HomeMy WebLinkAboutRIVERVIEW ESTATES BLK 9 LT 4Riverview Estates Block 9 Lot 4 #050-801-10 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 hftp://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP251051 Work Type: SepticTank Upgrade Tax Code Number: 05080110000 Site Legal Address: RIVERVIEW ESTATES BLK 9 LT 4 G:0358 Site Mailing Address: 21630 FALLING WATER CIR, Eagle River Owner: BRAUCHLE JOHN K & TRACY A Design Engineer: NORTH RIM ENGINEERING This permit is for the construction of: Effective Date: Expiration Date: r: i Delmi-tmcr,t Lot Size in Sq Ft Total Bedrooms: 3/14/2025 3/14/2026 62231 ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing 4 Received By: l S S %� ti�M �'`� Date: Issued By: Date: MUNICIPALITY OF ANCHORAGE ( Al Development Services Department \ Phone: 907-343-7904 On -Site Water & Wastewater Section ON -SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 05080110000 Property owner(s) BRAUCHLE JOHN Mailing address 21630 FALLING WATER CIR Site address 21630 FALLING WATER CIR Legal description RIVERVIEW ESTATES BLK 9 LT 4 Number of Bedrooms 4 Engineering Firm NorthRim Eng. Building Permit Number Day phone 360-1299 Not Applicable ❑■ APPLICATION IS FOR: APPLICATION IS AN: (® all that apply) Absorption Field ❑ Initial ❑ Septic Tank 0 Upgrade ID Holding Tank ❑ Renewal ❑ Privy ❑ Well ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: Permit/Rush Fees: 2 2 S Waiver Fees: Date of Payment: Z 5 Date of Payment: Permit No. O.S �2/��� Waiver No. Municipality of Anchorage Orrsite Water and Wastewater REVIEWED FOR CODE COMPLIANCE THI I� M ENGINEERING `� > SteveEng.com OSP251051, Curtis Toffisend,, 03/17/, RIVER VIEW EST BLK 9 LT 4 SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: The current septic tank has failed- the field still functions. Replace septic tank near same location, decommission old tank per UPC. This lot is over an acre and on a private well. Separation measurements to be made prior to construction. No adverse impacts are expected from tank replacement. Easements are depicted on the lot. The slope is as indicated in the area of the septic system. No conflicts to neighbor properties. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations. • New 1500 gallon MOA-Approved septic tank. Watertight couplings on inlet & outlet. • 5' minimum between the tank and trench. 5' to property lines & 10' to house. • 4' of cover or insulation is required for tank; an equivalent of 1" insulation for l' foot soil cover. Tank & solid pipe must be set on well compacted, stable soil. • No large rocks for tank bedding. Plastic/fiberglass tanks require special bedding per MOA- sand or pea gravel. • 4" diameter cleanouts with airtight caps are required l ' to 4' from foundation wall, prior to any 90 degree bend in 4 inch line, in 2na tank compartment, and two adjacent opposing cleanouts between the tank and the absorption field, not more than 10' from the tank positioned to provide cleanout access towards the tank and towards the absorption field. Manhole Riser required in 1 St tank compartment. • All cleanouts must extend to at least ground level. • In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron. • Insulation must be placed over any pipe installed under driveways or parking areas. • Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661, • Sewer Service Line is minimum 2% slope. • Septic Tank to be pumped every two years or when required. • Insulation board to be extruded direct burial polystyrene (Dow Styrofoam HI/equal) % %% _� \ 0f• '� 14► �c 11 I �4' 3/17/25 BIZ n � (b i M bd Sl D ID �i --j n m �rrl 7� D ID < 0 —I M jm 0 >70 m Gl D 70 � D m ti fn m D r � D O z i C u o Municipality of Anchorage On -site Water and Wastewater z 0 0 0 m 0 t-UK Iuut UunnruANU: i1, Curtis Townsend, 03i17/z p P W N zr- C);utnm 0 0 0 0 0 x 0 (/)� ° fD �+ 0 to c0 z�`° rn 0a 0 v <• CD i 0 0-CD 0 o 0 =- r0 -U 5 rn 5 -,.x ° 0 N ° o \3 0 00 0� 3 C m 0 . o coo En 0 C Sn 3 3 N En En o 0 0 o rn 0 a. 0 77 0 1 c 0 n 0 rr, V) E z z 0 m (A (p O o F+ O zoo < ZO co 0 m \1 ak q V 0 0(z TT� ''1 r1l� V 3 V V) D F-9 z H � n F_ 3> D z n F9 fTl iCJ z o __1 —9 I —I m O N I \ \ C F U