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HomeMy WebLinkAboutRAVEN MOUNTAIN ESTATES #1 BLK 2 LT 13 Municipality of Anchorage On-Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP221452 PID Number: 076-031-14 Dwelling: FE-1 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 0 Upgrade Name SARA ENGEBRETSON ABSORPTION FIELD Site Address 0 Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound 4900 CROW CREEK ROAD *GIRDWOOD, AK ❑ Other Phone 7Num6er of Bedrooms Soil Rating Total depth from original grade 907-227-8229 1.2 GPD/SF 8.01 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot SEE DWG. Ft. 6.02 RAVEN MOUNTAIN ESTATES #1; BLOCK 2, LOT 13 Ft. Fill added above original grade Gravel length Township Range Section SEE DWG. Ft. 42 Ft. N/A Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES 2.5 Ft - - Ft To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line 504 Ft2 1 N/A Ft. Well 100'+ 100'+ 100'+ - 25'+ TANK ❑ Septic M S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity Surface Water 100'+ 100'+ 100'+ _ GREER TANK 1500 Gal. Material Number of compartments Lot Line 5'+ 10'+ 5'+- NA PLASTIC 2 Foundation j �' 1 6+1 1►+ - LIFT STATION Manufacturer Capacity Remarks PER CONTRACTOR EXISTING SEPTIC TANK WAS DECOMMISSIONED G R E E R TANK 500 Gal. PER UPC. *SECOND COMPARTMENT OF STEP TANK Alarm location Electrical installed by NEAR ELECTRICAL PANEL IN BASEMENT ABPA PROFESSIONAL SERVICES PIPE MATERIAL House to tank Tank to Installer EXISTINdrainfield 1785 A.C.E.S. Drainfield D3034 Co/MTD3034 Inspector GEG BENCH MARK (Assumed elevation) 100.00 ft Inspection ectio1" 7/5/23 2nd 7/5/23 Location and description aro 7/6/23 4"' 7/6/23 GARAGE SLAB ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineers Stamp • 0oo6o4p�� Conditional Approval: Date oo �� OF 9s4� 0Je,Gorness.- D Septic Approved Od 9 '.1 I GSE-7953 PP vee Date c3.�`j�z3 �;o�o dte: this approval does not Include well permit requirem nts.�4p pr�fessio�°oma 4AECC884 �DOO�Ood (Rev 05/02/1 PERMIT NUMBER: PARCEL ID NUMBER: OSP221452 RECORD DRAWING 076-031-14 10TE: PIPE LOCATIONS ARE SHOWN PER .DWG FILE PROVIDED BY SURVEYOR. SIGNED .PDF IS ATTACHED 4 d � 4 d y 1996 T.H. BY LOUIS A. BUTERA, P.E. P a I / EXISTING HOUSE I po RPD�vS SCALE: 1" = 4 nln� _`— ENGINEERING, SALES, CONSULTING U' 3701 E. TUDOR ROAD, SUITE 101 'ANCHORAGE, AK 99507' PHONE (907) 3376179 • FAX (907) 330-3246 • WEBSITE: w g-sengineenng.com PREPARED FOR: PHONE NUMBER: PAGE NUMBER: O 907-227-8229 G — NEW DRAINFIELD LEGAL DESCRIPTION: DRAWN BY: PER THE CONTRACTOR, THE EXISTING FIELD WAS d DECOMMISSIONED WITHIN 12' OF NEW FIELD. CONTRACTOR ALSO NOTED THAT THE OLD FIELD • 4 HAD APPROXIMATELY 2.5' OF EFFECTIVE DEPT� DATE: d • DRAINF ELD.IS 3 +FROM GREER THPN OPESOPES FIP - WR#OSV201055 4' A-' NEW 1500 GALLON GREER 01 v TANK USED AS STEP TANK 4 A 1 d • 'O a d V / EXISTING HOUSE I po RPD�vS SCALE: 1" = 4 nln� _`— ENGINEERING, SALES, CONSULTING 3701 E. TUDOR ROAD, SUITE 101 'ANCHORAGE, AK 99507' PHONE (907) 3376179 • FAX (907) 330-3246 • WEBSITE: w g-sengineenng.com PREPARED FOR: PHONE NUMBER: PAGE NUMBER: SARA ENGEBRETSON 907-227-8229 2 OF 3 LEGAL DESCRIPTION: DRAWN BY: RAVEN MOUNTAIN ESTATES #1; BLOCK 2, LOT 13 D.J.G. TYPE OF WORK: DATE: SEPTIC SYSTEM RECORD DRAWING 8/9/2023 .........49.x ......................... ,r � ..••....................... ....... . . .� Jeep ey-GadeSS � � t� �1 �x r C -79 3AV : LICENSE ���• #AECC884 / PERMIT NUMBER: PARCEL ID NUMBER: OSP221452 RECORD DRAWING 076-031-14 TOP OF MH#1 = 99.37 TOP OF MH#2 = 99.41 FINAL GRADE = 99.25 TO DRAINFIELD TOP OF TANK AT INTLET = 93.35 TOP OF TANK AT OUTLET = 93.35 INVERT OF BUNG AT INLET = 92.69 TANK HOLE WAS DRY DURING EXCAVATION- GROUNDWATER WAS NOT ENCOUNTERED ANCHORAGE TANK PUMP PACKAGE WAS USED (PER CONTRACTOR) LOUIS A. BUTERA, PE T.H. MT CO ORIGINAL GRADE AT FINAL GRADE = 101.0-101.33 HIGHEST POINT = 100.32 2" INSULATION PER CONTRACTOR FILTER FABRIC INVERT OF PIPE = 98.33 6.02 FEET BOTTOM OF TRENCH = 92.31 RELATIVE ELEVATION AT BOTTOM OF T.H. = 84.32 (T.H. DRY ON 9/13/1996 PER LOUIS A. BUTERA, PE PER MOA RECORDS) OF _ ♦ s.,-°. w.a '%.. ,.....,:. .x-.h ..,_,u-:b, .,,. ,.... UwFa-,u; c.c ..m,.w *a ,v .:.. ..m .., _..x-h, Vis...: w a ,.,r: .,,....:, x.w ,,... ..,.. y��"''"•�•� •���'. k lS S IJP, /0. .