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HomeMy WebLinkAboutMCKINLEY VIEW ESTATES BLK 3 LT 5McKinley View Estates Block 3 Lot 5 #051 -792-33 Efr--\ ; t_ Municipality ofAnchorage Development Services Department- • / Building Safety Division . On-Site Water and Wastewater Program, 4700 Elmore Road \./ P.O. Box 196650 Anchorage, AK 99507 Page WNW ctanchorage.ak.us (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. SW090072 PID Number. 05149243 -1 of "am" Warren & Betty Johnson Wastewater System: 0 New 0 Upgrade Address P.O. Box 671115 Chugiak, AX 99567 ABSORPTION FIELD Prone NMMard Barron 3 0 Deep trench 0 Shue Truett D Bea 0 Mond 0 Dover LEGAL DESCRIPTION Sal""n° GPD,FI' Tats Oegn mmtarts oebe fl. BootLoc Subaon 3 5 vWMcKinley View Estates Dann m ten m from aiph grate FI. Grew depth beneath ppe FI Ta.nehr Range SernaL Fa aaoea tem angora pwe FI. Grams Length n. Well: • New • Upgrade Grew mem FI Number a vee Distance between Inn Gauacetan (Pm'eu. A B. C) Existing Tom Depn FI. Cased M FL TOM wwrpbm area CO Pre Main! Dela Dam Dmi,o Sint Waif LM FL InMMIr Stuart Gilbert Contracting, Inc. Dele inched 6/6/2009 Yield GPM Pump Sea a F,. Casing Her Above Grove. FL TANK SEPARATION DISTANCES 0 septic ❑ Holding ❑ S.T.E.P. ❑ Other: To From Septic Tank Absorption Field LM Station Holding Tank uaic/PrMle Sewer sine Th'ni4aa"" Anchorage Tank fly 1,000 Gs Wee >100' >100' N/A N/A >25' Motional Steel Number O Comp.tnrt. Two (2) Surface Water >100' >100' N/A N/A LIFT STATION La Line >5• >10' N/A N/A Sea GM Man.Ma.rr Faton'al >5' >10' N/A N/A 'Pmp on' eve at In Pump ate leve at n High hew Mame a In. Cahn omni None Noted Pump Mane a Moats Eiwvcal matron* patented by Remanu Septic Tank and Two Post Tank Cleanouts Placed Uner BENCH MARK This Permit Existing Septic Tank Pumped, Crushed and Lo(abal dna pesrwn Bottom of Siding. Backfilled On Site. Auunwd Ewvabun 100.0 FT Inspections performed by: S. Gilbert Dates: 181 6/6/09 kligninti +d,e` OF AC1 r, • s; eeegoA,q. 07 * : • 49� j� .e *��j «e«.«. ») 2nd 6/6/09 Development Services Department Approval Conditional Approval Date: 171St en ;mom I. *,e. CE-4381 •�f l eI Z• S E 1 :OF ,\\Val\%� ' ros.. ... ANDERSON: 42 r : t •• Alfa 044 ar SStO 4s'�� - -- Reviewed and approved by: v !/ Date: 7 ' Al//�� f O (x« 0406) / Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904 Permit Number. SW090072 MCKINLEY VIEW ESTATES SUBDIVISION BLOCK 3, LOT 5 3 23.E 63.72' ton s23" CO — Cleanout S — Septic Vent FCO — Foundation Cleanout Page 2 of 3 PID No. 051-792-33 Existing 101' Long x 5' ,!'i Effective Depth Absorption Trench to Remain in Service. I;I Existing Tank Pumped. Crushed and Backfilled. NOTE: Septic Tank Replacement Only Under This Permit. 4e • S : 49th •..i s g : }t� gip, MICHAEL C. ANDERSEN C, j • . •• No. CE -4391 ..,sssssssssss PLAN AS BUILT NOTE Not a Surveyed As Built. Locations May Not be Exact. SCALE 1' = 40' Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number. SW090072 PID No. 051-792-33 Page 3 of 3 1 U 00.1 N 00 /M�.MJmorq iti 000 Galton Septic Tank 95.2 9 .05 NOTE: Septic Tank and Two Post Tank Cleanouts Placed Under this Permit. Existing Absorption System Connected for Continued Use. PROFILE AS -BUILT No Scale Connect to Existing Absorption Trench MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 6 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: May 26, 2009 Expiration Date: May 26, 2010 Permit Number: SW090072 Parcel ID: 051-792-33 Legal Description: MCKINLEY VIEW ESTATES BLK 3 LT 5 Design Engineer: 0014 ANDERSON ENGINEERING Site Address: 022745 SENECA CIR Owner Name: WARREN AND BETTY JOHNSON Lot Size: 30039 SQ. FT. Owner Address: PO BOX 671115 Total Bedrooms: 3 Permit Bedrooms: 3 CHUGIAK , AK 99567 - This permit is for the construction of: ❑ Disposal Field ❑✓ Septic Tank 0 Holding Tank 0 Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Date: _972-i/2 �- 2 Parcel I.D. 051-792-33 Municipality of Anchorage Development Services Department Building Safety Division • On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 www.muni.org/onsite (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Property owner(s) Warren and Betty Johnson Day phone Mailing address P.O. Box 671115 Chugiak, AK Zip Code 99567 Site address 22745 Seneca Circle Chugiak, AK Zip Code 99567 Legal description (Sub'd., Block & Lot) Lot 5, Block 3, McKinley View Estates Legal description (Township, Range & Section) Lot Size 30.039 Sq. Ft. Number of Bedrooms 3 THIS APPLICATION IS FOR (0 all that apply): THIS APPLICATION IS AN: Absorption Field ❑ Initial 0 Septic Tank 0 Upgrade 0 Holding Tank 0 Renewal 0 Privy 0 Private Well 0 Water Storage 0 I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. 04-12.441. (Signature of property owner or authorized agent) Permit/Rush Fees: 153oWaiver Fees: Date of Payment: O — /?r-° — 0'7 Date of Payment: Receipt Number. 