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HomeMy WebLinkAboutMCKINLEY VIEW ESTATES BLK 2 LT 18McKinley View Estates Block 2 Lot 18 #051 - 792 - 22 72-013 (Rev. 9/91) MOA 25 Anchorage Page / of 1' Municipality of 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 9717 —1() PID Number ?)37 79Z /-- Permit Number: � ;,' Name 7Wastewater (' �1 11,/P;i" (.:p',4//;i 4, System: ' New ❑ Upgrade /r%/3 Address- .' �, , . ABSORPTION FIELD Phone:Deep No771i192- of Bedroom,: .1) Trench 0 Shallow Trench 0 Bed 0 Mound 0 Other LEGAL DESCRIPTION Soil Rating: 0, 6 GPD/Sq Ft. Depth to pipe bottom from original grade: ' l�' f A 'Tl ` $'.� '2' � GtFt Total D^,'.'*. `r^^' original pradei /I: '91 ° `el Gravel deptn oe eath pipe z.7 '%._5 Ft. 77,`.„,"`° r Lot: Block: r Subdiv�si n: �e �= I>�d(rl i.�,,. .. Township: ,%�/����io1`/// Range: , Lection: Fill added above original grade: f: Ft. Gravelravlength:a,, // ! .,t 375 (.. ?2: .'7 Ft. WELL: LI New ❑ Upgra Gravel_width, �jj �� w/ Ft. �ldthm //.1 o Number of lines: Distance between lines: //) Ft. Classification (Private, A,B,C). To>al-Bepth: Ft. Cased To: Ft. Total absorption �/ area: r�� SQ. Ft. / w m Pipe material: J) T 5/ rFdt3.4:,? Driller:'-- Date Drilled: Static Water Level: Ft. Inst�llQe: ) !z_tkey (y ;ti 7-ia 0(.vc Date installed: %rn - /1// a7 Yield; ='' GPM Pump Set at: Ft. Casing Height Above Ground: Ft. TANK I SEPARATION DISTANCES 'Septic 0 Holding 0 S.T.E.P. To From Septic Tank Absorption Field Lift Station Holding Tank Pubtic/Private Sewer Lines Ma ufacturgr �j 0 r/ 1f/��'* %%;�f� Capacity in gallons:' (K` /.,, / Well-/,�f) I "' / Material: // `%F Number of Compartments „;` Water O't' /rfil ri` `— -- LIFT STATION -�� Lot/ Line /` ` 1 p = Size in gallons: Manufacturer: . Foundation j/, t ! / ,; ! / ,_ _ "Pump on” level at: <` MrnJto f' level at: High water alarm at: Curtain Drain F / /%)6) 1 /07) ..r, _ _ ,__._. Pump Ma odel .-.,---" Elec rical Inspections performed by: Remarks: <?"/'a�r1Cr�;'-l..l`I1�` , I.'/f,�'�fr'f rif`/-�:�;%,� BENCH MARK Location and Description.. s / /js `' if/ 7441K:f" / //7X // Assumed Elevation: /fig, Ft ENGINEER'S SEAL OF /14 IN o° 00 cp E c,, '1✓ onev6 go 60 r e®a- mo..,,•0,,eas n t OSo .o®eamom aoa� ��<o . fg • ®d' 14% I<ennC- •• r s . d eaPF g F �e�pCc 71 LS,,,,..‹.*P;,0; ° ® v ��4,14" I � i j e Dates' 1st //i / 4% Inspections performed by: /11/ 2nd /y �a� �f /1/, /ei Department of Health and Human Services apprpv by: "t'°rte`"��� Date. 3'26-'675 Reviewed and approved 72-013 (Rev. 9/91) MOA 25 (S—BUILSYST_M P_AN Mc:MM....EY VIEW ESTATES SUBDIVISION, .BLOCK 2, 1.....011 1.8 Permit SW970033 PID#068-041-22 I H IF 19 497-1 A—C=50,8' B—D=54,5' AmE=67,9' D—E1=5 75' B—F=88,8' A—G=79,6' B-0=68,4 A—H=67A' B—H=94.8` ARY F WATER L11:1 4. AMIM3V, "d .995 766s, L(T 99,775 /16,' 98,93) cumm- "''.9',4- / '!,' f. V fri I , 0 1 11 I ! II ilY1,.. et i FILTER FASSISN M I 11 1 i 1 ' ":T:'.':.:':.::.: ..S '4 TANK , . , . 99,77) L 957oh„-' L J39 A 6„6.1 FINAL GRADE SCALF.Sr NTS K:5N1E9:HI M. C E.. 7 I_ 1 01 GA'''' 4'opbe,sslo''6' -gor -ow SIEWER R TREN011 1. - 37,5' FINAL GRADE FILTER SADRICNN .... TIUICTOR TUB- . 98,6C,TT, ••• -•-• ••••• • ... H. 94,75,111 SEVER ROCI‹ (...99.451) TRENCH 2 94,71 ............ .... MUNiTOR TUBE PREPARED I:URI EAGI...E RIVER GENERA1.... CHARLES FERRIN BOX 7709E7 EAGLE RIVER, AK 99577 CLEANOUT VARIES 5.2' VARSES :1"9471; (182.95 SEH 502 FET.I..D BOOKS COMPUTED: 1NIID ENGINEERING GOUNDARY: DRAWN: KMD STAKING' B. JOHNSON 'EcKEll KMD 20441 PTARMIGAN BLVD. AMASS: EAGLE RIVER AK 99577-8736 DWG. FILE: GRID: AGA° FITE: 97066. DWG JOS No' 97066 907 'AX 907696— PERFORMED FOR Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST t✓er em era LEGAL DESCRIPTION:�%%C/lie/ Vea)1 t. 52 Z./STownship, Range, Sect COMMENTS /ave//y / -n [i W� [p✓,l7%1C� 7ag /' 5o•,ne San//en se5 SLOPE WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water After Monitoring? Pr Wit, Kenneth M. Duf �, s2'1110 '.� CE7116 4�" 2'1p��iy Q DATE PERFORMED: `•4 J��'��U rfit ion: 913 SITE PLAN N Reading Date Gross Time Net Time Depth to Water Net Drop / 3-6-98 /: /o — Z,7" ._... Z (: 2.6) /O i. 75764 s/8 ,. 3 X- i; Zl — �,t _ 41 1:31 /0wtin 7 /6.. �!/iio„ S t:3a — — G 1; yZ. /0 min 7%8` 78 „ A /;53 /Da.,,'n 76/x" 578 " * tA)O-4-er Acta f_al PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN 3 FT AND FT PERFORMED BY KD !;f? ez-r- ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE 72-008 (Rev. 4/85) I 4/e144V-111 D� CERTIFY THAT THIS TEST WAS PERFORMED IN DATE MM Cote MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW970270 DESIGN ENGINEER:KND ENGINEERING OWNER NAME:KINTZ JAMES R OWNER ADDRESS:P.O. BOX 770927 EAGLE RIVER, AK 99577 PARCEL ID:05179222 LEGAL DESCRIPTION: MCKINLEY VIEW ESTATES BLK 2 LT 18 LOT SIZE: 30800 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 //--/3.a77 / v DATE ISSUED: 8/22/97 EXPIRATION DATE: 8/22/98 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: ISSUED BY: DATE: DATE: 6/"/92 X N D ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)696-6111/FAX (907)696-8111 July 31, 1997 Municipality of Anchorage Dept. of Health & Human Services On -Site Services Section P. O. Box 196650 Anchorage, Alaska 99519-6650 Subject: McKinley View Estates S/D Block 2, Lot 18 -New Septic System Permit Gentlemen: Following a request from the owner, on June 30, 1997 we dug two testholes for the proposed new system. The area and lot is served by community water. The results of the percolation tests are attached. The proposed system will be placed northwest of the house. As indicated on the site plan there is sufficient grade to maintain a gravity system. There is a gentle slope from northwest to southeast towards Baron Drive which will not affect this lot. A 1,000 gallon septic tank will be installed. A splitter will be installed to insure even flow to both trenches. As indicated by the site plan drainage arrows, natural drainage is away from this site and will be maintained after construction. There is no surface water within 100' of the proposed installation. There are no known curtain drains within 50' of the proposed installation. No wells exist within 100' of the proposed installation and the community well is over 200' away from the proposed site. This upgrade should have no adverse effect on development of adjacent lots. If you have any questions, please contact me at 696-6111/FAX 696-81LNv1RO NM11L . MONImN � t y Of IORATA L SERVICES DIV/S' eE CM Respectfully submitted, AUG 0 199/ KM Engineering Kenneth M. Duffus, P.E. attachments: On -Site Well and Sewer Application Wastewater Absorption System Details/Site Plan Soils Log / Percolation Test WASTEWATER ]IS. SAL SYSTEM/SITE PLA\ McKINLEY VIEW ESTATES SUBDIVISION, BL❑CK 2, L❑T 18 PROPOSED REPLACEME SEPTIC LOT 17 ALL LOTS SERVED BY COMMUNITY WATER SYSTEM. NO SEPTIC SYSTEMS WITHIN 200' OF PROPOSED WELL, EXCEPT AS NOTED. NO PRIVATE OR PUBLIC WELLS WITHIN 200' OF PROPOSED SYSTEM EXCEPT AS NOTED. Air OF ... AL4 \ KENNETH M. DUFF01 1 i CE 7116 ; Wa \,d p4DFEssioo\' LOT 7 LOT 8 DESIGN CRITERIA 1. 