�. • ............ v I..•......•.••...... ENGINEERING -SALES t CONSULTING 1 i 5 3701 E. TUDOR ROAD, SUITE 101 ANCHORAGE, AK 99507 • PHONE (907) 337.6179' FAX (907) 338-3246WEBSITE. wvw.gamesseng'tneenng.com ,• vi ••• fv•+'•+• �••{••••••••••••••••�;!•� PREPARED FOR: PHONE NUMBER: PAGE NUMBER: I cn % • rey A` `6;arness r' L i m SARA ENGEBRETSON 907-277-8229 3 OF 3 �� J,. C 7953 �"�AV PROJECT/LEGAL DESCRIPTION: DRAWN BY: ♦' Z3 .••' �► RAVEN MOUNTAIN ESTATES #1; BLOCK 2, LOT 13 D.J.G. ♦1FQ p'••• •.• �•'''�P�, TYPE OF WORK: DATE: LICENSE ESS, ,,�• SEPTIC SYSTEM PROFILE RECORD DRAWING 8/8/2023 #AEccaaa 0 25 50 US SURVEY Lot 14 FEET 0 J, 49'th'N /Star Say veyang OF q Lo t it3, B11ock 2 ON /shed 2nd ON t16 Lot 10 '0\N 0 A47.6S' t"' .. .... �77. ....... R70.00' •C? A-% Jer U CP LS- ti A62.18' NOTES R30.00' -All dimensions shown are grid bearings and ground distances, Record boundaries are per Plat No. 66-161. -49th Star has conducted a physical survey of the property and all details shown on this Asbuilt Survey are correct. Under no circumstances should any data hereon be used for construction or for establishment of property lines. -It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. AS BUILT SURVEY LEGEND 4th Star Surveying LLC Lot 13, Block 2, PO Box 738 Raven Mountain (R Well Girdwood, AK 99587 (907)891-6111 Estates, Unit 1, 0 Septic Clean Out JeremyC&49th5tarSurveying.com Girdwood, AK G Septic Tank lid W.O. 2333 IjATE 8/4/23 I SCALE 1 -=50'_ 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 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP221452 Work Type: Septic Renewal Effective Date Expiration Date Tax Code Number: 07603114000 Site Legal Address: RAVEN MOUNTAIN ESTATES #1 BLK 2 LT 13 G:4018 Site Mailing Address: 4900 CROW CREEK RD, Girdwood Owner: ENGEBRETSON SARA Design Engineer: GARNESS ENGINEERING GROUP LTD This permit is for the construction of: Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy �oIR e n t u v Depai-tment 11/16/2022 11/16/2023 Lot Size in Sq Ft: 45551 Total Bedrooms: 4 ❑ 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 �= 55tAf- Issued By: Date: Date: / 6h--'? M UHMPALrry OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 076-031-14 Property owner(s) Sara Engebretson Day phone 277-8229 Mailing address 4900 Crow Creek Road *Girdwood AK 99587 Site address Same Legal description (Sub'd., Block & Lot) Raven Mountain estates #1 132 L13 Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® att that apply) Absorption Field Fx� Initial ❑ Single Family (SF) ❑ (w/wo ADU) Septic Tank 0 Upgrade ElDuplex ElHolding (D) Tank ElRenewal 0 Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Drainfield to slopes greater Than 25% Distance: 30' I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 1 W5 ^ Waiver Fees: Date of Payment: I e) 3►) 2-?- Receipt 2Receipt Number: 01� I13A Permit No. 05 le -1'A S Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221452, Deb Wockenfuss, 11/16/22 MUNICIPALITY OF ANCHORAGE On -Site Water& Wastewater Program POBox 1ossoo 4rooElmore Road Anchorage, Alaska snn19-6650 Phone: 4 Fax: (907) 343-7997 Permit Number: OSP201388 Work Type: Septic Initial Tax Code Number: 07603114000 I1111,111111`11l!'Mm Mill Jim Effective Date: Expiration Date Site Legal Address: RAVEN MOUNTAIN ESTATES #1BU{ 2 L 13 B:4018 Site Mailing Address: 49O0CROW CREEK RD, Girdwuod Owner: ENGEBRETSON SARA Design Engineer: GARNESS ENGINEERING GROUP LTD This permit iafor the construction of: 2 Oiepomo} Field 2 Septic Tank 1771 Holding Tank 11 Privy 1O/7/2O2O 18/772O2| Lot Size in Sq Ft: 45551 Total Bedrooms: 4 El Private Well