0 3 9 5" 9 4 Receipt Number. (Rev. 11/05) ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 622-7773 522-6779 (FAX) May 15, 2009 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 5, Block 3, McKinley View Estates Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The septic tank on Lot 5, Block 3, McKinley View Estates Subdivision is failing and must be replaced. We are proposing to replace the tank with a new 1,000 -gallon steel septic tank to serve the three-bedroom home on the lot. We are therefore requesting a permit be issued for the construction of a new septic tank to serve the home. The attached Site Plan and backup documentation identify the location and configuration of the existing septic system and the location of the new tank. The area is served by the AWWU water system and no conflicts exist with water services or water mains. The new tank will be placed more than 10' from the water service on this lot and those in the area. The existing tank on the lot will be properly disposed on the property. The drainage patterns will be maintained after construction. The ground surface on the lot slopes to the west at varying grades. The new septic tank will be constructed near the location of the existing tank and as parallel with the slope of the land as possible in conformance with Municipal requirements. If the tank is constructed in accordance with our design the following statements apply: 1. The tank, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The tank, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The tank, if constructed as designed, will have no adverse impact on reserve Lot 5, Block 3, McKinley View Estates May 15, 2009 Page 2 of 2 space, either surface or subsurface, on any Tots located in the area. 4. The tank, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, ilLG-ad £Q...2„ Michael E. Anderson, P.E. Attachments car: is is Ma7 I° • i 49;^ •i;` •• NOTE: Area Served by AWWU Water System. AREA MAP SCALE 1' = 100' HOMESTEAD ROAD 4 114% 14/ 49th• • • • • 1410043. c. N1OZRSIN• •No. ¢-4381 j�� MCKINLEY VIEW ESTATES SUBDIVISION BLOCK 3, LOT 5 LEGEND - co — Cleanout SV — Septic Vent FCO — Foundation Cleanout NOTE: Septic Tonk Replacement Only Under This Permit. • 11 .... 17 Z 49th !^1 .j •is e. 1. MICHAEL E. ANDERSEN ♦ C • trw2s23.E 163.72. Existing 101' Long x 5' Effective Depth Absorption Trench to Remain in Service. 0(2) sV Pump, Crush and Abandon Existing Tonk In Place. Place New 1,000 Gallon Septic Tank, Foundation Cleanout & 2 Post Tank Cleanouts. NOTE: The Terrain Within 100' of the Lot Slopes to the West. No Breaks in Grade Greater than 25% Were Noted. SITE PLAN SCALE 1' = 40' ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 5, BLOCK 3, MCKINLEY VIEW ESTATES SUBDIVISION GENERAL: 1. The scope of this project includes the pumping, crushing and backfilling of the existing septic tank on the property and the procurement and placement of a new 1,000 -gallon septic tank at the location shown on the Site Plan. Work also includes the verification of the integrity of the foundation cleanout and placement of two new post tank cleanouts. The new delivery line must then be tied into the existing absorption trench line. The new septic tank must be placed 100' from all private wells and any surface water in the area and 10' from the water service line from the well. A minimum of 4' of cover is required over the septic tank. 2. Construction shall be in accordance with the approved site plan, 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 all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. The Contractor must also verify the location of wells in the area and assure that the separation distances are met. 4. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Development Services Department Building Safety Division On -Site Water and Wastewater Program for system installations. Owners installing their own systems must receive prior approval from the On -Site Water and Wastewater Program before beginning system installation. SEPTIC TANK INSTALLATION 1. A new 1,000 -gallon septic tank must be procured from an approved source and installed at the location shown. 2. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. Lot 5, Block 3, McKinley View Estates May 15, 2009 Page 2 of 3 3. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 4. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. 6. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drainfield. 7. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAINFIELD CONSTRUCTION: - EXISTING ABSORPTION TRENCH TO REMAIN IN SERVICE 1. The drainfield shall be constructed to the dimensions shown on the design. The bottom of the trench shall be within 2" of level. 2. Distribution piping must be placed level with perforations down atop a level bed of drainfield rock. Rock should then be placed over the pipe to provide a minimum of 2" of cover. 