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Home My WebLink AboutHILLSIDE VIEW LT 3Onsite File Hillside View Lot 3 #015-242-36 Updated as-built survey deferred to time of COSA under OSP201311. T Municipality of Anchorage 01 On -Site Water and Wastewater Section - (907) 343-7904 age.1 of 3 ON-SITE WASTEWATER INSPECTION REPORT ©Cr -2.0Z OSP201311 015-242-36 Permit Number. PID Number. 0 Dwelling: 7 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New *Upgrade Name RENE BAIRD ABSORPTION FIELD ❑Deep Trench ❑Wide Trench ❑ Bed ound Site Address 7500 ALATNA AVE. *ANCHORAGE, AK 99516 ❑ Other Phone Number of Bedrooms Soil Rating original grade 907-227-2568 5 GPD/SF �Totaldepth Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot HILLSIDE VIEW; LOT 3 Fill added above original gr Ft. Gravel length Ft. Township Range Section - Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total orption area Number of trenches Dist. between trenches From Tank Field Tank Line Ft2 Ft. Well 100'+ TANK M Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer GREER TANK Capacity 1500 Gal. Surface Water 100,+ 714 Material Number of compartments Lot Line 51+ NA . HDPE 2 Foundation *1 Q'+ LIFT STATION Manufacturer Capacity Remarks OLD TANK DECOMMISSIONED PER UPC Gal. Electrical installed by PER CONTRACTOR *5'+ TO DECK PILES Alarm location PIPE MATERIAL House to tank D3034Tank to D3034 drainfield Installer WILCO EXCAVATION Drainfield D30341EXISTING CO/MTD3034 Inspector JEFF GARNESS, PE BENCH MARK (Assumed elevation) 100.00 ft Inspection1st 9/3/2020 - Location and description nd es: 2 TOP OF MH 3d _ 0'_ ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp o OO� Conditional Approval: Date o� OF o � 1. •.'T_ off:"• /7H '•.��0 . .......... .........� Septic System V �� Approved �t'A Date 1 5 �O D et`frey . Gar ess. �0 9 ((// C&;gyp s go o Note: this approval does not include well permit requirements.no nAeccesa4��0o0000��0 tNev uwuzrits) * 0_n y dak_j WJ—lbu�'Qj S...S" be- i rav deal �t r -DH_11�CoS flair C -D V PE SP NUMBER: RECORD DRAWING PARCEL 4 NUMBER: OSP201311015-242-36 TOP OF MANHOLE = 100.00 FINAL GRADE = 99.64-99.81 MH ST2 2" INSULATION PER CONTRACTOR TOP OF TANK AT INTLET = 95.72 TOP OF TANK AT OUTLET = 95.71 NEW 1500 INVERT OF BUNG AT INLET = 95.11 GALLON H. D. P. E. INVERT OF BUNG AT OUTLET = 94.89 SEPTIC TANK 'Rot , Ar A��,TT ��,TT�+ ��TT g� �TT �TT y� A • q 1�ESS'1�11._iIN""l� ING G�� VP9 Ltd =........... .. .............. ........ .....M ... ENGINEERING, SALES-, CONSULTING. J/ 3701 E. TUDOR ROAD SUITE 101 -ANCHORAGE. AK 99507 • PHONE (907) 337-6179 • FA% (907) 338-3246 - WEBSITE:-gamessengineermg com ;, • `+„ PREPARED FOR: PHONE NUMBER: PAGE NUMBER: 77TYTt� DOUGLAS BAIRD 907-227-2568 3 OF 3 �j �'; A. Game s w= Ar LEGAL DESCRIPTION: DRAWN BY: •�� •• ». /, l7� •' �� HILLSIDE VIEW; LOT 3 D.J.G.l•••'"• •••• '••••P�. �4W TYPE OF WORK: DATE: LICENSE+1�r�r 'SS mow* SEPTIC TANK PROFILE 9/18/2020 #AECC884 PERMIT NUMBER: OSP201311 1-1 A B / DBL1 36.1 30.8 DBL2 36.8 31.2 MH 42.0 35.5 ST1 44.5 39.0 DBL3 45.5 40.7 DBL4 45.9 41.6 100' WELL RADIUS RECORD DPxAWING 'c ------------------ 20' CEA ROW EASEMENT (PER MOA ONSITE) . r •"4 DRIVEWAY 5 -BEDROOM HOUSE / D( PARCEL ID NUMBER: 015-242-36 I O 1&2 ------- --- --- 10' UTILITY EASEMENT / NEW 1500 GALLON HDPE GREER TANK WITH / DOUBLE CLEANOUTS BEFORE AND AFTER TANK / DOUBLE 3 & 4 ADDENDA;LOT2 IA N __�3 1 / / / / SCALE: / 1"=40' GARN]up,_.S S "El NGIN1lr`,'E7 RING GROW Ltd ENGINEERING SALES CONSULTING 3701 E. TUDOR ROAD, SUITE 101 'ANCHORAGE, AK 99507 • PHONE (907) 3376179 • FAX (907) 3383248 • WEBSITE: v .gamessengineemg.com PREPARED FOR: PHONE NUMBER: PAGE NUMBER: RENE BAIRD 907-227-2568 2 OF 3 LEGAL DESCRIPTION: DRAWN BY: HILLSIDE VIEW; LOT 3 D.J.G. TYPE OF WORK: DATE: �,_ SEPTIC TANK RECORD DRAWINGS 10/29/2020 . , 121 .................