El Water Storage All construction shall beinaccordance 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 (1O/AC72)and Drinking Water Regulations (18/AC80) 3. Thewaatmwaterooderequinaoinopechonuduhngthe|notaUation.Theengin*aroha||ncdifythoDevelopmont Services Department per AMC 15.Gb.Provide notification bycalling (UO7)343'7QO4(24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall boeither: a. Opened and Closed onthe same day, or b. Covered, sealed, and heated to prevent freezing Received Issued By Dote: 1 Municipality of Anchorage Ur.p:n'tmenr P.O. Box 196650 ® 4700 Elmore Road Anchorage, Alaska 99519-6650 a (907) 343-7904 ® Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: OSV201055 COSA#: Permit#:OSP201388 PID#: 076-031-14 Legal Description: Raven mountain Estates #1 Blk 2 Lt 13 Engineer: Garness Engineering Group Your request for a waiver of the required 50 feet horizontal separation from the absorption field to the excessive slope has been approved. The approved separation distance is 30.0 feet. This waiver approval applies to the proposed absorption field only. Any future upgrade to the on- site wastewater disposal system will require all separation distances be met or another approval from this department. ............................................... ■ ............................. ■ 1 Waiver is Granted: X Waiver is not Granted: Date: Approved by: Name of Reviewer ................................................M 0 M M M M R R M Z N 0 -;epri ............. ■ 1 **** VARIAN C E/WAIVER REVIEW **** MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Fax: 907- 343-7997 On -Site Water & Wastewater Program Mayor Ethan Berkowitz On -Site Sewer/Well Permit Application For A Single Family Dwelling Parcel I.D. 076-031-14 Property owner(s) SARA ENGEBRETSON Day phone 907-277-8229 Mailing address 4900 CROW CREEK ROAD *GIRDWOOD, AK 99587 Site address 4900 CROW CREEK ROAD *GIRDWOOD, AK 99587 Legal description (Sub'd, Block & Lot) RAVEN MOUNTAIN ESTATES #1; BLOCK 2, LOT 13 Legal description (Township, Section & Range) Lot Size APPLICATION IS FOR: ( ® all that apply) Absorption Field Septic Tank Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Sq. Ft. Number of Bedrooms APPLICATION IS AN: Initial Upgrade ❑ Renewal ❑ 4 THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR: DRAINFIELD TO SLOPES GREATER THAN 25% TYPE OF DEWELLING: Single Family (SF) (w/wo ADU) Duplex (D) ❑ Multiple Dwellings ❑ (SF and/or D) Distance: 30' I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: $ qq6, 9 5( CoV 16-11 Date of Payment: 1 1 1 51 a 01� 0 Receipt Number: Q b r 19 (9 G Permit No. Q S P.2O 1 3 ag Waiver Fees: 8 1 L S. 5 Date of Payment: 9 5 ? Receipt Number: d 9 G C Waiver No. OS u'0 A 0 5 5 (Rev. 01/11) Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201388, Deb Wockenfuss, 10/07/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201388, Deb Wockenfuss, 10/07/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201388, Deb Wockenfuss, 10/07/20 CONCRETE FUEL STORAGE LEAN-TO 4.0' . 6.4' CANT HOUSE DETAIL Scole: 1" = 30' Ton Gam'..+ M 6.4' Gp SHED � p,2 / Rs. C,�� � lk WELL SOLAR PANEL POLE OrFeT�F s S 23'47'00"W(R) y \ 15.47'(R) r� \' 15.38'(C) �� \ .: .. �• L=62.18 , 30.00 0 -EDGE EASEMENT NOTE: THERE ARE NO EASEMENTS NOTED ON LOT 13, BLOCK 2 ON THE RECORD PLAT. PLAT NOTE: IN THE STREETS AND AREAS PROVIDED FOR UTILITY EASEMENTS, SPECIFIC EASEMENTS WITH PROTECTION AND RESTORATION PROVISIONS PERTAINING TO STREETS AND PROPERITES WILL BE GRANTED FRANCHISED OR AUTHORIZED UTILITIES. PLOT PLAN _• AS BUILT K SCALE 1" = 40' GRID SE 4018 Project No 20-415/A1 p 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Long & Associates, inC. (907) 522-6476 Phone ®4ppp� (907) 522-4625 Fax k®nolangsurvey.com OF q Professional Land Surveyors jonothonOlongsurvey.com ���`'.......... .:N I hereby certify that 1 have surveyed the following described property: LOT 13, BLOCK 2, RAVEN MOUNTAIN