3. A silt barrier or geotextile fabric must be placed between the drainfield rock and the natural soil backfill. 4. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. 5. Contractor shall verify the septic tank and drainfield are a minimum 100' away from any private water wells in the area, 150' from a Class "C" Well or 200' from any community well. 6. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. 7. Grade area surrounding the absorption trench to drain away. 8. A minimum 2' of accepting soil is required below the drainfield rock for a 5' wide trench. All pockets of unacceptable materials must be removed and replaced. Lot 5, Block 3, McKinley View Estates May 15, 2009 Page 3 of 3 MATERIAL SPECIFICATIONS: 1. Septic tanks must be constructed by a municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). 5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer. 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve. INSPECTIONS: Municipal Ordinance requires a minimum of two inspections. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection. Contractor or owner shall provide a copy of all field survey layout and construction notes for use in preparing the certified as -built of the completed system. • MUNICIPALITY OF ANCHORAGE 7 ® ► ,� \ A'825 DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ' ENVIRONMENTAL ENGINEERING DIVISION L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME f B/ 1 /6' (,i' �'&1Gf.'te PHONE c4 - /79 [g NEW LI UPGRADE MAILING ADDRESS 5 r 5 = >a,,l ; ,, 6.1) ,9 f� ? f/113 feu, / t:, � : tE r d l� 1 / LEGAL DESCRIPTION '` L -3-- I?i t A ,= nit Iy re W [ hi f i LOCATION II? /Vet' Crrr'k [ilii 11 /eff JO /+ , fh/.,®1 ,r'it /G. tI(ifr,i /y $ iI NO. OF BEDROOMS 5 U DISTANCE TO: Well (tlj'!M1i)6ubir }t° Absorption area ,_ , Dwelli r PERMIT NO.,, _ )? t/ t.g 6/n /"�J ;d r/S 1— 2 Manufacturer , - Material,: ,. No. of compartments -; cn Liq. capacity in gallons r/ 1L tj' IF HOMEMADE: Inside length Width Liquid depth ® Y JUz DISTANCE TO: Well Dwelling PERMIT NO. ®z B S h Manufacturer Material Liquid capacity in gallons TILE DRAIN FIELD TRENCH DISTANCE TO: Well {C.ypieyGlforlf/" Foundation . , p u length of lines //9f Material beneath tile Nearest lot line i�,1/.> Trench width .gt '3G inches ,,rr^ i. Y✓/ inches PERMIT NO0 ,, R d® Distance between lines rz. ' Total effective absorptionfarea /O/1i/% No. of lines Length of each line'Total i�'! Top of tile to finish grade 9, , e nU' } ' SEEPAGE PIT Length Width Depth PERMIT NO. Type of crib Crib diameter Crib depth Total effective absorption area DISTANCE TO: Well Building foundation Nearest lot line J J Class Depth Driller Distance to lot line PERMIT NO. 1 DISTANCE TO: Building foundation Sewer line Septic tank Absorption weals) OTHER , d.: / t'•e �- PIPE MATERIALS ,.f L. C d' 4 SOIL TEST RATING11 Ai / d:, rd. '6%trl !�-- INSTALLER Kim i �- REMARKS =Eli. iiiimm IIIIINIF �■ .._. oA I IpAr. ism APPROVED DATE LEGAL 4 �. J ti °f .c ?: ). 0,- l r' lfl.F' ,Ire;r ��i f:; ,./ , `%.5'. 72-013 (Rev. 3/78) 1.3 V-4 IC kir* F," -.1C:1-1 IR: FR Li E.• DEPARTMENT OF HEALTH HND ENYIRONMENTHL PROTECTION 825 /L' STREET.. HNCHORHGE, AK. 99501 264-4720 EF.: R._ fr-4 fo �mr EE EWE: tm if - FERMI T f-PERMIT NO ( 821089 ) APPLICANT BILL GROUSE %S&S ENGINEERING SRB 196X 9957 694-2979 LOCATION LEGAL L583 MCKINLEY VIEW ESTATES LAT SIZE 999999 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING (SQ FT/BR)= 280 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: �UF"Th IL_EDNe-111-1== 7.11_01_ 11-7-R7FRVEEL_ THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). Fr.E7:47AUIFAEE> ���EF:6== ftLICEPOtra PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE �14 CD < :2? I> P4 El Ci':: -I- ff.D P4713 EE F9.1E:071.10_0 1A-7nEDI BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTIOR MINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR H PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM H PRIVATE WELL TO H PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLET%OU OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. ��"Ir EE I�F.E� ��R7.3.:LEENE24/EEF! I CERTIFY THAT 1: I GM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF HNCHORHGL 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 2: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. ISSUED BY~ 0 & E ENLiNEERING & DEVELOHMENT CO. Russell Oyster 694-2774 Performed for: Name. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 SOIL LOG Earl EIIIs 688-2280 Po6A-Lev v" .65 cc.) p41E/v r Tel. No Mailing Addressfr' L .6-" Legal Description: or , x 32 3 544-2- e /;2,<. 92774- L C y Vi( Depth Depth (feet) Soil Characteristics 0 1 / e-4,7 2 3 4 5 f-7 6 7 -- .3/44 le' CZ) e, 43 6749- 7/.4E4. 4 117:-) / 15A/ Tie/ 8 9 10 11 12 tqeprrem 4 <f-%. 