3 BEDROOMS X 150 GAL./DAY/BEDROOM = 450 GPD 2. SOILS RATING: 22 MIN/INCH = APPL. RATE 0,6 GPD/SF 3, 450 GPD/0.6 GPD/SF = 750 SE 4, 750 SF /(2' x 5') = 75'L 5. MIN, DESIGN SIZE = 2 TRENCHS - 37.5' LONG x 2' WIDE x 5' DEEP 6. DEPTH OF GRAVEL BELOW PIPE IS 5'. 7, TOTAL DEPTH OF SYSTEM IS 8,0' FROM ORIGINAL GRADE. NOTES: 1. TIE INTO TRENCH AT ENDPOINT. 2. INSTALL 1000 GALLON SEPTIC TANK. INSULATE TANK IF <4' COVER. 3. INSULATE TRENCH WITH 2" HD BURIAL FOAM IF <3' COVER. 4. CONTRACTOR WILL ENSURE MAXIMUM 2% SLOPE INTO SEPTIC TANK. 5. CONTRACTOR TO INSTALL SPLITTER. PREPARED FOR EAGLE RIVER GENERAL CHARLES FERRIN P.O. BOX 770927 EAGLE RIVER, AK 99577 KND ENGINEERING 20441 PTARMIGAN BLVD EAGLE RIVER AK, 99577 (907)696-6111/Fax (907)696-8111 DATE, 7/31/97 SCALE' 1' = 100' DRAWING # 97066-51 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: 61. 1, Leer 6e-/-1 �Cv/ l LEGAL DESCRIPTION: C n/P.y ViElt)k .6/42/,./ATownship, Range, Section. SLOPE .,ce1rn xi V►lRCAA figio6.6 ovis coo ..7021 00 46- rill are• - Tare 101s aa:,/ s keitweth M. t ItE 74 DATE PERFORMED: COMMENTS IJdLG _pre-s_24s-^ WAS GROUND WATER ENCOUNTERED? S IF VES, AT WHAT /./1 p Dale. 74/97 Depth to Water Aher Monitoring? .7l SITE PLAN N e 3 Reading .1 Date Gross Time Net Time Depth to Water Net Drop / 6-30-27 2;210 _. /D.� — 7'z„.. s 6/z” �,. 8 3 • z:37 `/ 2.:H] JO min ce 1/8" 3/3" 5 2:4/8 — 57/5- Z : `J 9 /0 H1/-7 _ /D )14 /.1 1/O/c eeWe r-/ "- 6 t/2.., / /- c44„,4 y//3 " 7 9 8 3:0 rf 9 3 ' Lc 3: zv - /Ds,ti;h 3/14— .. z/8 " /O PERCOLATION RATE 5RD (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN 7 FT AND J FT Vtv� -['o P,S� IVTy PERFORMED BY VILELn'?eGr r• I r •. 1k[ s CERTIFY THAT THIS TES1 WAS PERFORMED IN ACCORDANCE WIT 11 ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE I 72.008(Rev 4,851 (77 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR:' -/.14 fiL✓ j 6e -s7 `�Gt¢/lam/ LEGAL DESCRIPTION: �e'42/e�/ VIEW Gil • d nrptu J/ Lir 1497,2 ''`•; � S•weee•iiT ®F • Kenneth D® �♦ Vie• C 7M.16 • • � 8� pAOFESStflN� DATE PERFORMED: ��@asQ.@•;'3.'+`�' Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water After Monitoring? Dr /VD /Va S L 0 P E Date. 74 47 /-/e SITE PLAN N e S //a Reading Date Gross Time Net Time Depth to Water Net Drop / 6-3.0-97 2 : 2/ 71/2. 2 z : 3/ /6,02.7 7'S/4. " 7/ , „ 3 2:32 — 7" — D 7/''' A.62._ s • 2: 3 - 2:53 /O,4,.: -r 79// ' `z ., 7/i�„ 1 7 Z:5 I - A' 3:0j /0,4;,,,7/4," W aJP.y 4-1-44-6/ PERCOLATION RATE 1 (mmutesJmch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND COMMENTS Mole. preSoaked Fwiar 70 +e$�IY7C/. 