ESTATES (Plat No. 66-161) p° 49T Anchorage Recording District, Alaska, and that the Improvements situated thereon are """'""""""" "' within the property linea and do not encroach onto the property adjacent thereto, that no Improvements on the property lying adjacent thereto encroach on the surveyed P • • remises and that there are no roadways, Q A KENNETH ,IANC p oys, tronsmtsston Tines or other visible m�� easements on said property except as Indicated hereon. O( Doted this the 1L' ''S— _c _� 0?. Day of ^" of Anchorage. Alaska DQ,o •�••• 04ppFesslottoa `� M Is the responsibility of the owner to determine the existence of any easements, 4pppp*�" covenants, or restrictions which do not appear on the recorded subdivision plot. AECC963 Rick Mystrom, Mayor Municipality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 September 24, 1997 Keith Bucklin PO Box 141 Girdwood, Alaska 99587 0141 Subject: Lot 13 Block 2 Raven Mountain Estates Subdivision Permit #SW960308, PID #076-031-14 The subject permit, issued September 24, 1996 by this office for a single family well and/or on-site wastewater system, has expired as of September 24, 1997. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as-built inspection report must be sent to this office for review, approval and documentation. Ail inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the fees are: $320.00 for an on-site wastewater permit; $120.00 for a well permit and $440.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. r On-site Services enc: Copy of Permit cc: Eagle River Engineering Services MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE 1 OF ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW960308 DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES OWNER NAME:BUCKLIN KEITH OWNER ADDRESS:P.O. BOX 141 GIRDWOOD, AK 99587 DATE ISSUED: 9/24/96 EXPIRATION DATE: 9/24/97 PARCEL ID:07603114 LEGAL DESCRIPTION: RAVEN MOUNTAIN ESTATES ~1 BLK 2 LT 13 LOT SIZE: 45551 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM 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 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS RECEIVED BY: ~"~"~ DATE: DATE: Eagle River Engineering Services Louis Butera, P.E. P.O. Box 773294 (907) 694-5195 tel Eagle River, AK 99577-3294 (907) 694-3297 fax September 11, 1996 Jim Cross, P.E. Manager, On-Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Raven Mountain Estates #1 Lot 13, Block 2 Narrative & Permit Application Dear Mr. Cross: The proposed well and septic system will have very limited impact on adjacent properties for the following reasons: 1. The surrounding lots are large, allowing sufficient room for septic sites. 2. Immediate neighboring septic systems are all +30' distance. 3. Reserve space is adequate, due to absorption capacity and lot size. 4. Drainage will not be affected and is not a major consideration in our design. If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. \1996\96-079^-N^R.DOC RECEIVED SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM LEGAL: Raven Mountain Estates #1 Lot 13, Block 2 09/11/96 GENERAL 1. The well and septic plan are for a single family residence only. 2. The drawing and or site plan shall be a part of this specification. 3. All materials and workmanship shall meet the Anchorage Department of Health requirements. 4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer. 5. All excavations and depths are advisory and are to be verified in the field by the contractor to meet Municipality of Anchorage requirements. 6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi-family wells. 7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. 8. It is always recommended that a surveyor locate the nearest lot line position and the location of any easements. 