes if No ft Water Service Line > 10' 7 Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway Community Sewer Main > 75' M Yes if No ft [D Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water > 100' f7l Yes if No ft Property Line > 5' [✓ Yes if No ft Wells on Adjacent Lots: 0 Absorption Field > 5' ❑✓ Yes if No ft Private Wells > 100' M✓ Yes if No ft Water Main > 10' 0 Yes if No ft Community Wells > 200' 0 Yes if No ft Water Service Line > 10' 7 Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ❑✓ Yes if No ft If absorption field is under driveway comment below Property Line > 10' M Yes if No ft Wells on Adjacent Lots: Water Main > 10' 0 Yes if No ft Private Wells > 100' 0✓ Yes if No ft Water Service Line > 10' 0✓ Yes if No ft Community Wells > 200' R Yes if No ft Surface Water > 100' F,71 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION o G I certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with p MOA COSA guidelines in effect on this date. ": qT* . *. QO ,J' f y barn ss: O� CE -79 Q;p COSA Checklist yellow sheet QQ a p n°Goy ro f ess10 #AECC884 10��0©Q Municipality of Anchorage Development Services Department Building Safety Division 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 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAHILY DWELLING Parcel I.D. 050-792-42 1. GENERAL INFORMATION Expiration Date:, "7 - /';~-. '" O L~ Complete legal description RIVER VIEW ESTATES SUBDIVISION; LOT 11, BLOCK 8r .Location (site addre.ss or directions) 21323 WHITE WATER CIRCLE * EAGLE RIVER, AK. 99567 Current Property owner(s) Mailing address Lending agency Mailing address Other Party Mailing address MIKE MCGOUGH · - Day phone. 244--0350 300 HI~'ILAND DRIVE * EAGLE RIVER, AK. 99577 Day phone Day phone Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 e TYPE ,OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well I Individual On-site I Individual Water Storage r-] Individual Holding tank D Community Class. Well [--] Community On-site D Public Water System D Public Sewer r"-I The Municipality of Anchorage Development Services Department (DSD) Issues Cedificates 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 Served 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 oFB Wells-~'r':~l~biic'~a~-(~F - · system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 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 Health Authority 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 fudher verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101' ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date Si Engineer's Comments: In conducting this evaluation, GEG, Ltd. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and 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 ~:eadily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate durtng the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they gu. aran!ee 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 party is not authorized, nor will it confer any legal right whatsoever.' 'DSD SIGNATURE bedrooms. Disapproved. Conditional approval for bedrooms, with the fllowing stipulations: ' . 4 --. Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Other (Rev. 12/01) .. O.r. igin..al .C_ ~.~ti~._c~.. t _e_ _-D a_ .t e. :_ . hL -/2' ozF . Municipality ,of Anchorage DevelOpment services Department ~ii' i' ~Building Safety Division ' : On-Site Water & Wastewater Program i .... ,: 4700 South Bragaw St. ' ;, ! ! P.O. Box 196650 Anchorage, AK 99519-6650 . : ~ www.ci.anchorage.ak.us ~ (907) 343-7904 [ ; . .::, . "' '[ HEALTH AUTHORITY APPROVAL CHECKLIST LegalDescriPtion:~[ ' RIVER VIEw ESTATES' S/D; iLOT 11~ BLOCK 8r ' :;,Parcel ID: 050-792-42 A. wELL]'DATA , ' . Well type PRIVATE If A, B,'0r C provide PWSID# .N/A . Well Log (Y/N) YES Date com[pleted 6/09/2003 ..Sanitary seal (Y/NI YES ~ Wires properly prote~ted (Y/N) YES Total d~i~th' 200 ft. Cased to 46 ft. ' Casing height (above ground) 24 in. :' "[ FROM WELL LOG '~ ' AT INSPECTION Date ~°fitest 6/09/2003 ' Static water level 23 ft. ~ . __ . Well production 1.1 g.p.m.~, ~ , .p.m. WATER, SAMPLE RESULTS: r ~ , !, Co'lif(~rm I 0 colonies/100 mi. Nitrate 0.10' mg/L ' ' · Other badteria 0 colonies/100 mi. Arsenic:~_. {'N/A mg.lL. :Date of sampi'e: 31 4 Collected by: GEG, LtD. B. SEPTIC/HOLDING TANK DATA : '; r.ypl.? ' '': il . TankT /Material PI_~ST1C Date installed ' ' · '9/08/2003 Tank size., 1300 gal. ' NumberofCompadm~nts!i 2 Cleanouts~' (Y/N) YES Foundation cleanout (Y/N) .YES ' Depression ovor tahk (Y/N); NO High water alarm (Y/N)' N/^ Date of p,umping NEW Pumper ~' -- C. ABSORP~TION FIELD DATA J'BELOW FINAL CRADEI ., - Date' inSt~Jlled ' 9//08//2003 Soil rating ~r fl~bcJrm) '1.2 Sy{t?m type TRENCH Left,th '~ .' 65 ft. Width !5 i . ft. - GroVel below pipe. 2.77 ft. Toial depth' .7.1-7.5 .ft. Eft. absorption area. 533 f~ Monitoring tube YEs~ [ Depression over field NO Date of adequacy test , NEW Results"'(Pa~s/Fail), - ' 'il :~. For 4 bedrooms Fluid depth in absorption field before test - in. iJ Water added ~ - ga.Il,, ii New depth - in. Elapsed Time: - min. Final fluid depth. -~ in~~ Absorpti0n,.rate >= - :~i ~'.j , ~. g.p.d. Any reju~,enation treatment (past 12 mo.) (Y/N & type) If yes, give date - LIFT STATION . Date installed · '"Pump on" level at ~,~ . ~ High .wats?la. th1 i.evel a~ ~ _.,_,, ' in. Da......tutu~ ' ,:Cycles te§ted~. '~- ~ ~ _ Meets alarm & cirCuit requiremehts?. sEPARATION DISTANCES ,- SEPARATION DISTANCES FROM WELL oN LOT TO: Septic tank/lift Station on 10t 1 oo'+ Absorp~ti0n field On 10t ~ 100'+' Public sewer maih N/A sewer/septk~ SeNice line ' 25'+ " .:~ on adjacent lots on adjacent lots 'Publi(~ sewer manhOle/Cleah0ut Holdir~g tank 100'+ 100'+ , N/A sEPARATION DIS~ANC~=~ FROM SE~j~:FIc/HOLDiNG TANK ON LOT TO: Building foundation 5,+ p~opeity line. 5'+ water main N~/A' Water serVice line .10,+ Wells on adjacent lotS 100'+ ~_. sEISARATION blSTANCE FROM ABSO'RjS:rI~N 'Fi~L'I~ ON LbT TO: Prbperty line 10'+ Water serVice line Absorption field Surface water 1 O0'+ Cudain drain NONE "Buiidii~ fouhdation .10'+ Watermain . N/A 10'+ Surfabe water lb°'+ Driveway, parking/vehicle storage KNOWN Wells bn adjacent lots 100'+ 10'+ F. cOMMENTS G. ENGINEER'S cERTiFICATI°N I certify tliat I have d&'terriiined through field inspections and review of Municipal records that the above systems are in ~ conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name JEFFREY ~A.. GARNESS Date z~.,/ ~"'/Oz~, " :E-7953 .,," ~~~ HAA'Fee $ H _"~b Date of Payment Receipt Nurr{ber (Rev. 12/01) Waiver Fee $ Date of Payment. Receii)t Number