�....:... r .'......N..� ..4�..............M..�.e...� 0. ,jefreyA. Gare •�'(�� i. r,• 0-795,3 �+ LICENSE f 4,_'R `S`;� 1� • #AECC884 / MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program POBox 19OG5O 470VElmore Road Anchorage, Alaska Sgb19-6850 Phone: 90* Fax: (9N7)343 -73V7 hup:xnwmmmuni.vrg/onoke Permit Number: CXSP201311 Work Type: SepticTank Upgrade Tax Code Number: 01524238000 Site Legal Address: HILLSIDE VIEW LT 3 G:2740 Site Mailing Address; 75OOALATMAAVE, Anchorage Owner: BA|RDDOUGLAS &RENEE Design Engineer: GARNESS ENGINEERING GROUP LTD Lot Size in Sq Ft: 8/17/2020 8/17/2021 1771 Disposal Field R1 Septic Tank E1 Holding Tank 0 Privy f_1 Private Well 171 Water Storage All construction shall be Inaccordance with: i- The attached approved design. 2. All requirements specified inAnchorage Municipal code Che pters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) -. The wastewater code requires "inspections during the installation. The engineer mhaU' � the Development Oan�oeoDepadn�entper AMC 15.O5.Pnov�onotification bycalling (QO7)343-79O4('--)� 4. FnomnOctober i5toAph|15' oaubeur�cenoi|abaoqtionsysbmmunderconstruobon^^�freezing weather shaUb*a�rh�during ngweo er a. Opened and Closed onthe same day, or b. Covered, sealed, and heated boprevent freezing Received By: Issued By: Date: J 11 5 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201311, Rebecca Carroll, 08/17/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201311, Rebecca Carroll, 08/17/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201311, Rebecca Carroll, 08/17/20 Hillside View Lot 3 #015-242-36 WELLS ❑ PRIVATE ❑ OTHER (Identitvl Classitication (A,B,C) Total Depth ased to rfT FT FT Installer Date Installed: REMARKS: I l - R-1 cl Municipal and State guidelines in ellect on this date: n Health Department Approval: Scale: /'!_ xo Inspections Performed by: )r Il Date: 7l certify that this inspection was perlormed according to all Date. v ENGINEER'S SEAL TANKS MUNICIPALITY OF ANCHORAGE ❑ HOLDING Manufacturer /Q 11 FT DE 1TMENT OF HEALTH AND HUMAN SER ES O! J �� ® , - FT TYPE OF SYSTEM Environmental Health Division BED ❑ W. DRAIN ❑ OTHER Gravel width ` 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 Total absorption area Distance between lines ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT 21,33 SQ FT Name JO e �l6ic?n / �( Number of lines DISTANCES Pipe material .� SXeiTd@f TO A3f35t��/� SEPTIC ABSORPTION WELL Address FROM TANK FIELD Phone(s) Permit No. No. of Bedlws WELL t 3b /fl m �3-2` l LEGAL DESCRIPTION LOT LINE Lot Block — Subdivisii /� �l�s.el �e w FOUNDATION / �� 00, Township, Range, Section 77 �zN �3 AJ S a AS -BUILT DIAGRAM (Show location of well, septic system, property lines, foundation, tlriveway. water bodies. etc.) WELLS ❑ PRIVATE ❑ OTHER (Identitvl Classitication (A,B,C) Total Depth ased to rfT FT FT Installer Date Installed: REMARKS: I l - R-1 cl Municipal and State guidelines in ellect on this date: n Health Department Approval: Scale: /'!_ xo Inspections Performed by: )r Il Date: 7l certify that this inspection was perlormed according to all Date. v ENGINEER'S SEAL TANKS I SEPTIC ❑ HOLDING Manufacturer /Q 11 FT Capacity in gallons Material Gravel depth beneath pipe No. of Compartments ® , - FT TYPE OF SYSTEM TRENCH ❑ BED ❑ W. DRAIN ❑ OTHER WELLS ❑ PRIVATE ❑ OTHER (Identitvl Classitication (A,B,C) Total Depth ased to rfT FT FT Installer Date Installed: REMARKS: I l - R-1 cl Municipal and State guidelines in ellect on this date: n Health Department Approval: Scale: /'!