9. Any remaining open test hole excavations shall be filled. SEPTIC TANK 1. Septic tank shall be 1,000 gallon, minimum, MOA approved. TRENCH 1. The trench is to follow the natural land contour to maintain uniform total depth of the trench bottom. The bottom of the trenches shall be level, plus or minus 1.5". The total depth of the trench excavation shall not to exceed 10' at any point. The effluent line within the trenches shall be laid level within 0.03'. The trench gravel is to be covered with typar fabric material. Soil or combination of soil and extruded board insulation to a depth of 3' or equivalent is to be placed over the leachfield. The area over the trench is to be finish graded to prevent ponding of surface water runoff. The septic tank and leachfield must not be closer than 100' to any existing private well, 150' to any Class "C" well, or 200 feet to any community well. 3. 4. 5. 6. RECOMMENDED LEACHFIELD DIMENSIONS: TOTAL DEPTH = 10' GRAVEL DEPTH = 6' under pipe, 2" over pipe TRENCH LENGTH = 32' TRENCH WIDTH = 3' SOIL RATING = 1.2 GPD/ft2 BEDROOM CAPACITY = 3 SEPTIC TANK = 1,000 gallons, minimum Twenty-four (24) hours notice required for all inspections. \1996\96-079a-spc.doc \ \ \ X [] - TEST HOLE ~, · - MONITOR TUBE ~ o - SEhNER CLEANOUT ~ ~ - WELL NO KNOWN CURTAIN DRAINS /- EXISTING L~CHFIELD W E L L/S E P T I C S I T E P LA N LEGAL: RAVEN MOUNTAIN EST ~1 LOT 13, BLK 2 OWNER: BUCKLIN CONTRACTOR: N/A JOBff 96-079A/DATE: 09/12/961 SCALE 1" = 60' EAGLE RIVER ENGINEERING SERVICES EAGLE RIVER, AK. 99577 (907) 694-5195 FAX: (907) 694-3297 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" ,Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: ,~,~.~.~---.~.-/ ~ DATE PERFORMED= LEGAL DESCRIPTION: ~ /~ ~ ~ Township, Range, Section: SLOPE 2 11 12 13- 14- 15 16 17 18 19 20 SITE PLAN WAS GROUND WATER ENCOUNTERED? S L IF YES, AT WHAT ~ O DEPTH? p E Depth m Water After ~ Monitoring? ~ Dale: ?-/~'-74 . Gross Net Depth to Net Reading Date Time Time Water Drop ) ~, ~:o¢ 7.. o//~" PERCOLATION RATE I ' I~ ~' (m~nutes/inch) PERC HOLE DIAMETER (.Z~ ,H PERFORMED BY: /~'f ,.T',"-/ ~= ~g r I ~~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE, DATE: /-~ ~ ~¢o/ EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 Eagle River, Alaska 99577 (907) 694-5195 ERES Project No.: 96-079 Calculated By: LB Date: 9/12/96 Legal: RAVEN MTN ESTATES #1 LOT 13 BLK 2 Single Family 3 Bedroom Dwelling TEST HOLE Deep Trench Subsurface Wastewater Disposal Field Water use at 150 gallons per bedroom = 450 gallons Percolation rate = 1.08 minutes per inch Wastewater application rate -- 1.2 gallons per day per square foot Required absorption area = 375 square feet Trench width ON) = 3 feet Gravel depth (D) = 6 feet Required length = Required absorption area / 2 / D Required length = 375 / 2 Required length = 32 feet Total Excavation Depth = e~8 feet / 6 Eagle River Engineering Services Louis Butera, P.E. P.O. Box 77329,~ (907) 694-5195 tel Eagle River, AK 99577-3294 (907) 694~-3297 fax January 29, 1997 Jim Williams Municipality of Anchorage Department of P.O. Box 196650 Anchorage, AK 99519-6650 Re: Raven Mountain #1 Lot 13, Block 2 RECEIVED d/~,~/ 30 1,997 D Munioipalit f opt, H al~h ?,o, Anchor n~ ~urvIce~ Dear Mr. Williams: This letter is in answer to your request for additional information after review of our application for a conditional Health Authority Approval (HAA) on the above referenced property. We have addressed your concerns in your order of presentation: 1. Directions have been added to the blue form. 2. Old septic system is currently serving in a one bedroom capacity, and will be abandoned upon upgrade this spring. 3. The address and lending institution have been added to the blue from. A copy of letter from National Bank of Alaska requesting conditional HAA is attached. 4. Well log attached. 5. Well was drilled at proposed location as shown on site plan that was reviewed for a permit issued September 1996. A revised site plan showing the actual well location is attached. 