7-- 13 14 15 16 7' PLOT PLAN /Jo 56114E- PERC. TEST "L4sr t) .44 / t7- / F Ground Water Encountered: Yes No V If yes, what depth Proposed Installation: Seepage Pit Drain Field Comments. cri P. V0•0 caeow4. u Ellis 41;1 00 NO. 7 / 45-E cG0%) .e-o 13 44%. FE SSW Performed by: a41 t• 14g !../ Date' Parcel I.D. Municipality of Anchorage Development Services Department Building Safety Division Onsite Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING 051- `442--P)3 1. GENERAL INFORMATION Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address COSA# cr)lp D5' f l Expiration Date: / 2 - i' 4/ - 07 McKINLEY VIEW EST.; LOT 5, BLOCK 3 22745 SENECA CIRCLE • CHUGIAK, AK 99567 MARDI & AMBER HUTCHENS Day phone C/0 AGENT Day phone EVA LOKEN w/PRUDENTIAL VISTA Day phone 689-6476 16635 CENTERFIELD DRIVE * EAGLE RIVER, AK 99577 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well 0 Individual Water Storage 0 Community Class "A" Well l� Public Water System 0 TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank Community On-site Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered In the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or 8 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, 1 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 GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD. SUITE 101 • ANCHORAGE, AK 99507 Phone 337-6179 Engineer's Printed Name JEFFREY A. GARNESS. P.E. Date Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system In accordance with ADEC and MOA DSD Guidelines 6 Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily Identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report Is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party Is not authorized, nor will It confer any legal right whatsoever. 5. DSD SIGNATURE Approved for 3 bedrooms. Disapproved. Conditional approval for Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory (Rev. 1145) rLicht bedrooms, with the (flowing stipulations: r Arsenic Advisory Maintenance Agreements Supplemental Engineer's Reort Other Original Certificate Date: / 2 - 1 14 - OG Municipality of Anchorage Development Services Department Budding Safety Division On-Sde Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.arg/onslte (907) 343.7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: McKINLEY VIEW EST.; LOT 5, BLOCK 3 Parcel ID: A. WELL DATA Web typesus 'x' If A, 8, or C provide PWSIDff 210097, Web Log (WN Date completed Sanitary seal i. ares property protected (Y/N) Total . _,. l• Cased to ft Casing height (above ground) in FROM WELL LOG AT INSPECTION Date of test Static water level Wed production WATER SAMPLE RESULTS: ft. gpm Coliform colonies/100 mi. Nitrate mg /L Arsenic: Date of sample: B. SEPTIC/HOLOING TANK DATA Tank Type/Material SEPTIC/STEEL Collected by Date installed ft. g.p.m. colonies/100 ml. 10/20/1982 Tank size 1000 gal Number of Compartments Cteanouts (YIN) YES Foundation cleanout (Y/N) YES Depression over tank (WN) , NO High water alarm (Y/N) Date of pumping 1t 1410C Pumper re. n9 C. ABSORPTION FIELD DATA N/A Date installed 10/20/1982 Soil rating (g.p.d./ft'or t bdrtr 300 System type TRENCH Length 101 ft Width 3 ft Gravel below pipe 5 ft. Total depth '7 ft. Eff. absorption area 1010 ft' Monitoring tube YES Date of adequacy test 10/5/2006 Results (Pass/Fad) PASS Fluid depth in absorption field before test 45.5 in Water added 460 gal. Depression over field NO For 3 bedrooms New depth 53 in Elapsed Time: 375 min. Final fluid depth 50 in, Absorption rate >a 450+ g p d Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN if yes, give date - p) e- so 614 0 1 10 6 .. re0-1. 0 20 64-cc4. Aal .3 CI' (14 S4Sreal n: on.. TV P E—So4-t.. 5Z.S,-Fs (re -Sot D. UFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on" level at in "Pump off" le = • High water alarm level at in Cydes tested Meets alarm & circuit requirements? Datu E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot On adjacent kits Absorption field on lot On adjacent lots Public sewer main 1c sewer manholeldeanout Sewer /septic service line Holding tank ment areas Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Water main 5'+ Property line 5'+ Absorption field 10'+ Wens on adjacent Tots 200'+ 5'+ Water service line 10'+ Surface water 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Water service line 10'+ Curtain drain NONE KNOWN F. COMMENTS G. ENGINEER'S CERTIFICATION Building foundation 10'+ Surface water 100'+ Wells on adjacent Tots 200'+ 1 certify that 1 have determined through field inspections and review of Munidpal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. 4 J° y�erpZ+ s. Engineer's Printed Name JEFFREY A GARNESS ,•�+'• CE -7953 ;'\ Date 11--A1O� 1,� �Cp�ol•irnWd� Water main 10'+ Driveway, parking/vehicle storage 10'+ COSH Fee $ LRO . U O Date of Payment/0C- Receipt ayment/dv) G /UG Receipt Number (a V t-� 5t/ (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number iLec•14. 