_ xo Inspections Performed by: )r Il Date: 7l certify that this inspection was perlormed according to all Date. v ENGINEER'S SEAL Depth to pipe bottom fromTotal ` "i depth from original grade original grade c..S FT /Q 11 FT Fill added above original grade Gravel depth beneath pipe ® , - FT 2 FT Gravel length Gravel width 17 FT 3 FT Total absorption area Distance between lines 21,33 SQ FT -- FT Number of lines Soil rating Pipe material /73 Sp FT A3f35t��/� Installer Date Installed WELLS ❑ PRIVATE ❑ OTHER (Identitvl Classitication (A,B,C) Total Depth ased to rfT FT FT Installer Date Installed: REMARKS: I l - R-1 cl Municipal and State guidelines in ellect on this date: n Health Department Approval: Scale: /'!_ xo Inspections Performed by: )r Il Date: 7l certify that this inspection was perlormed according to all Date. v ENGINEER'S SEAL ^ ~f ^ ` ^ � I to, SO L. 1 -7- "W" tit F- all ��!I:*-:,?,! Il":4�� DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L STREET, ANCHORAGE, Al.;.-.' 99501 260-47250 PERMIT NO: 870124 UPGRADE DATE ISSUED: 06/09/87 APPLICANT: JOE BRANDSTEDDER ADDRESS: 7500 ALATNA DR" Ah -ICI HORAGE� AK 99516 LEGAL DESCRIP: SUBDIVISION: HILLSIDE VIEW LOT: 3 BLOCK: N/A SECTION: 24 TOWNSHIP: 12N RANGE: 31W LOT SIZE: 49000 (SOFT. OR ACRES) I certify that: 1. I am familiar- with the requirements Ica, on~site sewers and wells as set forth by ihe Mur! icipality of Anchorage (118A) and thee State of Alaska. 2. I wi-ll install th� system in accordance with all MOA codes and regulations, and in compliance with the desUgn criteria cd" this permit" 3" I will adhere to all MOA and State of Alaska requirements for the set back distances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. ` IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS^BUILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN" SIGNED DATE: APPLICANT: JOE BRAND ISSUED BY DATE: � 7��^ � � ��W ^v &-yeroxe et eo�oz 16 � ^� ^� '-'—v "4 '�� «�� ==�� -97 41"- c-vfi14 11g7--1 MUNICIPAL!!`!' OF 47 W E D z) lebenle oee-411a,,jX� v7 .F) lve�, y QVbTN WS A% BEVAN ENGINEERING Anchorage. AKt99511 90,42.- �' ' 0 r Approved Well & Septic Engineers (907) 522taaa "*� 49TH /.... .. . ...• '.../ -_ ..._. .... "-. .._(907)258-0584 00 ! SOILS LOG — PERCOLATION TEST o r� •�-HUGHR.BEVAN PERFORMED FOR: Zee DATE PERFORMED • �'"' r'��Aw LEGAL DESCRIPTION: 7 3 //few Township, Range, Section: o�H—I SLOPE ;SITE PLAN ' ' WATER ENCOUNTERED? S /� IF YES, AT WHAT L DEPTH? P Depth to Water Atter Monitoring? -o 1 Date: s Reading Date Gross Net Depth to Time Time Water Net Drop [u PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT COMMENTS /4"Yn �/ //%l%!li/s� / .jAi�f /'GYa�f oY' /.�'v y AE.Lo �a�� , p. o✓�i�s5r� �n<.��.�� e/S% /�.fS� �i ice= /�3 � Z/6�M PERFORMED BY: CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72nna ion.. I,.., MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99509 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAMEPHONE a 143 NEW ❑UPGRADE MAILIN ADDDRES[S� �) LEGAL DESCRIPTION LOCATION NO, OF BEDROOMS - 0 Uy Well,� DISTANCE TO: ��"� Absorption area Dwelling PERMIT _ C P Q Manufacturer ,'� Materi No. of corppartments LU Liq. cap cG in,gallons IF HOMEMADE: Inside length _ Width Liquid depth --- `1DISTANCE J Z TO Well Dwelling PERMIT NO. O Z FManuf er Materi d capacity in gallons OI wz DISTANCE TO: We ll Z•°I Founda on Nearest lot line PERMIT NO. ' C� 7 J W Z F Z w' No. of lines G �i Length of each line I ([.7 Total ength ofnes Trench widthDistance betw n lines I ; ches per. Top of tile to finish grade ®4 , Material beneath tile r --T Total effective absorpt n rep s W Length Width Depth PERMIT NO. 0 Q F wa Type of rib iometer Crib q:��T tal effective abs ion ar a W rn DISTANCE TO: We I Building f and ' n are line J�� J Depth Driller Distance to lot line PERMIT NO. - .