6. On behalf of the owner, Mr. Keith Bucklin, we wish to formally request a conditional HAA. A conditional HAA will allow construction after break up, as this is a very difficult area to access with the large amount of snow cover present. The road to the site is not fully maintained for conventional vehicle access. 7. Existing septic system is located approximately 85' from the new well. We are not requesting a waiver, as this system will be abandoned as soon as the construction of the upgrade is possible, in the spring of 1997. If you have any questions, please contact our office at 694-5195. Sincerely, Louis Butera, P.E. \ 1997\96-079A-LTR.doc MUNICIPALITY ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 076-031-14-000 Expiration Date: 12/1/2023 Legal description RAVEN MOUNTAIN ESTATES #1 BLK 2 LT 13 Site address 4900 CROW CREEK RD Girdwood AK 99587 Current property owner(s) ENGEBRETSON SARA LIVING TRUST X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: A Original Certificate Date: 9/1/2023 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 X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA ApprovM_June 2022 Development Services Department p P Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On-Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 076-031-14 Complete legal description RAVEN MOUNTAIN ESTATES #1; BLOCK 2, LOT 13 Location (site address) 4900 CROW CREEK ROAD *GIRDWOOD, AK Current property owner(s) SARA ENGEBRETSON 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS Day phone 907-227-8229 3. TYPE OF WATER SUPPLY: 0 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: 0 Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age NEW - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed 0 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 $ Z ��a Waiver Fee $ Date of Payment 0/x�F/z3 COSA # C--- Date of Payment Waiver # COSA ApplicaVon_June 2022 "9ll COSA Checklist Legal Description: RAVEN MOUNTAIN ESTATES #1; BLOCK 2, LOT 13 Parcel ID: 076-031-14 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA 9 Well log is filed with Onsite (or attached) Date drilled 11/1 /96 Total depth 77 ft Cased to LINK ft Q Sanitary seal is functioning correctly R Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 7/12/2023 Static water level at beginning of test 40.1 ft. Comments B. TANK DATA Measured operating fluid level in septic tank _ Date of pumping - ❑ Required maintenance completed, if AWWTS Comments: NEW SEPTIC TANK D. ABSORPTION FIELD DATA'J`S�- x/23' ! 2, Which system tested (date installe 7/ 25( R ALL standpipes present per recor d ng Total measured depth from grade 9.02 ft (max) Measured depth to pipe invert from grade 2.67 ft (min) ❑ N/A — pressurized field. FE -1 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 Comments/Deficiencies: Well production at time of test 7.0+ gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes 0 No R Coliform bacteria is Negative Nitrate 1.28 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L R Arsenic less than MRL (ND) Collected by GEG Date 7/12/2023 C. LIFT STATION ❑ Required maintenance completed Age of lift station NEW years Lift station material PLASTIC Comments: Adequacy test date N/A Results 0 Pass Fluid depth prior to test Water added - gal New fluid depth in Elapsed time - min in Final fluid depth - in Absorption rate 600+ gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 72 in Effective depth used 0 in Effective depth remaining 72 in COSA Checklist June 2022 q4 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' Community Sewer Manhole/Cleanout > 100' MN Yes if No ft M Yes if No ft Neighboring Tank > 100' 0 Yes if No ft Private Sewer/Septic Line > 25' Q Yes if No ft Absorption Field on Lot > 100' M Yes if No ft Holding Tank > 100' Fil Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' Q Yes if No ft no Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' DYes if No ft 0 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' Fm� Yes if No ft Surface Water > 100' 0 Yes if No ft Tank to Property Line > 5' Field to Property Line > 10' Water Main > 10' ❑o Yes if No ft Wells on Adjacent Lots: n Yes if No ft Private Wells > 100' Q Yes if No It Community Wells > 200' 0 Yes if No ft Q Yes if No ft Water Service Line > 10' ❑■ Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS DRAINFIELD IS 30'+ FROM SLOPES GREATER THAN 25% (OSV 201055) 'THERE IS INTERMITTENT SURFACE WATER ON THE SUBJECT LOT (NEAR THE WELL). 