6 FT PERFORMED BY f J f7 e'llr eer(M ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE 72-008 (Rev. 4i85) /(enrie7I i14 iu.t s CERTIFY THAT THIS TEST WAS PERFORMED IN DATE Municipality of Anchorage Development Services Departme 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 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 051-792-22 COSA # 0 OL4 1 4 1. GENERAL INFORMATION Expiration Date: MOROI S'. en Complete legal description Lot 18, Block 2, McKinley View Estates Location (site address) 21326 Baron Drive Chugiak, .Alaska Current Property owner(s) Ron & Kathy Salmon Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 99567 Day phone (907) 688-9029 PO Box 671042 Chugiak, Alaska 99567 Day phone Jeannie Erickson/Prud.Vis ta Day phone (907) 277-7388 16635 Centerfield Drive, Suite 103 Eagle River, Alt 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 A Well Public Water System TYPE OF WASTEWATER DISPOSAL: ❑ Individual On-site in ❑ Individual Holding Tank 0 © Community On-site 0 ❑ Public Sewer 0 The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Pinard Engineering Name of Firm Address PO Box 871347 Wasilla, Alaska Paul E. Pinard, P.E. Date 1'27,2768':.1 Engineer's Printed Namei-1C, Li‘4 , 451:° 1 • °°'q r .1-; e?: Ptpi ) ��O° .eac - OR�t � , ..' t 4 ff;oo lot- on E. W° ow /tit, ys'5�:,1% P. t1u8 fes. �'ktttrdi / t?t1 Phone 99687 (907) 357-3647 5. DSD SIGNATURE XApproved for 3 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other (Rev. 11/05) Original Certificate Date:/ -24: 08 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: A. WELL DATA Well type A Date completed _ Lot 18, Block 2, McKinley View EstateparcellD: 051-792_22 If A, B, or C provide PWSID #210697 Sanitary seal (WN) Total depth ft. Cased to FROM WELL LOG ft. Date of test Static water level ft. Well production 9 p m WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate mg/L Arsenic: • ug/L date of sample: B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Tank size 1000 gal. Number of Compartments 2 Foundation cleanout (Y/N)Yes Depression over tank (Y/N) Nn Date of pumping 11 /26/08 Well Log (Y/N) Wires properly protected (Y/N) Casing height (above ground) AT INSPECTION ft. g.p.m. in. Other bacteria colonies/100 mL Collected by: Date installed 11 /97 Cleanouts (Y/N) Ye 21 High water alarm (Y/N) NA Pumper JRs Pumping C. ABSORPTION FIELD DATA Date installed 11 /97 Soil rating (g.p.d./ft2 ornZt 0 - 6 Length 75 ft. Width 2 System type Deep Trench ft. Gravel below pipe 5 25 ft. Total depth9 _ R ft. Eff. absorption area 788 ft2 Monitoring tube Ye q Depression over field Nn Date of adequacy test 11/25/nR Results (Pass/Fail) Pnna Fluid depth in absorption field before testy in. Water added e480 gal. Elapsed Time:90 min. Final fluid depth 58 4 An ter 24h Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) None Knnwn If yes, give date For 3 bedrooms 72 New depth] 8 in. D. LIFT STATION NA Date installed Size in gallons Manhole/Access (YIN) 'Pump on" level at _ in. 'Pump oft' level at _ in. High water alarm level at in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: NA — PUBLIC WATER SYSTEM — NO WELL ON LOT Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer /septic service line Holding tank Animal containment areas Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 10 + Property line 101+ Absorption field 101+ Water main 101+ Water service line 101+ Surface water 1001+ Wells on adjacent lots 200' + SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 101+ Building foundation 101+ Water main 10' + Water Service line 101+ Surface water 1001+ Driveway, parkinglvehicle storage 51+ Curtain drain None Known Wells on adjacent lots 2001+ on Lot F. COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that 1 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 Paul E. Pinard, P.E. Date 12/2/08 ,.eQOw •fes n� n O DO •'' V� " 0� 4 7e`L (cote' • 14 Al • e• • 1"1;C•cr11<'L. Mord :r; V •1 Fi E•4! £e'i •�!