C-) ` ) i O I�I —I I I"I -1 D 3 m o ;,D OD v 0N UI 4�1 W rU ~' tj - - - F9 ;;0 C n t:j D V) to m S ro �a ro () ro 0 C Ln r) rD" ro ro ro n ro 33X-33� p ro * rD `+ -0 ro sn z O 3 O 0-3 -3 X Z ro D n to r0 3 OLq3 ro - I n V) r0v)p<'M U1 � 3�403 O )7< Oro--3h nc+n. —.3T(O Dnootn n­ ro -ft°D v) 9 3 Q Q° 03 0 ° r- rroo 0 Ln -00ID n -'N-0 Zt)3� ° ro ro O 0 Q`o n 3 n(Ln D Ln -r, Q-0 0 V0 ntd pQ�n=6 F10 o_ _33-003 � � -) �--I Q �_ t d --j O(D p hi 3 C 0 F3 0 ro �N :0 rD Ln 3 n 3 u-n < -p -0 ro �111 rD 3 rD S �n ro p r �r0 `n Q r- c C+ � V) 6-n Q (D v (7 0 _0 rD ro Q IDro 3 -9 go O C7 p IDn D 3 w T-� o n c� o 3 �� 3 p 0 < p p p n (D r) ro -5 n Ci- ro ro r0 V): ^ D 3 � Q v Q \ l� 3 H 3 -0 to ro C p m 3 rD p F -i < rD Z m 3 ro X p n �,+ ro h n to S to p (D M 3 -q oQ C+ 900 rLn 3 O o ro to D r) v) 3 1­ O � U Dp 3p nip O -C C+ T p —I� p p p O n O< n 30 3 7� rD p r0 Q p ro Q r0 O O 0 0 to 3 Q (D ru ro p p 3 0 tlt td ro C+ ro r0 3 rD 0 C+ D (j to 0 p 3 3 c-F O Q° 3 � TI 3 ro rp 3 Q n 3' C C+ to Q p 0 C7 ro p 3 0 C+ pality of Anchorage Water and Wastewater FOR CODE COMPLIANCE il, Curtis Townsend, 03i17/, Municipality of Anchorage Page of 2 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: �g� 13 9 PID Number: Name: S 6) i Wastewater System: New ❑ Upgrade Address: m7 ABSORPTION FIELD Phone: / No. of Be r oms: ❑ Deep Trench Shallow Trench C Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: / Tot al/gepthfrom orig�nalgratle: GPD/So. Ft. Y' J �' J • `J Lot: Block: Subdivision: _ Depth to pipe bottom from original grade: Gravel depth beneath pipe % 2, 7 Ft. _ • Ft. Township Range:' Section: Fill added above original grade: Gravel length, I 46 Ft. 2ev --35 e Ft. WELL: 1zs1 New ❑Upgrade Gravel width: Number of lines: Distance betvfeen lines: /S Ft. Ft. Classification (Private, A. B,C): Total Depth: (oQ Cased To: �� Total absorption area: /r � Pipe material: U �"3CI.3L� /'if�l �//�/� _ Ft. Ft. / Y� SO. Ft. ,%t% Driller: ' / I� p / �G/L L l E `LG Date Drilled: % lU "'� " Static Water Level- �J Installer: /- / /l AS/✓�C/S.$ Gi�� Date installed: / p . <I�I✓ Gi. / J V (v 1 FL 0/v' Yield: �" 5f Pump Set at: a��1 Casing Height Above Ground: 2,0 TANK GPM Ft. Ft, SEPARATION DISTANCES Septic ❑Holding ❑S.T.E.P. To Septic Absorption Lift Holding Public/Private Manuf eture/r: �/ /'%'vet Capacity in gallons: From Tank Field Station Tank Sewer Lines �tl(•/70/\�(TC :2 JV Well- ��,Z %dL} — 20 -4–�1 Material: �. ` Number of Compartments: Surf Watere /bD /oo't LIFT STATION Lot I / Size in gallons: Manufa Line Foundation / 3 '7 I / "Pump on" level at: " off' level at: High water alarm at: Curtain d /Ol , � O , Pump Make & Model Electrical Inspections performed by: Drain NPump A-�/; N/ Remarks: ��- 7��i1/✓�ULf7 /�l BENCH MARK Location and Description: _ %IL -LD 4)gs GCJI%II _ L LJL i�OH,C�. Assumed Elevation: Ft ENG AL ,mow S & S ENGINEERING Inspections performed bY7e34 EagIP River t n_p maNn. 700ates: 1 st A t Eagle River, Alaska 99577 2nd d a6 q D yt } ppB�RY C. COWAN �G' Department of Health and Human Services approval XU, .., CE-as©1 f�w Reviewed and approved by: Date: 2-121, 72-013 (Rev. 9/91) MOA 25 PERMIT n'o. SW9801 39 PAGE 2 OF 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION RE], Box 196650 *Anchorage, Alaska 99519-6650 • Tele hone) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LECAi. LOT 4, BLOCK 9, RIVERVIEW ESTATES S/D P.I.D. No. 050-801-10 LOT 4JSE ITlcoz c05MT2 N a o �' w N o St. I �i 1 NEW 4 6�'�D6R G �A li 1 1 TRENCHES FCO \ ` J I COI i� �� N 'RAVEL DRIVEWAY rnro "t03 1` NDN FO x NEW 1250 W1250SEPTIC GAL (' ( i DBL CO �I X0ANK 0• wf i1 lil i ALT. SITE (Ry0 JHi t� I iL. _ CUTBANK LOT 1 so x 25' RIVER \ � AfAfIYT. ESNT STS ST2 C01 SOUTH FORK,.E'.4GLE RIVER FINAL GRADE 1LT1 CO2 84.8' 03.8' CO3 C04 MT2 NJt,�gnc,v-� ' NEW C01 82.0' 83.4' 12fi0 GAL CO2 82.0' S.T. 83.2' SCALE 1" = 60' N.T.S. CO3 81.3' F.N A B SR C04 81.4' ��� �� ... ••• CO 17.0 5.5 9R S� ,.• ti., Tl 41.5 37.5 79.4' P �y��� T2 37.5 70.7' BLI 53.5 40.5 41' 49th t b S BL2 54.5 41.5 N.T.S. 9 •2.7_ �,�_,,,�„„• Ol 83.0 48.5 ..r�:....... 