�. Lu DISTANCE TO: Building foundation Sewer line Septic tank Absorption rption area s OTHER PIPE MATERIALS 1°J cr S 0 1 7 ST RAT NG _ L INSTALLER REMt)IRKS rLA APPROVED DATE LEGAL �� Y�. _,1)/h e6/( -i 77, r z �i,°, � ..'A0 �J0Ad� 1 VA �iD �°3�9' �TAIEZ alGUTg A ANC1H[OlE2AGEy ALAfiKA �°.��®�' 34A-7714. SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF740 'deet. DRILLED AT THE RATE OF 19000 PER FOOT.. PROPERTY OWNER Ifilto fee Sande t4- 0)tdeJLed bI, at. X,ctth. Iiloo�te 349-4955 LOCATION OF WELL SITE ft- B.t.k.. $moo DRILLER Be&&ie Ctau-j a Z'al2 t? G7ahk4o WELL LOG: 0-----78' St tV. cta�t. 75% 78----38' D� a i t tc7 cycaveC wLth 40% Ct a<, b to de t -ta A&Ma t ton. 38---740' Bed tock. R 4ed unen ta&* dock.. 7i'am. 727 to 732 Teet ¢ pau.j ande gyp• nock 4haw4ag, a goad Lia-te�t. /viodu�a. The y tetd a-� 4WIR 4houtd rycave to tnc�ie"e AV 7000 with toe. 95 feet of- wa tet 6 tar rLtag, da c.a4taq- 3/4 iga&4e- Su &meu,t, rte ahou (d be i " to C f epi den feet 04 bot t=- A -Caw wa 4&t cwt off- maV a.C6o be tn4 to l t ed ion mato& pta-te_c tton . Coat a� 0&t stag; x'2!!660.00 1 Co'j-t of- &.Tett. Seat vD22.50 2 1 a COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF 92682-50 THANK YOU VERY MUCH. BERNIE CLAYS OF RAMPART DRILLING WORKS DATE- /'�.u�t 76.th, 1980 e 7 SERVICE CHARGE - OF 1 S.a5..� %:°� PER MONTH WILL. 8E ASSFGaFn N U N 10 1 F:::'"F-I I I -r V C, F-- " " I= " (--I F;t " 93 E - DEPARTMENT O'HEALTH AND ENVIRONMENTAL F-�ITECTION '825 -"L STREET, ANCHORAGE., AK 99'-,-.L 264-4720 nr-J� Cor-4—*F. 3: -F- F= "=l=-tlF:=F-: F-"r--F-'lr'l PERMIT NO, 800,371 ) APPLICANT LEE SANDERS 3842 CARAVELLE DR. ANCH 243-5816 LOCATION ALATNA RD & HILLSIDE LEGAL Llk3'HILLSIDE VIEW S/D LOT SIZE 49000 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATING (50 FT/BR)= 210 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: E- r="^ -F 1-1 -=- A :-::o I Er—.N C-1 -F " aF- 1258 1:3 F;1_11 n Ove EZ I E -v F= F=' -r THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BET14EEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE I'S. 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). F-7 FE Cl! 11 1 FREE 0- :E. FE F=" -r I ®Z -r " P-4 K _w I :::"F= C-1 0 Fl 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. _. — -r t4 1-n < " > I r -4 :E; F-0 F-- 0 -f- I f --I " =- F4 F;.I.o ME F;.:-* EF f--,% NJ I F-,-* FE U -B — — — BAC KF I LL I NdG BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BET14EEN A WELL AND ANY ON-SITE SEWA13E DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F= a FZZZ M I -T- a X F=" I F? a _�-- C -a a 0 E- M E� E'F? =-:c-1 - -1 :51:a 0 I CERTIFY THAT 1: 1 AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: 1 WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: 1 UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. SIGNEDX APPLICANT LEE SANDERS ISSUED V4. 0 r ❑ SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST Pouch 6650, Anchorage, Alaska 99502 276-2221 SOILS LOG - PERCOLATION TEST aGacnnhAgn Pnrt• - �< LEGAL DESCRIPTION: D H 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMM PERFORMED BY: —�.,-, F,c\' C' dtn-� DATE PERFORMED: 4� C/* a-mj ) - LOPE I r WAS GROUND WATER S ENCOUNTERED? L O P E IF YES, AT WHAT DEPTH? SITE PLAN Reading Date Gross Time Net Time Depth to Water Net Drop �x 4S �-I"00 -- -i i Reading Date Gross Time Net Time Depth to Water Net Drop �x 4S �-I"00 LG PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN :dz FT AND - FT CERTIFIED BY: 1 11 • Municipality of Anchor. e DST On -Site Water and Wastewater Progra a 6 �QJS (907)343-7904 Certificate of On -Site Systems Parcel I.D. 015-242-36 1. GENERAL INFORMATION Complete legal description Hillside View; Lot 3 Location (site address) 7500 Alatna - Anchorage - 99507 W Expiration Date: �6 Current Property owner(s) Jespen John Scott DEC of Trust - Day phone 602-0304 Mailing address Real Estate Agent 2. TYPE OF DWELLING: © Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 5 4. TYPE OF WATER SUPPLY: Individual Well 0 Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ WaiverNarianoe request for: N/A Day phone TYPE OF WASTEWATER DISPOSAL: Individual Holding Tank ❑ Community ❑ Public Sewer ❑ Received b : Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ J�IIo Date of Payment /O// tt //t�_ Receipt Number o9g0("1 COSA# m& 5 / 571l Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OFJN8P1='CTI0N BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Garness Engineering Group Ltd. (GEG) Phone (907) 337-6179 Address 3701 E. Tudor Road, Suite 101 Anchorage AK 99507-1259 Engineer's Printed Name Jeffrey A. Garness Date IDiIt i In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic.Vi\r�\� 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 systemis on the - -- -- +� G .. ,�• - . datels of the evaluation. Separation distances were measured to readily identifiable features. - • •e'� . •'� ., Hidden defects or encroachments may exist that were not identified during the evaluation. The i J,•• operational life of all welfs and septic systems depend on 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 systemis. ^••�•" ^ • •'•• •^^�•^'•^ These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no %C :� .A. Gamess ; representation whether an alternative well or septic system can be Installed on the property in the i C 7g53 ` event either of the current systems fail The content of this report is for the sole benefit of the ♦� 0. 1V fi ,.•f.� person/party who retained GEG. Reliance upon the information provided in this report by any other person orparty, including but not limited to subsequent property purchasers, is not authorized. In ,Z! short, GEG disavows any legal duty to anyone other than the person/party who paid for this report. 4A S\\f\tii1�� OF q�fe,tyop��/// 6. DSD SIGNATURE QQl� j ON-SITE G'� System #1 Approved for bedrooms =� WATER AND System #2 Approved for _bedroomsE o WASTEWATR 5:Z Disapproved a QROGRAM J Conditional approval for bedrooms, with the By: IVee r• Original Certificate The Municipality of Anchora�Vbevelopment Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. - 7. ATTACHMENTS: COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory _� Other COSH blue sheet 91-12 doe If more than 7 septic system is on the lot: COSA Checklist # of Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: HILLSIDE VIEW, LOT 3 Parcel ID: 015-242-36 A. WELL DATA *PER WELL LOG, BUT IT IS ASSUMED TO BE ONLY CASED TO BEDROCK AT 38 FEET Well type PRIVATE If A, B, or C provide PWSID# N/A Date completed 8/16/80 Sanitary seal (Y/N) YES Total depth 140 ft. Cased to *140 ft. FROM WELL LOG Date of test 8/16/80 Static water level 45 ft. Well production 4 9 - p.m - WATER SAMPLE RESULTS Coliform 0 colonies/100 ml. Arsenic: ND ug./L. Nitrate ND mg./L. Well Log (Y/N) YES Wires properly protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION 9/9/15 57 ft. 0.8+ — g -p.m - Collected by: GEG. Ltd, Date of sample: 9/9/15 B. SEPTIC/HOLDING TANK DATA STEEL SEPTIC TANKS ARE APPROACHING SEPTIC STEEL THE END OF THEIR USEFUL LIFE / Tank Type/Material SEPTISTEEL Date installed 1987/1980 500/1250 Tank size gal. Number of Compartments 1/2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping 5/23/15 Pumper MCDONALDS PUMPING C. ABSORPTION FIELD DATA *BELOW EXISTING GRADE Date installed 1980/1987 Soil rating (g.p.d./ft or /bdr 210 173 System type DEEP TRENCH Length 61+17 ft. Width 3/3 ft. Gravel below pipe 7 ft. 854/238 Total depth *9.319. ft. Eff. absorption area_ ft2 Monitoring tubeYES YESDepression over field NO Date of adequacy test 9/23/15 Results (Pass/Fail) PASS For 5 bedrooms Fluid depth in absorption field before test **52 in. Water added**75�jal. New depth **60in. Elapsed Time: **120min. Final fluid depth **56 in. Absorption rate >= 750+ g,p.d, Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date — **TESTING RESULTS FOR 1980 TRENCH; 1987 TRENCH REMAINED DRY THROUGHOUT TEST. ALSO TESTED THE 1987 TRENCH ON 9/17/2015 WITH 1000 GALLONS. MT WAS DRY UPON ARRIVAL AND ENDED WITH FLUID DEPTH OF 68". AFTER 120 MINUTES THE L.L. IN THE 1987 TRENCH HAD DROPPED TO 47". 1980 TRENCH REMAINED AT 65" THROUGHOUT TEST. D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on" level at in. "Pump otr level High water alar level at in. Cycles tested Meets alar $ circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main Sewer /septic service line 25'+ Animal containment areas 50'+ Public sewer manhole/cleanout 100'+ Holding tank 75'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field UNK Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+; 150'+ CLASS "C" SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+; 150'+ CLASS "C" F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that 1 have determined through #aid 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 JEFFREY A. GARNESS Date�Zc-2 i (Rev. 11/05) Municipality of Anchorage na� Development Services Department '� d Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Water Well Advisory Certificate of On -Site Systems Approval (COSA) # OSC151574 During a recent COSA on-site inspection and test of the potable water supply well on Lot 3 of Hillside View subdivision, the well's productivity was determined to be .8 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 5 -bedroom residence is .52 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. Jeff Garness From: Jepsen, J Scott <Scott.Jepsen@conocophillips.com> Sent: Friday, October 30, 2015 1:44 PM To: Jeff Garness Subject: Hillside View Lot 3 Jeff — this note is to confirm that in the 18 years that I have lived at 7500 Alatna Ave., I have never had any freezing problems with the drain field or septic tank for the house. Scott Jepsen 7500 Alatna Ave. Anchorage, AK 99507 I ' . g I / I / 1 \ \ i I I Ot 0 2 a DIc. 0 1 10' UTILITY EASERFNT _NB9 59'LSB".. 0000ppp4 OF_A��s�oo 49 TH C, 5v0, r'10ayyf"" AS-BUIL{ SURVEY 1" =30' NOCORNE SETTHISDATE oo� a SHANE A HOLT am O LS-seta g,�o� I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY 044a,O /eaaion°1 ve^oe OF THE LLOWING DESCRIBED PROPERTY d4pp0000� .LOT 3, 4ILLSIDE VIEW SUB. ANCHORA;E RECORDING DISTRICT, ALASKA, AND THAT THE _ VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN FPA�WSHOWN RMATION HEREONIS FOR THE USE OF LENDING IN5TITVTIONS SPECIFICALLY TO SHOW ANY THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS S BETWEEN EXISTING STRUCTURESAND PLATTED LOT LINES ANDYOR EASEMENTS; AND IS EXIST OTHER THAN NOTED. V5ED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES. DATED A ANCHORAGE, ALASKA THIS _38TH DAY OF S OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT, ARE NOT SHOWN. UNLESS-INDICATED) I SEPTEMBER , 