100'+ FROM THE NEW TANK AND DRAINFIELD 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 Gamess Engineering Group, LTD. (GEG) Phone Engineer's Printed Name Jeffrey A. Gamess 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 systems 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 systems; therefore, GEG makes no warranty (express or implied) regardin 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. COSA Checklist June 2022 907-337-6179 OF IT ::o ,J frei,A. _pjrness, CE 79 3 �p t UCENSN j'rofession000 #nEcxaaa ��OC�0000  MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section OV~,l~...~ll_ 343-4744 CERTIFICATE OF HEALTH AUTHORITY . APPROVAL FOR A SINGLE FAMILY DWELLING' Parcel I.D.# 076-031-1~' HAA# GENERAL INFORMATION Complete legal description Raven Mountain Estates #1 Lot 13, Block 2 Location (site address ordirections) Approximately 5.5 miles on Crow Creek Road in Girdwood, ,a~:,~he:junction of Crow Creek Road and Omega Court. Property owner Keith Bucklin Mailing address P.O. BOX ]41, Rirr]wn~a, Aw Lending agency_ NBA / C~-~istine Maztin Mailing address P.o. Box 107025. Anchorage, AK Agent N/A ~9%R7 Address Day phone 783-2419 Day phone 257-3611 99510-7025 Day phone Unless otherwise requested, HAA will be held for pickup. 3 NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well ×× Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72q)25 (Rev. 1191) Front MOA#21 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance With all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. *Conditional on septic system approval as per permit SW960308 to be completed 1997. Name of Firm Eagle River Engineering Services Phone 694-5195 Address p.o. P~× 773294, Eagle River, A/< 99577 Engineer's signature .... ~_~'~ .~'~-~'~" ' Date //¢~/~ 7 6. DHHS SIGNATURE Approved for '7~/~(~/~ Disapproved. Conditional approval for 2 bedrooms. bedrooms, with the following stipulations: The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA ~1  Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825 L Street, Room 502 · Anchorage, A aska 99501 · (907) 343-47z~:~ Health Authority Approval Checklist LegalDescription: ?n~ ~DOW:~JN ~/ ParcelI.D.: A. WELL DATA Well type Log present (Y/N) Total depth Sanitary seal (Y/N) Date of test Static water level Well production If A, B, or C, attach ADEC letter. ADEC water system number Date completed ///~//~ Cased to ~ 7 / Casing height (above ground) Wires properly protected (Y/N) /~ FROM WELL LOG AT INSPECTION '~ g.p.m. ~' ~ g.p.m. WATER SAMPLE RESULTS: Coliform -'~'- . Date of sample'. /Z//~/;/-/q'& / B. SEPTIC/bI~3t;~t~G TANK DATA Date installed ize Nitrate ?,95/~ ~6/Z.~ Other bacteria //7/¢i2 Collected by: Number of Compartments ~ Cleanouts (Y/N)~ Foundation cleanout (Y/N) Date of Pumping C. ABSORPTION FIELD DATA Depression (Y/N) Pumper (Y/N) Length Soil rating (g.p.d./ft2 or ft2/bdrm) Gravel thickness below pipe Effective absorption area Date of adequacy test System type ~present (Y/N). Results (Pass~ Fluid depth in absorption field before test (in.); Fluid depth (ins) Minutes later: Peroxide treatment (past 12 months) (Y/N) Total depth __ Depression over field (Y/N) __ For bedrooms after Immediately ' ·: Absorption rate = . If yes, give date 72-026 (Rev. 3/96)* Date installed ~ Manhole/Access (Y/N) High water alarm level at* Cycles tested Size in gallons *Datum ~, E. SEPARATION DISTANCES F. "Pump off" level at* SEPARATION DISTANCES FROM WELL ON LOT TO: septic/ho~:tfr~j tank on lot Absorption field on lot Public sewer main ~m. wcr/septic service line C/DO On adjacent lots On adjacent lots ~ / O 0 / Public sewer manhole/cleanout /'v/,,'~ Lift station Foundation ¢/~ / Property line '¢"1¢ / Absorption field ~ /~) / / Water.m..