02 83.0 40.0 { 103 7I 81.0 ATHfl3 R08ERT C. COWA4 78,0 54.5 NO WATER FOUND dpiCE_880jl 50.0 37.0 2 77.5 58.0 7BB 23-B8 �rF w `" Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: 'ti% I FCAi nFS(`P1P"r1111 ` !-31-IC. DEPTH 0K 0 2 3 4 " c .�/'�Dy S G✓ 5 � \ (u,�Sorlc �s%� fl d�G J 6 d o1 / 7 ,. 8 0" 9 a., ROBERT C. COWAN Q- 10- �`'4' lr"•' , DATE PERFORMED: ��•U ,1�� •I • i „�A" 0 11 G .o / 12- 10 A 13 0 14 15 is 17 18 19 SiAiEs Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? O S IF YES, AT WHAT — L DEPTH? O P E Depth to Water After r Monitoring? _ Dale: SITE PLAN G V w Reading Date Gross Net Depth to Net Time Time Water Drop 20 PERCOLATION RATE (minutevinch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT COMMENTS % 110dG -11-16 %O /J/ 1',tie)NS5�it-c-�tti S /1wl Sa t 1 A 5 7-a�17- Ra 4,f` 1L 4. `:y7 //a1 � !J Z PERFORMED BY: +'sn''•�QQ.t EnglaAARl ar- �,gg®gqgrrt���ryry_ Zajd Ain- 21m CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITI#9.'cVX%AN�StJI�1N?ARL GUIDELINES IN EFFECT ON THIS DATE. DATE: c1 72-008 (Rev. 4/85) /, ��19 H b.Ap O t. Ir rarltltC?I ROBERT C. COWAN Q- � `i �,�••` GE - 8801 �`'4' lr"•' , DATE PERFORMED: ��•U ,1�� •I • i „�A" SiAiEs Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? O S IF YES, AT WHAT — L DEPTH? O P E Depth to Water After r Monitoring? _ Dale: SITE PLAN G V w Reading Date Gross Net Depth to Net Time Time Water Drop 20 PERCOLATION RATE (minutevinch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT COMMENTS % 110dG -11-16 %O /J/ 1',tie)NS5�it-c-�tti S /1wl Sa t 1 A 5 7-a�17- Ra 4,f` 1L 4. `:y7 //a1 � !J Z PERFORMED BY: +'sn''•�QQ.t EnglaAARl ar- �,gg®gqgrrt���ryry_ Zajd Ain- 21m CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITI#9.'cVX%AN�StJI�1N?ARL GUIDELINES IN EFFECT ON THIS DATE. DATE: c1 72-008 (Rev. 4/85) C.trttfteb rilli"n ILag by DOC Co. dba SUL L;\I V'AN WATER WELLS BOX $70272,. GHUGIAK, ALASKA 99567 • TELEPHONE 688-2759 OWNER OF LAND T' 1 1 .�•/`,�j ti 7`,t r ADDRESS J Q J-5 t' r,4 d 1 �t•_r' LEGAL DESCRIPTION ��'�i1r It PERMIT NUMBER�13Date of Issue u l c� TAX INDENTIFICATION-`` NUMBER 05.0 - A`IQ) (7 Is well located at approved permit location? [7) Yes [73 -No Method of Drilllhg: 041r rotary C1 cable tool Depth of well: o F- Casing Type S'r ta'i 'f. Wall Thickness r_) inches inches Diameter, �� r! inches, depth .� feet Liner Type: )4., ), Casing Stickup Above Ground: feet Static Water Level (from ground level): feet k Pumping`lerl:,'' feet after hrs. pumping gpm Recover Rate: , „J, y " gpm Method of Testing: E!�i /i Well Intake Opening Type: C1 Open End C) Open Hole ❑ Screened; Start feet Stopped feet C] Perforations Start feet Stopped feet yy �� Grout Type: t1fa, ii' ). )I.t't �'Vo[ume Depth: from t_) feet, to - feet Pump Intake Depth: Pump Size hp Brand Name Well Disinfected Upon Completion? ® Yes rj No Method of Disinfection: (; k4adl -Ji Comments: 0A I BORE HOLE DATA DEPTH From To I 71A it !JYy 19ry al , i) . r�J/ E3�)� �^j lid r S b Esc & ()�` J6A, j e '��✓r )/0 ;� v f/j6 J %'tc iC Jto 3 ,,11� I 71A it !JYy 19ry al , i) . r�J/ E3�)� �^j lid r S b Esc & d t, f` r"% J6A, j e '��✓r gra RECr I VE D_ ulul, {,;pality of Anchorsge 'T�aalth & Human Services Driller's Name ATTENTION: 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 ANCHORAGE Cib Department of Health and Human Services On -Site Services Program o 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650iv� (907) 343-4744 t ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Initial Date Issued: Jun 01, 1998 Expiration Date: Jun 01, 1999 Permit Number: SW980139 Parcel ID: 050-801-10 c,rn [ ,� �� j� Design Engineer: 0003 S & S Engineering Legal Description: RIVERVIEW ESTATES BLK 9 LT 4 Owner Name: Scott Shaefer Site Address: Owner Address: 10233 Colville Lot Size: 62231 SQ. FT, Eagle River , AK 99577- Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: =�� Disposal Field /1 Septic Tank ::] Holding Tank Privy 1 V1, 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 DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 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. 5. The following special provisions. Any changes to the attached design must have prior approval from this department. 