2015. NCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE IiNES ORP051'IION ADDITIONAL IMPROVEMENTS HOLT LAND SURVEYING G SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE. SNOW AND/OR ICE. 600 T LAND SU DRIVE ANCHORAGEAK 99515 13B87' FB 174-8 345-5513 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 HealthAuthority 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 7egulations,in effect on the date of this inspection. Name of Firm s& s ENGINEERING Phone 6 p y 7a-9 _7 q 17034 Eagle River Loop Road No. 204 Address Eagle River Ala ka 995 Engineer's signature �lzDate C/&/q7 N1,4- 6. DHHS IGNATURE DHHS for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: 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 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. MUNICIPALITY Ur ANL_rj rMVU ENVIRONMENTAL SERVICES DIVISION Municipality of Anchorage JUN Of 1997 DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division R E C E l V 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744 Legal Description: L o T 3 A. WELL DATA Health Authority Approval Checklist 14 -L-s 10 46- Y I �- z✓ Parcel l.D. p 1 S -,-)q -;t —3( - Well type f'/el v*47 �'- If A, B, or C, attach ADEC letter. ADEC water system number 1° 9 S completed Date com � " %1(. / �0 Log present �/N) p Total depth 1 `/ o , Sanitary seal &N) Date of test Static water level Well production 6 S Cased to FROM WELL LOG ye � WATER SAMPLE RESULTS: Coliform ''' Date of sample: 6131-17 Nitrate Casing height (above ground) Wires properly protected ON) *Y 4. S AT INSPECTION /s/4 7 g.p.m. /. / g.p.m. 0 • 1 Other bacteria S & S ENGINEERING Collected by: 17034 Eagle River Loop Road No. 204 Eagle River, Alaska 99577 B. SEPTIC/HOLDING TANK DATA gjjylgo& �l-,/g7 oS-0 so4 / Yf- S Date installed Tank size Number of Compartments Cleanouts &/N) Foundation cleanout((rV'N) Depression (Yo 1v High water alarm (Y/� ^' Date of Pumping / 7 Pumper � #0''' � ��"a `i s C. ABSORPTION FIELD DATA Date installed��y�go d 7 /, /6�v Soil rating (g.p.d./ft2 or ft2/bdrm)'� �a &/73 System type fi £^ c -N Length �' 1 r � 7 Width, 3 ` Gravel thickness below pipe - � Total depth °1 4 "0 Effective;absorption area V' H `/� 3 Monitoring Tube present &N)yc 5 Depression over field (YO ^V Date of adequacy test t r / 7 Results (Pass/Fail) p� 5 s For s bedrooms Fluid depth in absorption field before test (in.); 3 i- Immediately aftelaoo0 gal. water added (in.): Fluid depth I " (ins) Minutes later:c49H1s 35,,... Absorption rate = ->'S-0 -?g•p•d• Peroxide treatment (past 12 months) (Y/N) H 4 v #- If yes, give date 72-026 (Rev. 3/96)' D. LIFT STATION Dato installed Manhole/Access (Y/N) High water alarm level at* Cycles E. SEPARATION DISTANCES Size in gallons "Pump on" "Pump off" level at* *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Se tic holding tank on lot % 0 0 t On adjacent lots r Absorption field on lot ° c1 -r On adjacent lots Public sewer main N /,+ Public sewer manhole/cleanout Sewer /septic service line aY-r4- Lift station SEPARATION DISTANCES FROMgE MHOLDING TANK ON LOT TO: Foundation f Property line S Absorption /0 a I -74- Water main/service line o1 5 Surface water/drainage no fi Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line > 0 Building foundation o "� Surface water pd /+ Water Water main/service line Driveway, parking/vehicle storage area Curtain drain /", ^vim k ^Vd w/V Wells on adjacent lots / 0 J -Y, Lv I LL T o T N 4, bi & S T 944 S.. 4 4 of l ie FFF S T &,,A9 , s N 0U F. ENGINEER'S CERTIFICATION l certify that I have determined thru field inspections and review of Municipal recon in conformance with MOA HAA guideli es in effect on this date. J Signature 4.6Engineer's Name /C a �r�c T C Co �✓.9✓ ,•, Date HAA Fee $ ' r� Date of Payment Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number / 0 0 -4- !