2UU61:12:36PM3073gGarness Engineering Group, Ltd•tc JRe Pumping TO Box 773415 FA* Rihr, AK 99577 • (907) 694.6454 bsinlno information Games Engineering Group 3701 E Tudor Road . Suite 101 Anchorage, AK 09507 (907) 337.8179 1 (Job Site Information Caleb • 22745 Seneca Circle Chugfak, AK 99567 (907) 337-8179 Additional Location Comnten s Blue Home wNra Septic Ca left side of Home Pipes are © grotmd.Level at Under Metal Caps Job mak: 1000g P.O. Number. Tarns: Net 30 No.6539 P..1 e2 Me5r1� vr �.sl 133 solver: Kar11a MT book Croaasaeetr. Homestead Road Job Commode: Service Agreement Number: 021902 Order Date: 28 -Nov -2008 Service Date: 04 -Dec -2006 12:0 Tectnidam. Don 3►r3-7gQ6 •: Tart %:• • Jeb Twee Re�at Map Gad: 21- - Last Sent Unknown REC: Jeff to tank Inspection .. w. h e tank had rocks. lots of solids Gttle water , . . Dtexam: 31D6m.me121902 p URI i�blz*+et'1- 1 ,g ?Ur -.p 1St- Cay`+ �tef`I puMOa `u•"W Zrr E oSfb Sella Type . Qty Pace Each ✓ SeptIcService 1SK 1 5135.00 V Show-tp Fee 1 350.00 NEED DRAWN Gallons Planned: 1000 Gal. Actual: $512 Tax? No No Hose Lengttx Double Tank 0 Pump System: 21 Baffles Inlet 0 Baffles Outlet: O Extension Actuat 3135.00 350.00 Estimated Charger Asad Mapes: NenTaabk Toed 5165.00 Tst.66 Total 10.00 Toot Total 30.00 Grand Teed 1165.00 Customer vs b 6n enna add conditions shown. THIS ISA BINMNO AGREEMENT. Stgnaka and TW. of Custarw R.proeennti,. Dab Accepted by JRa Pumping Dae Accepted For your added cmwe$.nee In, exepk Amsrkae Erproas. Moat, Viae and Master Card paymanta ever 1. plow MIN 30 Days nub ala be toned ever to Co$edona_ 523.00 Fu NSF Chadd RWund. -ie pts i ASSUILT I HEREBY CERTIFY THAT 1 HAVE SURVEYED THE FOLLOWING DESCRIBED PRO?ERTY, AND THAT NO ENCROACHMENTS EX(ST EXCEPT AS INDICATED. 17 IS THE RESPONSIDILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS WHICH DO HOT 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. I Alex. L-wJE Exits C,,ue1rr; .Afle$1. Flea, T16i VO Vncir.e. •, 41 12-A2104 40 t /Cr Tim af,...p- c,n ' SEWARD A ASSOCIATES USD SURVEYING 694-O829 e�E OF....4 • %P4 9 T ....:7 • • i y 1 .‘%.4bt1721lgAs - • - MUNICIPALITY OF ANCIIORAGE Page 1 of 1 To: GEG 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.muni.org/onsite (907) 343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET Legal description: McKinley View Estotes,_Biock 3_Lot_5 The attached paperwork has been reviewed and is being returned for the following reasons: Original signature or stamp missing on _ Calculation error in design. Additional soils information needed. _ Water monitoring results inadequate. Discrepancy in information submitted. Topographic information missing or inadequate. Incomplete; missing Incomplete; missing _ Additional adequacy test information needed. _ Water sample unacceptable. _ Measured/proposed distances/dimensions missing. _ Locations of all soils, percolation and water monitoring tests not shown. __ Proposed system too deep for soils information submitted. Well log required. _ Omission in narrative. _ Insufficient fill over tank or field._ Other. Please show the location of the water line. •— Sat A- act1ED Ar-Goicr to -n. i idt *4/ vinzew Lae Name of reviewer: Deb_Wockenfuss Date: 12/11/06 t d c. A-nd of Please supply the necessary information and re -submit your request LEAVE THIS FORM ATTACHED TO THE PAPERWORK http://gayness/phprojekt/mail/mail.php?mode=viewRaction=showhtml&ID=64346 12/11/2006 ASBUILT I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: .ilo.!.r✓«v /i�!/eli-vial f�9, IoTS�=.� ' AND THAT NO ENCROACHMENTS 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. ..449.9freiv tor g.,ro SEWARD h ASSOCIATES LAND SURVEYING 694-0829 SCALE: /'=j'o DATE: GRID: est," FB: DRAWN: set OF ?it 1 •.• —4-• t e CO • ce49TH • r • • Duane /Ark Sows .tk is 2• b'eG,t ,RAS v ws 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 Parcel I D # C\' 19-1,-:213 1. GENERAL INFORMATION HAA# Complete legal description Lot 5; Block 3; McKinley View Estates Location (site address or directions) NHN Seneca Circle, Chugicak, Alaska Property owner Mike Fallon 688-5960 Day phone Mailing address P.O. Box 670278, Chugiak, Alaska 99567 Lending agency Day phone Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 �J 3. TYPE OF WATER SUPPLY: Individual well Community well Public water XXX 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 xxx 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 921 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. Name of Firm 5 s iiV(�TNEkRiiVG Phone Address 77034 Eagle River Loop Road No, 204 Eagle River, Alaska 99577 Engineer's signature Date 6. DHHS SIGNATURE Approved for ,2 /— 3 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: By. Additional Comments 2-0 CAUTION,:r Date 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- 02:7 (110v. 1/01) Back MOA#21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description �t L -VV. 3 fALIH)�� Parcel I D A. WELL DATA Well type !''c If A, B, or C, attach ADEC letter. ADEC water system number 244 Log present (Y/N) Date completed Total depth Cased to Sanitary seal (Y/N) Wires properl Date of test Static water level Well flow level FROM WELL LO gpm Driller Casing hei ected (Y/N) oC 5-,7= c o z , z :u m o T (715 `z (.9 ry U S 0 (7!o z AT INSPECTION g Artini SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot ; On adjacent lots Absorption field on lot A ; On adja Public sewer main P sewer manhole/cleanout Sewer service line WATER SAMPLE R TS: Petroleum tank Coliform Nitrate Other bacteria e of sample: Collected by B. SEPTIC/HOLDING TANK DATA f{� Date installed Cleanouts ON) High water alarm (Y& Tank size \o(>a z-- Compartments -Z— Foundation Foundation cleanout O/N) 1l Depression (Y/ Alarm tested (Y/N) JIB .A� Date of pumping / o - 2-1 —% z— Pumper - 1. L� rS Pav L SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot G'® On adjacent lots To property line 1 a Surface water/drainage 72-026 (Rev. 7/91) Front Foundation Absorption field - Water main/service line CONTINUED ON BACK PAGE C. LIFT fiTATIoN Date installed Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y/NJ Manufacturer Manhole/Access (Y/N) - �PGmp off" level at Cycles tested SEPA.RATJ )WDT TANCE FROM LIFT STATION TO: Well on lot On adjacent lots D. AII3SCIRPTION FIELD DATA Date i nstallr-.d \ ._, Length \ S? 5 Width Total absorption area l o t c> k Depre3sion over field (Y0 Results (pajls?fail) PP,4 S Peroxide treatment (past 12 months) (Y/ _J Soil rating Surface water Systern type -R-E- Gravel thickness 5 t Total depth -_2, r Cleanouts present &N) 7 Date of adequacy test - /0 ` 9 - for Nf "1 f. K4o k± na If yes, give date bedrooms SII:PAI(ATION DISTANCE FROM ABSORPTION FIELD TO: Well onlot Gc / On adjacent lots 4/4 Property line t'\ To building foundation To existing or abandoned system on lot t 4- On adjacent lots 3 Cutbank_ ' t /k Surface water \ Li-"c714- Curtain c?tk- Curtain dram E. ENGINIIEER'S CERTIFICATION tt Water main/service line _ i 0__ Driveway, parking/vehicle storage area I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effec gpthe date of this inspection. Signature Engineer's Name Date t S ls: S ENGINEERING 17t):4 yi'.ajk giver h€ia lawracl loo„ 204 Fact^ ttimr,Mstta 9 'i HAA Fee$ _1_76 Date of Payrnent _,/ta'Z% a/ -/-- Receipt Number 24440 C 72-026 (Rev. 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number CF la LA DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE DISTRICT OFFICE 800 E. DIMOND BLVD., SUITE 3-470 ANCHORAGE, ALASKA 99515 Mr. Ray Shafer S & S Engineering 17034 Eagle River Loop, Suite 204 Eagle River, Alaska 99577 October 26, 1992 1144 CV\ - WALTER J. NICKEL, GOVERNOR (907) 349-7755 SUBJECT: McKinley View Subdivision Class "A" Public Water System, PWSID 210697 Dear Mr. Shafer: I have completed a review of this office's files concerning the monitoring status of the above -referenced Class "A" Public Water System and found the following: 1. The last satisfactory Total Coliform Bacteria Sample results was submitted to this Department on September 11, 1992. This does meet the provisions of 18 AAC 80.200(a), of the State Drinking Water Regulations. 2. The last inorganic Chemical Contaminants Sample results were submitted to this Department on February 4, 1991. This does meet the provisions of 18 AAC 80.200(a), of the State Drinking Water Regulations. 3. The last Radioactive Contaminants Sample results were submitted to the Department on June 10, 1992. This does meet the provisions of 18 AAC 80.200(a), State Drinking Water Regulations. 4. The last Organic Chemical Contaminants/Volatile Organic Chemicals were submitted to this Department on June 23, 1992. This does meet the provisions of 18 AAC 80.200(a), State Drinking Water Regulations. Issuance of this letter does not imply that the above -referenced Class "A" Public Water System is in compliance with other provisions of the State Drinking Regulations. If you have any questions on the above information, please do not hesitate to contact this office at 349-7755. Sincerely, iiihd 4 Michael Lu Environmental Eng. Asst. II panted on recycled paper o y C.0 MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I D # HAA # /9/1(3 l/nc77 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 5; Block 3; etMcKinley View Eatatea Location (address or directions) NHN Seneca (b) Property owner AHFC #43074 Telephone : (home) Business 5 A1-1900 Mailing Address .520 Ea6t 34th, Anoho'rago., A!aA!2a 99503 (c) Lending Institution Telephone Mailing Address (d) Real Estate Company and Agent 7A('K GIHTTF COMPANY/Lynda &anne_+c Address Telephone I' . ,. i r. ,, r.. 694-5500 23ge Rvven, AEabh'c 99577 (e) Mail the HAA to the following address: (or check here I , if hold for pick up.) List