644,98 98 Pity 5 f4d1,/vga/(wSQ_ 0R1taC-j(J (#i t$ 0 fA a tasa"tlp 41k r To HOVE w 05Lt 5,11-e NAR OoLlm)4rFLY' 30 FEF;_ " Tl -(E 56(A r/4 Afsr AS A Rt3wL,T of rrst Diel or j" A RivO rr-�t V U 11-41Arl 51 rE L acia Received By: Issued By: laN, Date: Date: 6 - ( - q 2_ S&S\ ,inecntnq HEALTH AUTHORITY APPROVALS May 21, 1998 ROBERT C. COWAN, P.E. CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box t96650 SEWER &WATER Anchorage, AIC 9919 MAIN EXTENSIONS REFERENCE: Lot 4; Block 9; Riverview Estates SEWER&WATER Request you issue a permit to install a septic system and drill a well to serve the INSPECTION proposed four bedroom house on the referenced property. Two test holes were excavated and percolation tests performed. The approximate location of the test holes are located on the attached site plan. ENGINEERiNG STUDIES AND REPORTS At the time of excavation no ground water was encountered in the test holes. After seven day ground water monitoring, the monitoring tubes were checked and were found to be dry. WELL INSPECTION & FLOW TEST We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic system. SITE PLANS There are no points of contamination within the proposed well radius that can be seen on the attached site plan. If you require additional information, please contact us. ROAD DESIGN Sincerelv, SOILTEST �} Robert C. Cowan, P.E. PERCOLATION RCC/gk TEST Enclosures STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 F—� i 1" 0 30' a>Z Zit SCALE Lil (ncc I Carr/ G `ro O ()• � ri on b OO �m'I o Z [az7 �xcn O azo p , Z co �A) �c/) H O� II m z 11 F—� i a) U, N N a>Z Zit o+ Lil (ncc I ire G 0 ()• � ri on b OO �m'I o Z z zmmm d H < w-4 t"t � II m x � O \ Y Y \ \ gzvp s\ on,/ a u \ �X \ \ m az E zo \ \ SO ; x \ 0 Ho _LA \ / \ 9 !// \ DESIGN DETAIL 47 a) U, N N a>Z Zit o+ Lil (ncc a ire G O ()• � ri on b OO �m'I o Z z zmmm d H < w-4 t"t C�7 II m � O / N W M s i a) > h. f� 0 -0 co at II (A Z II Z N 0 ;u 0 �m C) .NO U 01 z a>Z Zit o+ opo a ire n O ()• � ri on b i7Om < C r' Q z d U r O Y Y V z a>Z Zit o+ opo a ire n O ()• � ri on b i7Om < C r' Q z d U r nC.� �tz �z x � ka�c�L 7, moo z a>Z Zit o+ opo a ire n O ()• � ri on b i7Om < C r' Q z d oAl �-���� nC.� �tz �z x � ka�c�L 7, moo N a>Z Zit ;a{ x A bf opo m ire FA ()• � ri on b i7Om < C r' Q oN z m o C�o C G m (U N L ON co co w y N O q Mui 1 " = 50' SITE PLAN DESIr" SCALE v 0 c7$9 O 3 tr` ✓ '•I fl AD G cn CA cn cn 02 ere,- I -r m 144 Z II X11 % D ` 7° II rr, nn Ilos Nps ' A 0 xo �6 I-1 ;a ' S m O C7 ✓o o � n X o. o %� 00 zo e✓G 1CW' oma i S L -J MOO .oz 35_11�� ttb Z � « :2 C P. Nmm ,S 'U ♦�u -moi Z m W z 0 (,n O z oo a n C n .T_l = C I I�� cry& o �GJ� C�fN�m CZm N g r d � r cn < O ZDmm -i -- I mow � p;OAN co o v ;,2Ni—<inm (�] ` m d-''"-- y O -i m D{ m c.. ,{o to F K z 00 10 O rn `.� ca, rzi�immmm Ui 0 OM H8 xv'x �D�O m0 N .'O 2 O �� p1 `� m Tz 1� Z 0 O N r a N d w 1107 p cF� _ m A 9 •�>. ZCA t; ri 1• 1 1. oi (1 ir C<37 i xp� VI,"tOn i <y55 .1a D m - �. •Jl LA rr, z i.,�y •�+�9 0 PERFORMED FOR LEGAL DESCRIPTION: I— DE PTH > 7 v- 8 c 9 '. Municipality of Anchorage . DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOO — PERCOLATION TEST Cvi J 5/- /9J=62 u k043E FP C. COWAN CE - 3801 DATE PERFORMED: '{/� ',J�-..�" A'j RfVE viww ?isi. Township, Range, Section: SLOPE 10 - WAS GROUND WATER , ! _ ENCOUNTERED? 11 S IF YES, AT WHAT """ L 5A.,4 gwkLDEPTH? P 12 16.ty E 1, S6mZ' L'i&'l } Aay sac c 13 - A Depth to Water After j Monitoring? Aity Date: S✓r?/`t� 14- 15- 16- 17 4151617 81920 18- 19- 20 COMMENTS SITE PLAN Reading Date Gross Net Depth to Net Time Time Water Drop 0 y 5 PERCOLATION RATE / (mmutesiinch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND S, - FT 1w PERFORMED PERFORMED BY: � �- /.4 - I 17p0411 Fy�tdr±(R�iwSnk� IgngnS.. nv.�blFj�-IAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IIN*EFFECTedN iHIS�ATE��DATE: 72-008 (Rev. 4/85) DEPTH (FEET) 2 3 s' 4 5 6 5w 7 v- 8 c 9 '. Municipality of Anchorage . DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOO — PERCOLATION TEST Cvi J 5/- /9J=62 u k043E FP C. COWAN CE - 3801 DATE PERFORMED: '{/� ',J�-..�" A'j RfVE viww ?isi. Township, Range, Section: SLOPE 10 - WAS GROUND WATER , ! _ ENCOUNTERED? 