~J~/service line ¢'~ /~ Surface water/drainage ~-,/(~-~ / Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line '-~/~.~ Building foundation ¢'~'//~) / Water mairt/service line Surface water --~/~O / Driveway, parking/vehicle storage area Curtain drain //k/¢A/¢ /¢P/¢/.¢/~¢~:/~'~/~' Wells on adjacent lots ENGINEER'S CERTIFICATION ,,;:,: :..,!~? ._.:~ .?;¢~?~,~. I certify that I have determined thru field inspections and review of Municipal re~¢S'~hai the,a~'~'¢e?4)¢tems in conformance with MOA HAA guidelines in effect on this date Signature ;¢¢~7' ;*- Engineer's Name DCU/5 ~ O~[ ~, HAA Fee $ ~. ~ Date of Payment Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number ~ ~'AT E R WELL EC/ 8'r~,TE Of ; OEPART~IENTOF NATIIRAL:RESOURE~ ..... ', MotetJal; ~ Nee Cemefl~ ~ 0 ,Ir: , CT&ii Environmental Services Inc. CT&E Ret'# 966~8001 Client Name Eaglc Riwr Project Name/# Raven Mt. l-I~ights CliaVt Sample ID L13 Matrix D~'it~k-itg Wa0er Ordered By Sampig Remarks: Sample coite~tetl by: Bill Momblou Client Prt~ted Date/Time 12/~3/96 ~oRecleO Date/Time 12/t8/96 Recdved DatodTime 12/18/96 Techui~-,~l Dic~ior; Ste~len C. Ede 0.943 0 0.100 m9/k 0 coL/100mL $H15 45QO-H~f 10 rr~x 1Z/~0/96 EN8 SMl$ 9222B 12/1~/~ UEP CT&E Envi~onmenta! Services Inc, Laboratory Division Drinking Water Analysis Report for Total Coliform Bacteria 200 w. polt~ Anchorage, AK 99518-1605 RE,4D INSTRUCTIONS ON REt./ERSE SIDE BEFORE COLLECTING gAMPLE To/: (fl07) MUST BE COMPLETED BY WAT£R SUPPLIER PUBLICWATER/gYSTEbILD.# ~' t I I I I~ PRIVATE WATER BY.EM Fax: (907~ 561-5301 TO BE COMPLETED BY LABOR~TORY Analysis shows this Water SAMPLI~ to be: 5atisfaeto~ Uns~isFacto~ Smupte over 30 hou~ old, r~uRs may be unreliable Sampte too long in tramit: ~ample ~ou~d ~0: ~ over 48 hours old at examine[on to indicate reliable ~ul~. Plebe,end new ~mpt* via spe~ial del~v~7 mail. Date R~eive(I J/~ Time R'Ceiv,d .. . J ~-~ SAMPLE, DATE: ~-'~' j~ ~ Month D~¥ Year SAMPLE TYPE: ~ Routine CI Treated Water 13 Repeat Sample (for routine sample /~ Untreated Water with lab ret. no. ) CI Special Purpose SAMPLE LOCATION Collected By Analyti~l ~lethod: .~eY Membrane Filter Cl MMO-MUG * Number ofcolonies/100 mi. Result* Anatyst Client notified of unsatisfactory resulf~; Phoned Spoke with BACTERIOLOGICAL WATER AHALYSIS RECORB E · ~_ Colnnle~'t00 mi COLIFIRa',[ MMO.MUC Re~utt: Tot,at Coliform Membrane £iltet: Direct Count . F~al Coliform Confirmation Coliforml[ O0 mi [] Fl~x~d ~ ~ Member af ~ha SGS Group {$acje~t~, G~rv~tate de Survnillancel ENVlRONM~RTA[. FACILITJ[Lq iN ALASKA, C, ALIFO~INIA, FLORIDA, ILLINOIS. MARYLAND, MICHIGAN. MISSOURI. ~I~W J£RSEY, 0HJO. WEST VIflG/N~A ~ - TEST HOLE ~ · - MONITOR TUBE ~ o - SEWER CL~NOUT NO SURFACE WATER PROPOSED L~CHFIELD NO KNOWN CURTAIN DRAINS I- ~XlSTING L~CHFIELD W E L L / S E P T I C LEGAL: RAVEN MOUNTAIN EST #1 LOT 13, 13LK 2 OWNER: BUCKLIN ~&~'." CONTRACTOR: N/A J08~ 9~-07~A/~AI~: 0~/29/971 SOAk[ 1" = ~0' ~~~~;.,~":"~ EAGLE RJVER ENGJNE~RJNG ~ P.O. Box 773294 ~ ~AGLE RIVER, A~. 99577 ~'~ ~ · (907) 694-5195 FAX: (907) 694-3297 l atioz al January 9, 1997 Lou Buttera Eagle River Engineering P.O. Box 773294 Eagle River AK 99577-3294 Re; Bucklin Lot 13, Block 2 Raven Mountain Estates Girdwood, AK Dear Lou: As we have discussed, National Bank of Alaska wiJl accept a Conditional DEC approval of the well and septic on the above-referenced property. We would require an escrow ora minimum of one and one half times the highest bid to complete the septic system and bury the wires to the ~ house. If you need any further information, please feel free t6 give me a call at 257- 361 Thank you for your assistance. Sincerely, Christine S, Martin Assistant Vice President