�� 1(�I Via. •i�orESr�y. a COSA Fee $ 424 - Date -o-Date of Payment ic210 Receipt Number //51-114 3 (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number PINARD ENGINEERING Paul E. Pinard Registered Engineer/AK & ID P.O. Box 871347, Wasilla, AK 99687 (907) 357-ENCR(3647) ON-SITE DRINKING WATER AND SEWER SYSTEM ENGINEER'S EVALUATION PROPERTY DESCRIPTION: LOT 18, BLOCK 2, MCKINLEY VIEW ESTATES This property Is developed to serve a single-family residence with a total of 3 bedrooms. Owner's Name(s): Owner's Address: Buyer's Name(s): Buyer's Address: Ronald & Kathleen Salmon PO Box 671042 Chugiak, Alaska 99567 John & Shannon Post NSITE DRINKING WATER SYSTEM: R' XX This property is served by a Public Water System approved by ADEC. A recent drinking water sample was tested at an ADEC certified laboratory and was found to meet current ADEC drinking water standards for total coliform bacteria. NOTES: ON-SITE WASTEWATER DISPOSAL SYSTEM: __A new wastewater disposal system has been Installed. Based on periodic visual observations, it appears this system was constructed In general conformance with current 18 AAC 72 regulations and ADEC polities. This wastewater disposal system was installed by an ADEC Certified Installer and approved by ADEC. ef XX The existing wastewater disposal system was tested in accordance with current MOA and ADEC policy and found to be operating satisfactorily. The readily identifiable features of this system were observed and documented. XX It appears that this system meets requirements of the ADEC and the MOA, based on record Information at the MOA. This system does not meet the horizontal separation distance requirements of 18 AAC 72 regulations and conformance with the vertical separation requirements of these regulations, to seasonal high groundwater and impermeable sayers, is unknown. Components are unknown and it Is undocumented with ADEC. NOTES: This report does not constitute a guarantee of any kind, explicit or implied, as to the future performance of this water supply or wastewater disposal system. It does accurately portray the conditions found on the date they were tested and/or documented. DATE / Zl2-lO9) PINARD ENGINEERING P.O. Box 871347 Wasilia, AK 99687 (907) 357-ENGR (3647) ADEQUACY TEST LOCATION: Lot 18, Block 2, McKinley View Estates APPLICANT: Ronald & Kathleen Salmon PO Box 671042 Chugiak, Alaska 99587 SEPTIC TANK TYPE/SIZE: Stee1/1000 Gallons, per MOA Records ABSORPTION SYSTEM: Deep Trench, per MOA Records DAILY FLOW: 3 BEDROOMS x 150 GAUBR • 450 Gallons TEST DATA JOB NUMBER: 08-270 DATE OF TEST: 11/25/08 FIELD STAFF: PJ Pinard NUMBER OF BEDROOMS: 3 SCUM: 0.0' SLUDGE: Minimal NEEDS TO BE PUMPED: Yes No XX CURRENTLY IN USE: Yes XX No Time Time SAS MTI SAS MT2 PM Flow Rate (GPM) Volume Cumulative Volume Septic Tank Septic Tank Soil Absorption System 1'sm Comments 3:30 5.3 (GALS) (GALS) Liquid Level • A Level Monitor Tube 1* A SAS Level Monitor Tube 2' A SAS Level 3:45 5.3 - -4.0' - 4.5' - 0.5' Start Flow -Meter 369460 4:00 5.3 80 80 4.1' 0.1' 4.9' 0.4' 0.5' 0.0' 369540 4:15 5.3 80 160 4.1' 0.0' 5.4' 0.5' 0.5' 0.0' 369620 4:30 5.3 80 240 4.1' 0.0' 5.9' 0.5' 0.6' 0.1' 369700 4:45 5.3 80 320 4.1' 0.0' 6.0' 0.1' 0.9' 0.3' 369780 5:00 5.3 80 400 4.1' 0.0' 6.0' 0.0' 1.2' 0.3' 369860 80 480 4.1' 0.0' 6.0' 0.0' 1.5' 0.3' Stop Test - 369940 REC Date Time SAS MTI SAS MT2 11/25 7:30 PM 5.01-1.0' 1.51-0.0' 11/26 3:20 PM 4.5'/-0.5' 0.61-0.9' 'ALL MEASUREMENTS IN FT. TEST: PASSED XXX FAILED COMMENTS: There was 4.5' of measurable liquid In one SAS MT and 0.5' in the other, prior to beginning the test With the addition of 480 gallons to the system (more than the design daily flow), the levels rose to 8.0' and 1.5', respectively. Recovery measurements stowed satisfactory absorption. Reviewed by: Paul Pinard Date: 11/29/08 11/26/2009 09:59 9073449821 JRs Pumping PO Box 773415 Eagle Rims AK 99577 (907) 6944454 IOitllna Information si Prudential Real Estate 18835 Centerfield Drive Eagle River, AK 99577 (907) 889.8478 Eve's direct One (Job Site Intimation Jennie 21328 Baron Drive Chupek. AK 99587 (907) 227-7380 JRS SEPTIC Job O..afplmi 10009 P.O. Number. Totem Net 30 Sang: Dawn -pawn wP gook 1 Cram Sleets: Job Canneole: Homestead Rd PAGE 01 Service Agreement Number. 027798 Opfer Date: 25 -Nov -2008 Service Date: 28 -Nov -2008 12:0 Technician: Mike Tex iv 0 J99 TYPE Repeat Map Grid: 21- - Last Service Unknown never been there serviced and chedied tater levels normal beck Rushed twice -tank cleaned up real well Additional Location Comments moor! ;r v enruncr ee brio 3 bdrm yellers h color vinyl siding ranch Septic in the back yard HAS PRUDENTIAL SIGN W/ SOLD ON IT IN DW Service Type Septic Service 1251( MINI St MOK* Qty Prka Each Tax? 1 3165.00 No Gallons Planned: 1000 Gal. Actual: Hose Length: Double Tank: O — Pump System:12 Baffles Inlet: O Baffles Outlet: 0 Extension Actual 3185.00 No.Taaa is Total farmed Clergy': 3165.00 Actual Charges: Taxable Total 30.00 Tax Total 50.03 ORM Total 319:.00 Customer amen to The terms erd cadges teem. THIS ISA 9INOiNO AOREEJI ENT. ItttrAkiAmdliCkiraritA no. 20o� Accepted by JRa P aapee ore Paroled For you eased come tem a we accept American Empress, DCuwr. Nes and West Cant payments aver en phare. Aller 30 Days mount wW be tuned ever 10 COLLECTIONS. 530.00 For NSF Chequ Reamed 4k'-64-1 13144 nazi .1 Sal MI/►f nr me• .....n r• 0 • ,1 VA 0: . 707198 • , tTo••' T"1 6ian "4 * i .. • • an• •NN•. M�.O«,.S � • .. •• • (' 416.•Q • I' Q.• •.• 1. L idle" • • • • ; ' •AS4PUILt • t • I Atttbr Sir ion •invarmincinnven i Mad ttw sargzital at •• de at Alia as fA tma ens IMISSIWI artsegnm emit ill Ts: • 2I MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING HAA # PAw1 Parcel I D # % ci 1. GENERAL INFORMATION Complete legal description 7 Location (site address or directions) %V%`f% / /7 Property owner ;946 °` ¢% r. Day phone Mailing address 7/,)r) •/ 7 Lending agency Day phone Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. 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. 4. 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. 72-025 (Rev. 1/91) Front MOA x21 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. 