11 S IF YES, AT WHAT """ L 5A.,4 gwkLDEPTH? P 12 16.ty E 1, S6mZ' L'i&'l } Aay sac c 13 - A Depth to Water After j Monitoring? Aity Date: S✓r?/`t� 14- 15- 16- 17 4151617 81920 18- 19- 20 COMMENTS SITE PLAN Reading Date Gross Net Depth to Net Time Time Water Drop 0 y 5 PERCOLATION RATE / (mmutesiinch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND S, - FT 1w PERFORMED PERFORMED BY: � �- /.4 - I 17p0411 Fy�tdr±(R�iwSnk� IgngnS.. nv.�blFj�-IAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IIN*EFFECTedN iHIS�ATE��DATE: 72-008 (Rev. 4/85) 0 Percent Passing by,Weight n C) 0 (0 d o O 0 O b G O O O O p8 m CA AMM 5 1 N � o �n ra V4" r mom Z w n In a. o v' 0 ro yy No. 10 a n16 No. 20 930a (D' No. 40 Ct. C) h n so CIO No. 60 �Bo P No.100 NO 200 r (9 pF� Q' l ago 0.01mm N. h by CD R -27 s moi' N O 4 O O 07 6 O\ O In O J, 6 V) O O 2i B� C9 » rry 0 c c U 0 L� .y L7 a R. N N Uo � v U7 e z iz 9's9sss99LOs avrlisn vxsvgv' wv L9.s s6-zt-9 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST pyo `rr __•�.•�• ROBERT C. COWAN PERFORMED FOR: JLO� .J `7 AEF�IL DATE PERFORMED: 5 ,. 7 LEGAL DESCRIPTION:_✓•�' B9 t 'r,yjp-yg5 Township, Range, Section: n� SLOPE SITE PLAN TW 112- (40(a" TN) 5 SANDt1 SvJ \ 6 _ �WI `SOME GRAVbI- 7 -0- 8 9 G. - 6 10 a 11 12 13 14 15 16 17 18 19 WAS GROUND WATER eU ENCOUNTERED? JJ S s L 0 P 1- 410 /qY E r �2 1! IF YES, AT WHAT DEPTH? Aa,/ Depth to Water Alter Monitoring? X'l Date: ■■■■■■■RMIN ENIME NOON■■ ■■■ ■■■ NONE ■■■ ■■N=N■■■E■ ■■■ ■. .E. Reading Date Gross Net Time Time Depth to Net Water Drop siw—E Aivai.,Lf is VIS AL t—) 5 w5 L5 Som,LAE AS I 20 PERCOLATION RATE L' ! (minutes/inch) PERC HOLE DIAMETER i-:NC!,INV,E'VtINry TEST RUN BETWEEN FT AND FT COMMENTS17034 Eagle Rivor L(3uj) Road, No 204 Ea91n River, Alaska 99577 n n PERFORMED BY: �Y/ r�iT"lf'�� CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) HEALTH AUTHORITY APPROVALS SEWER&WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSAL SYSTEM DESIGN s&s\ ,tnevninq ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS REFERENCE: Lot 4, Block 9, Riverview Estates May 21, 1998 GENERAL: ROBERT C. COWAN, P.E. CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 The scope of this project includes the installation of a 1250 gallon septic tank and a leachfield trench to serve the proposed four bedroom residence located on the referenced property. 2. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground utility locates. 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 d Page Two Lot 4, Block 9, Riverview Estates May 21, 1998 5. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed -up) before gravel (sewer rock) placement. 2. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 3. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. 4. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. 5. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. Page Three Lot 4, Block 9, Riverview Estates May 21, 1998 MINIMUM MATERIAL SPECIFICATIONS: Any septic tank proposed for installation must be constructed by a Municipal approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Tyne of Pike Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements, which ever requirement applies. INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. Page Four Lot 4, Block 9, Riverview Estates May 21, 1998 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre -construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to cant' out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate-ofOn=Site-Systems-Approval Parcel 1. D. 050-801-10-000 Legal description RIVERVIEW ESTATES BLK 9 LT 4 Expiration Date: Site address 21630 FALLING WATER CIR Eagle River AK 99577 Current property owner(s) HORN LESLIE J 9/23/2023 X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: 6/12/2023 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist Absorption Field Advisory Tank Age Advisory Other X Well Flow Advisory Nitrate Advisory X Arsenic Advisory M COSA Approval_June 2022 MUNICIPALITY OF ANCHORAGF Development Services Department Phone -907 -343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems App.r_ov_al_Application 1. GENERAL INFORMATION Parcel I. D. 