contact person and day phone number below: S & S ENGINEERING/694-2979 17034 Eagle Riven Loop Road, Suite 204 Eagle Riven, Alae(za 99577 2. TYPE OF RESIDENCE Single -Family? Number of bedrooms 3. WATER SUPPLY Individual Well E Community Q Public E Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 (Rev. 7/88) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of Phis Health Authority Approval 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. ` Name of Firm Telephone _ /171- Z r/' Address S & 5 ENGINEERING 1Road-No Date Eagle River, Alaska 99577 6. DHHS APPROVAL Approved for \ bedrooms by Approved ___ Disapproved 71/ Conditional Terrns of Conditional Approval NMI CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated 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. 7/88) Back Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 343-4744 Legal Description A. WELL DATA Well Classification i If A, B, C, D.E.C. Approved4DN) y Well Log Present (Y/N) Date Completed Yield Total Depth Cased to Depth of Grouting Static Water Level Pump Set At Casing Height Above Ground Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot ; On Adjoining Lots t To Nearest Edge of Absorption Field on Lot h ; On Adjoining Lots To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected by ; Date Water Sample Test Results Comments USS. 2- b6 B. SEPTIC/HOLDING TANK DATA moi, Date Installe&0 ,'' /631— Size 1 Glc3/4:3 No. of Compartments `2--- StandpipesaN) °( Air -tight Caps¢PN) y Foundation CleanoutdDN) / Depression over Tank (Y,0 Date Last Pumped 1 7--ZI—'Z9 Pumping/Maintenance Contact on File (Y/N) a ; for 1,3 Holding Tank High -Water Alarm (Y/N) /A Temporary Holding Tank Permit (Y/N) ��A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: I i To Water -Supply Well `�'� To Building Foundation' t To Property Line i p To Disposal Field G To Water Main/Service Line l�I k To Stream, Pond, Lake or Major Drainage Course Comments (2- S Pu?1 "J ST„ 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 7--OG56 /4Wy Type of System Design F t`F-1-� I-‘ Dater Installed Vo, _ 2�, — ell-- _ Length of Field t c=)11 Wids:h of Field t Depth of Field Gravel Bed Thickness Square Feet of Absortion Area �- 1 o Statndpipes Present N) Depression over Field (Y/LEA Date of Last Adequacy Test — i- --7---'t c') Results of Last Adequacy Test ____c�/5'r(��5F" -To{+--�-T �R--- SEPARATION DISTANCE FROM ABSORPTION FIELD: l To Water -Supply Well 9-c- I h._ To Property Line sr To Building Foundao To Existing or Abandoned System on i nt �� ; On Adjoining Lots To Water Main/Service Line 10 taream, Pond, Lake, or Major Drainage Course To II)riveway, Parking Area, or Vehicle Storage Area Comments T'. ;qty° %; ki/471 To Cutback (if present) C=C) Ali" D. LIFT STATION Date:: Installed Size Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. "Pump On" Level at - I-ligh Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments "'`Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and inspection. Signed ._ _, 4X i 4.1TA�il1-� Company 17134 Einigie River i-oop itoa i tvk . `4ui¢ Eagle. giver, aM . !; W j MOA Nrr Date Receipt No Date of Payment /Gz - ��'"� (2/ s 2 p Amount $ % 2 72-026 (Rev. 7/88) Back Receipt No. HAA guidelines in effect on the date of this ngi npp'$$''rSeal n ,Ofnl_ i• 1 t bort it $11'0t' <a4 : Rh.0 ` „ p *Auto nFin Waiver Fee: $ Date of Payment Page 2 of 2 .r1.1 q• • d , 1.1 ta..1 .\\1;\ DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE WESTERN DISTRICT OFFICE 3601 C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 S & S Engineering 17034 Eagle River Loop, Suite 204 Eagle River, Alaska 99577 STEVE COWPER, GOVERNOR December 20, 1989 563-6775 PWSID: #210697 According to the records on file in this office, the McKinley View Subdivision Water System is in compliance with the State of Alaska Drinking Water Regulations. VEC:bas Sincerely, VERA E. CRAIG Environmental Field Officer MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 5; B2oeh 3; McK-Lr ey Heights Subdtivision. Location (address or directions) Amon.son Road behind Chevron (b) Applicant Name Gany Moon Applicant Address P.O. Box 670430, Chugiak, A.2a6ha 99567 (c) Applicant is (check one): Lending Institution 0 ; Owner/builder E ; Buyer 0 ; Other 0 (explain); Application Date Telephone: Home 688-4265 Business 694-2885 (d) Lending Institution Secun-i.ty Pctei La Mortgage Telephone Address ATTENTION: Bob Hess/2550 DenaP.i, S.neet, Suite 615, Anchorage 99503 (e) Real Estate Company and Agent none/kefU.nanc..t.ng Address Telephone (1) 'The HAA to the following address: S & S Engtineen,i.ng SRB 196X Eagke Raven, Alaska 99577 2. TYPE OF RESIDENCE Single -Family n Multi -Family 0 Other Number of Bedrooms 3 3. WATER SUPPLY Individual Well Community 0 Public 0 Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4.. SEWAGE DISPOSAL Onsite t(1 Public 0 Community 0 Holding Tank 0 Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 5. ENGINEERING FIRM PROVIDINL .JSPECTIONS, TESTS, FILE SEARCH, DA'k.. AND INFORMATION 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 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. S & S ENGINEERING Telephone 6 9V-2?