1 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. Name of Firm Address KND Engineering 20441 Ptarmigan Blvd. Eagle River, AK 99577.9736 Phone Engineer's signature Date 6. OHM SIGNATURE Approved for bedrooms. Disapproved. —•. a:P�OF I, ,.;41t) .ba b 491.►+...'( '; *'10 P9•♦ N ••••.••••of l i••"••••••••«••Y••.e••.r behr i+••" V4 .ntKenneth M. Dutfus w o #•� % CE7116 « "�.' ' Q••n••• Conditional approval for bedrooms, with the following stipulations: Additional Comments By.��1/2C�i C ��� Date ` i( CAUTION 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 (Hay. 1/91) Back MOA #21 RECEIVEL1 Municipality of Anchorage SEP 04 DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division MUNICIPALITY OF 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 34324% 4 Health Authority�Approval Checklist q Legal Description: ko+ l8 7 K/�'/ z C�✓J(L'l/ UtPte) C61, Parcel I.D.: 051 7F2-22 A. WELL DATA Well type A If A, B, Log present (Y/N) Total depth Sanitary seal (Y/N) Date of test Static water level Well production , attach ADEC letter. ADEC water system number 2 C CQ Date completed Cased to Casing hei. t (above ground) Wires p •perly protected (Y/N) AT INSPECTION FROM WELL LOG WATER SAMPLE RESULTS: Coliform Nitrate Date of sample: B. SEPTIC/HOLDING TANK DATA ,/ Date installed /t / 97 Tank size //V 0 Number of Compartments Z. Cleanouts (Y/N) 1` g.p.m. Other bacteria g.p.m. Foundation cleanout (Y/N) Y Depression (Y/N) /Y High water alarm (Y/N) /V,4 Date of Pumping / .A.) Pumper C. ABSORPTION FIELD DATA Date installed/ ///97 /re4 eAe-s Length 37.5' ea- Width / Effective absorption area 78 7, 5 Monitoring Tube present (Y/N) Y Depression over field (Y/N) A/ Soil ratim (g.p.d./ft2 orft bdrrn) System type De`o Z Gravel thickness below pipe 3 Zs+ Total depth 9 3 9• Date of adequacy test //ffu✓ Results (Pass/Fail) Fluid depth in abs rption field before test (in.); Fluid depth (ins) Minutes later: Peroxid reatment (past 12 months) (Y/N) 72-026 (Rev. 3/96)* For bedrooms Immediately after gal. water ded (in.): Absorption rate = g.p•d• If yes, give dat D. LIFT STATION Date installed Size in gallons / Manhole/Access (Y/N) "Pump on" level at* "Pump off" level at* High water alarm level at* *Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot / On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer /septic service line Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation /U / Property line // f Absorption field v Water main/service line Z5 + Surface water/drainage //),0 f' Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line /0 f Building foundation /0 Surface water /OD / f Curtain drain /uD' f 200 /4 Water main/service line 25 4 Driveway, parking/vehicle storage area F. ENGINEER'S CERTIFICATION 25' Wells on adjacent lots 200 4- I certify that I have determined thru field inspections and review in conformance with MOA HAA guidelines in effect on this date. Signature 1> Engineer's Name nJ/ eno e % M •f /,v- ft(. -.s Date ,/✓��� of Municipal records that,Soke ,K systems are ve:..°"It 4 1 O ,, owIP co mr0. . o' * ; 9I � 9 ,t 71`Z ,t KennethM.f 4QC - .. CE7116 t r,pSS P,,�**r Waiver Fee $ HAA Fee $ �? ` ) Date of Payment / /L-9 //c/i< Receipt Number 72-026 (Rev. 3/96)* Date of Payment Receipt Number