050 801 10 Complete legal description RIVERVIEW ESTATES BLOCK 9 LOT 4 Location (site address) 21630 FALLING WATER Current property owner(s) HORN 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS Day phone 3. TYPE OF WATER SUPPLY: ❑■ Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ❑■ Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ❑■ Plastic ❑ Concrete ❑ Fiberglass Age 25 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ■❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ S 5-0 Waiver Fee $ Date of Payment C// : 3 A COSA# �SC-Z-31 0J Date of Payment Waiver # COSA Application—June 2022 COSA Checklist_June 2022 COSA Checklist Legal Description: Parcel ID: If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank Date of pumping Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes go to bottom of effective. If not, state depth into effective Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) If yes, enter date Adequacy test date Results Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) in Effective depth used in Effective depth remaining in Comments/Deficiencies: COSA Checklist_June 2022 E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F.ENGINEER’S COMMENTS G.CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Phone Engineer’s Printed Name Date C&M ENGINEERING CHARLES BALZARINI, PE 6/9/23 UJ FAMPQUTY O ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT On -Site Water and Wastewater Section www.muni.org/onsite Septic Tank Advisory Certificate of On -Site Systems Approval # OSC231195 Subdivision: Riverview Estates Block:9, Lot: 4 907-343-7904 Fax: 343-7997 The septic tank for this property is 25 years old. The average life of an asphalt coated steel septic tank is 20 years. Typical replacement costs are $10,000 or more, not including engineering, surveying or MOA permitting fees. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of what the metal of a 30 year old steel tank MAY look like. M UMCD PAU T Y OF ANCHOROE DEVELOPMENT SERVICES DEPARTMENT On -Site Water and Wastewater Section www.muni.org/onsite Arsenic Advisory Certificate of On -Site Systems Approval # OSC231195 Subdivision: Riverview Estates, Block: 9, Lot: 4 907-343-7904 Fax: 343-7997 A water sample revealed an arsenic concentration of 11.9 micrograms per liter (ug/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Information on arsenic is available from the On -Site Water and Wastewater Program website (www.muni.org/onsite) or at 343-7904. 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.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. O - X01- Il) COSA a ORDiT r + Expiration Date: — oZ O " 1. GENERAL INFORMATION Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing Address Riverview Estates, Block Sh, Lot 4 21630 Falling Water, Eagle River, Alaska Evan and Valerie Buxbaum Day phone 227.9775 Day phone Audrey Mason Day phone 622.3344 16600 Centerfield Dr., Ste. 201, Eagle River, Alaska 99577.7702 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 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 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 Onsite 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 Douglas T. Kenley, P.E. Address 9606 E. North Star Drive, Palmer, Alaska 99645 Engineer's Printed Name Douglas T. Kenley 5. DSD SIGNATURE _jtff�o Approved for .. �_ bedrooms. Disapproved. Conditional approval for bedrooms, with the folio% Phone (907) 746.1073 Date S`t*Z-- 08 Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date: n ' Q ' OR JP" 11,051 Municipality of Anchorage Development Services Department Building Safety Division ff!L�A On-Site Water 8 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 CHECKLIST Legal Description: Riverview Estates SID. Block 9, Lot 4 Parcel ID: 050-801-10 A. WELL DATA Well type Private If A. B. or C provide PWSID # _ Well Log (Y/N) Y Date completed 6/26198 Sanitary seal (Y/N) Y Wires properly protected (YIN) Y Total depth •360 ft. Cased to '51 ft. Casing height (above ground) 24 in. FROM WELL LOG AT INSPECTION Date of test '6/26/98 7/29106 Static water level '75 ft. 50.1 ft Well production '2.5 g.p.m. 3.4 9.