� Name of Firm Address SR B 196X pa+s+++ 001,00 A. Sheller t w r .+ Ho. 145. ." 4 7E • 6. DHEP APPROVAL // `/ll Approved for /(3lbedrooms by iv2�� . Date 7/776 Approved K Disapproved Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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. Page 2 of 2 72-025 (11/84) A. WELL DATA Well Classification t & he -\\G°I�IUNICIPALITY OF ANCHORAGE (MOA) c�PAck(EALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 nix 264-4720 Legal Description. �1 S 1'1-1L� to t-ValUthIS If A, 8, C, D.E.C. Approved (Y/N) Well Log Present OAP to Date Completed A4',izOJX, J' 72 Yield Total Depth 0,4. Cased to D 1 ,,,----"Depth of Grouting --- Static Static Water Level / Pump Set At U' Casing Height Above Ground G -w, -1-i / 2- " Sanitary Seal on Casing MN) Electrical Wiring in Conduit ON) Depression Around Wellhead (Yrp Separation Distances from Well: / To Septic/tield+rrg Tank on Lot it%.5- ; On Adjoining Lots lOa f To Nearest Edge of Absorption Field on of /'L'8 ; On Adjoining Lots / 7 4-- inl To Nearest Public Sewer Line To Nearest Public Sewer� -T r Cleanout/Manhole P To Nearest Sewer Service Line on Lot 'ZS , Water Sample Collected by S ` Stii0Ctvitri -t"- ; Date (1:7' 0 - B6 Water Sample Test Results 5 G j r/ Comments B. SEPTIC/FhtGTANK DATA Date Installed 7-14"81 Size /®i No. of Compartments Standpipes(( /N) Air -tight Caps (eN) Foundation Cleanout ®N) p 30-8/ - Depression over Tank (Ye pate Last Pumped /Q Pumping/Maintenance Contract on File (Y/N) Holding Tank High -Water Alarm (Y/N) ;for Temporary Holding Tank Permit (Y/N) A/A Separation Distances from SepticAHefdirrg-Tank: To Water -Supply Well / Or i To Building Foundation / C /4- To Property Line In r To Disposal Field 55 i -t. To Water Main/Service Line/ /1-/-0 �To Stream, Pond, Lake, or Major Drainage r� A Course Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA 7±7 Soils Rating in Absorption Strata BS se_ Type of System Design _ _ p A�_iJrf✓t EL t Date Installed 1-14- el/ Length of Field L/7 Width of Field _ 1120// Depth of Field 5- 1 Gravel Bed Thickness Z Square Feet of Absorption Area 3"3 5 4. Standpipes PresentrG%N) Depression over Field (Y(1f1� Date of Last Adequacy Test A%EA^- Results of Last Adequacy Test L -Ess 7-7-%7+,.j 2 7/2-$. 01--(0 Separation Distance from Absorption Field: To Water -Supply Well / '7 r k To Property Line _ /o To Building Foundation 1715 To Existing or Abandoned System on N Lot %1 ; On Adjoining Lots 3rd /15 II-- / To Water Main/Service Line /4- To Cutbank (if present) /A To Stream/Pond/Lake/or Major Drainage Course LI To Driveway, Parking Area, or Vehicle Storage Area /35 1:1-7 Comments / D. LIFT STATION Date Installed ' i q Size in Gallons S--00 .1,1-, "Pump On" Level at Sy %P O1` High Water Alarm level at Tested for N A Dimensions 5b0 TAAML. Manhole/Access Pt. H. "Pump Off" Level at 5Z" ice Electrical Codes /N) Comments VentO/N) L q " T P of f--1, tl. Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. S & S ENGINEERING Date JI 11 _ 19R SR Company B 196X "EMOA No SS' -d' EAGLE RIVER, AK 99577 Receipt No ," ' Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) •a. nw waw•+*.• '7.4/0 WO A. Shwfor No, 11.5/4 Time Time e (VI 2 Date Date Date (M. IA- q.1-q1A 1 A 1-1 Inspector Inspector Inspector I Comments Conditional Approval miim F.NmIr, -HON ---" oil '' c Date Sewer Installed Permit No.Septic .`-•1 \ CY-.•,°1 Atcy-o.c-a. Tank Size /0 (3 Holding Tank Size Soils Rating Well To Absorption Area Well to Tank Well Log Received APPLICANT FILLS OUT LOWER HALF ONLY (,) 6=1-4-0-5..„.05..A; C (4.4 f V,,,,,L,,,,,,',,,1 (....--( 5 G , cii-_,,5, LE 10-4;,--f, ' -i .1. (1, 17 Phone (;ci Property OwnerC-7\75)1,Z_C C... C ,. Mailing Address VO (10 '4. ()() Buyer Address Lending Institution 1L 1,,,„:-..„ -C :_, j.,,,„,,A (-24 c .(z.,.'-- - - Address ",-- s' /....(a)c-1 `--- { -1:4 7-1- -'1-- '( 64,A Phone Phone / Realty Co. & Agent i..,c' WIe',5 -1, (5"..- C---' i.„(...-4_ ,--(4/-6.1 (., /A: -5,--5-5- e Address Legal Description (JTZ,f .:',:. 4::., VAA (---L .- Street Location Type f Residence ri'Single Family LI Multiple Family No. 0 Other of Bedrooms ... Water Supply 0 Individual ATTACH WELL LOG. A well log is required for all wells drilled since June •'''OMrili.inity 1975. For wells drilled prior to that date, give well depth (attach log if LI Public ULilbt f_ available.) Sewanjp Disposal tndividual E Public Utility D Holdihs Tank Year Individual When Connected ACCOMPANY EAC 5- Installed REINITIATED. to Public Utility' 1 BFOUEST DU:0HE NIOCF,CtiaNG CAN MOTE: ME INSFUlTION ''M..:: OUT