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate ND mg/L Other bacteria 0 colonies/100 mL Arsenic: 24.2 mgll Date of sample: 7/29/08 Collected by: F. Kenley B. SEPTICIHOLDING TANK DATA Tank Type/Material 'SepticJSteel Date installed '8126/98 Tank size '1250 gal. Number of Compartments '2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (YIN) N High water alarm (YIN) NIA Date of pumping 8113106 Pumper Sanitary Pumpers C. 'ABSORPTION FIELD DATA Date installed 0686198 Soil rating (g.p.d.e or 0bdrm) 0102 System type '5' wide trench Length 033.33=66 ft. Width '5 ft. Gravel below pipe 02.6 a 2.7 ft, Total depth 6 ft. Eff. absorption area '516 ft� Monitoring tube Y Depression over field N Date of adequacy test 77/9/08 Results (Pass/Fail) Pass For 4 'bedrooms Fluid depth in absorption field before test 0 in. Water added 799 gal. ` New depth _Oin. Elapsed Time: 70 min. Final fluid depth 0 in. Absorption rale >= 600 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N if yes, give date — D. LIFT STATION Date Installed Size in gallons Manhole/Access (YIN) 'Pump on' level at _ in. 'Pump off' level a water alarm level at in. Cycles tested Meets alarm 8 circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 1000t On adjacent lots 100+11 Absorption field on lot 115+ ft. On adjacent lots 100+ft Public sewer main NIA Public sewer manhole/cleanout NIA Sewer /septic service line %Q'* 4 r W. Holding tank N/A Animal containment areas 50+ Manurelanimal excrete storage areas 100+11 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 35+ ft. Property line 75.ft Absorption field 10+Ft. Water main NIA Water service line 10+11 Surface water 100+FL Wells on adjacent lots 100+ ft. SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 45+ ft. Building foundation 30+ ft. Water main N/A Water Service line 10+11- Surface water 100+R Driveway, parking/vehicle storage 70+ft Curtain drain N01pk" 10*iW Wells on adjacent lots 100+ ft. F. COMMENTS: • From MOA records. G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Douglas T. Kenley Date _ 6 - k7 . o>5 COSA Fee $ Date of Payment Receipt Number (Rev 11105) Waiver Fee $ _ Date of Paymeni Receipt Number �t.71,51 . . A .r• e. •. ,•• • .. T Pit . •' Municipality of Anchorage ..� Development Services Department j% Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 Arsenic Advisory Certificate of On -Site Systems Approval # 080278 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 9, Lot 4 of Riverview Subdivision. This inspection revealed an arsenic concentration of 24.2 micrograms per liter (ug/L) for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Information on arsenic is available from the On -Site Water and Wastewater Program website (www.muni.or /og nsitg) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. ASBUILT iY7�'or yf' � rss. c� I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: .f�!/EiT,6l/Ek/�J7A�Sil/4lcl'//�*� f' AND THAT NO ENCROACHdENTS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE TH7 EXISTENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OF FENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES. 0 90� aQ� � ZS •f/rfY�i�f %r.� bLVIARD S ASSOCIATES LAND SURVEYING 694 SCALE= /"sad 'S O F A"t* DATE: / • • • .....d k GRID: + 49r sw �s6' D Ar oB� FBr�j . is -era + DRAWN: Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and 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 c FOR A SINGLE FAMILY DWELLING Parcel I.D. C6b-- 1-10 HAA # OJ�"n(j1GF{ Expiration Date: 1 2 — 1 U 1. GENgRAL.INFORMATION CGle'legaldescripfi6h, i( Fctil CTT aL ) c /e 9 6T Lncation,(site address or cirections) oZ %1.3 rO n L ti//l Tfi2 Current Property pwriks) lsr� f �a4,r Day phone mailing address' >'Z/ (�3n FAL[itl C c�rA77<2 �t Lending agency . ' f Day phone_ Mailing address Real Estate Agent u rc Yi/ri. ., Day phone ��-0 3S Mailing Address I�f,�ii't/¢ gn 4 Ct, dc OfV_4 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well bd7 Individual On-site O' Individual Water Storage /❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services 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 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 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 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 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 Address Phones Cr 702 Engineer's Printed Name S7 - 251/F Date_`��/GS L� f��• Ot-� 41.-41, % 1 .......•...., ,. 5. DSD SIGNATURE orng , 5te , w, :•'s t s •. ; V"' Approved for � bedrooms. 1 fF •.,� PE 6256 Disapproved. `?orC,::u,+ Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: ni�1 �" O — Original Certificate Date: (R., 01102) Municipality of Anchorage o o • 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 HEALTH AUTHORITY APPROVAL CHECKLIST' Legal Description: Lye-41-wrG.! Z2 Parcel ID:oSo A. WELL DATA Well type ! If A, B, or C provide PWSID # _ Date completed -cl-40t Sanitary seal (YIN) Total depth 36o ft. Cased to sY ft. FROM WELL LOG Date of test _ 2 i Static water level -71 ft. Well production -2.5, •S 9— p.m- Well Log (YIN) +.Wires properly protected (YIN) T Casing height (above ground) c?lq in. AT INSPECTION 7z n. 5 g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 ml. Nitrate d..S mgg//,1. M6 L Other bacteria G colonies/100 ml. 7/ Z Arsenic: mg./l. Date of sample: /OS Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material 40/C HJre.4 ie Z2YAA ISr-"L Date installed Tank size /Z SG gal. Number of Compartments 2 Cleanouts (YIN) Foundation cleanout (YIN) Depression over tank (YIN) High water alarm (YIN) N�A Date of pumping 14A_,0 `1 Pumper T le j C. ABSORPTION FIELD DATA Date installed 400P Soil rating (g.p.d.Ift2 or414bdim)/,?, System type JZX,.W c%t Length.2@—-?S ft. Width 4' ft. Gravel below pipe Z. % ft. Total depth _6_ ft. Eff. absorption areaEd_ftZ Monitoring tube __Y_ Depression over field AJ Date of adequacy test OS Results (Pass/Fail) �111S-r For bedrooms Fluid depth in absorption field before test O in. Water added6X gal. + New depth d in. Elapsed Time: ,t<p min. Final fluid depth D in. Absorption rate >= O® -t- g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) l AI&- If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) `Pump on" level at i 'Pump off" level at in. High water alarm lev at in. Datum Cycles tested Meets alarm & circu' requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: t Septic tank/lift station on lot /O G rf Absorption field on lot 166 ' 1'- On adjacent lots Ica "o. - On adjacent lots / G O •E' Public sewer main Al 69 Public sewer manhole%leanout a //.4 r Sewer /septic service line 2S + Holding tank .✓/4 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: r Building foundation .S r Property line �[_f' Absorption field S Water main NR Water service line hD 1 4- Surface water 14 O '4 - Wells on adjacent lots A) G r SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line / �* Building foundation �p 'f Water main A I Water Service line /D rt Surface water Driveway, parking/vehicle storage 2S ~ Curtain drain Ala Wells on adjacent lots /a Q 'f F. COMMENTS rn ntIs r4.t. ........, •'Qs �� G. ENGINEER'S CERTIFICATION a�Q;•• •••� i91) 1 certify that I have determined through field inspections and;:49L ••• •: review or Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. ... •••• ATF r.� G , (I Steven W. E Engineer's Printed Name � r�j �l :•• PE 6256 Date // / los HAA Fee $ 7" .3 0 Date of Payment 9 — O s Receipt Number 3 7 ;F Z� (Rev. 12/01) Waiver Fee $ Date of Payment Receipt Number m z_ nz c� m- G — �o ✓t�y9•SO - S h 414 V �1• o, f.(b Z l fa O�y �O e O mm +i ya)c,) mm S� Z N � U cn see = Q�ye1 g 8 Aly ¢ m z N 1 m 'b4 � 4 E 1 a ` 42.7 .00 OM1 1 I H • 1 1 0 1 w , 1 11 O 00 5 m % m 1 A T cn> lj //II 1n 1 0 4p m z m �v 1 74110 � 6y6 � m o 8 1 s � 1 �,�i � yd�3♦ l l _Arm omp oevvz p m vooc�0 UIID p 1 AA 2 p Z3m ��omm D W N s' o n e o n m /!� --1 A ti mm 4� O 5'O m O m m f0 CD w W w 'e� r mn mmnm'�ej �• ,,i G1 N m>F•a �• N Z aa _ r# m = C i Oen u,p• p`�m m�'� % Q•: • •I^ ��•� I r p� aOn�i q N N O a O Ip O e' u 0 / O�• r • W ��'S O 1 =Q N p n < m m -1 Cp, . 3 u v / 7 : Ili • GL -.00 " m o mon m N Ni jjn o v 4 • 'm « c • m P. :-�/ n cPi " g vl m G O M +3 �� M 1 7 /m • i M Z Pin a A Po t4 Ar 2 Q m ME m 3 Vi e• ^it S *•�U. O M W � 0 CA A ua "K�Do,g c N W U A