- -is- 4- as4- ' 41-14 Y. %Wtems are ,ERT "C•"COWAN CE -81 a4� JUN -06-1997 17:07 CT&E ESI ANCHORAGE AIL CT&E Environmental Services Inc. CT&E Ref.# Client Name Project Name/# Client Sample ID Matrix Ordered By PWSID Parameter Nitrate - N TotaL Coliform 972833001 S & S Engineering N/A Lot 3 Hillside View SID Drinking Water I• 9075615301 P.02iO3 Client PO# Printed Date/Time 06/06/97 16:14 Collected Date/Time 06/03/97 22:00 Received Date/Time 06/04/97 09:05 Technical Director: Stephen C. Ede Released By A a941 A % Allowable Prep Analysis Results PaL Units Method Limits Date Date snit 0.100 U 0.100 mB/L SM18 4500-NO3F 10 max 06/05/97 JBL 0 coL/100mL SM18 92228 06/04/97 RAM MUNICIPALITY OFANC .. CHORALE. 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 FORA SINGLE FAMILY, DWELLING Parcell.D.# 01 S' aye -3G orf., :.Ha4`#=:1�ac.n�nr✓1 _ ... .. 1. __GENERAL INFORMATION „ �� :,;<, >, sA�1 3 t,7r`; ;;., ,•, , _. _' Complete legal description Lot 3; Hillside view ! �L,gcatIon,(site address or directions) 7500 Alatna Ave. Anchorllge, AK 4t';PHH/HOMEQUITY C/O Jack White Co. Property owner. Day phone "Attn: Patty Seymour Maili.ng address 3201 "C" Street Sutie 200 AnchorlIce AK 9950_ Lending agency ti Day phone a fling addrass gent _ riT 4'A�yL'H y r water NOTE: - 4 idress 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site - xxX Ness otherwise requested,, HAA will be,held pickup Holding tank yfor Yaq(,,,,:' Community on-site UMBER OF BEDROOMS ., Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. (PE OF WATER SUPPLY x 34< _ _... Individual well F m 43, `kS i`"t,, Community well 1 �'�..� y' 9 r, . �. v H T ��I.i?Sd�- Ch• Z � 'd9� ti`s * -j <f • :: l �.h t ASC Public r 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 - xxX 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 #21 5. . STATEMENT OF INSPECTION BY. ENGINEER As certified by my sear 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 invest!qation 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 ENGINEERING6 9 ti" a g 7 9 Name of Firm_17M E15116 ver LOOP RoaTNo. 204 Phone Address Eagle River, Alaska 99577 Engineer's signature Date C -jg I q P. r C411TION 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 orderto 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-=(R".1/91) Beck MOAx21 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744 Health Authority Approval Checklist Legal Description: Le 3 H s, o f V C w Parcel I.D.: 3 A. WELL DATA Well type PA've4 r ' Log present &/N) _ Total depth 1Y Sanitary seal (ON) Date of test Static water level Well production If A, B, or C, attach ADEC letter. ADEC water system number Y li 5 Date completed 9 11 (. I s v I Y c,5 Cased to J ti ° FROM WELL LOG CS 1)(./ gc 4s - WATER SAMPLE RESULTS: g.p.m. Casing height (above ground) Wires properly protected ON) _ AT INSPECTION S-/�-ti/q6 S-0 Y f j g. p. m. Coliform C / Nitrate 0,1 Other bacteria p l 3 y( 4 Collected b S& S ENGINEERING Date of sample: S- y' age Kiver B. &EEOHOLDING TANK DATA Eagle River, Alaska 99677 _71_1/57 ;2 d' I Date installedet'l/P Y�J '' Tank size Number of Compartments Cleanouts &N) Foundation cleanout (ON) Depression (Y/IS'9l ^ 0 High water alarm (Y/W v � Date of Pumping /� 9 Pumper it 2 vf ce y C. ABSORPTION FIELD DATA Date installed ��i��a 1� 7/7 7 Soil rating (g.p.d./W or ft2/bdrm) 2i ° 17.3 System type r ¢ ~ H Length 6 ( 4- 17 Width 3 Gravel thickness below pipe 7 Total depth 1 /0 Effective absorption area 8 Monitoring Tube present &N) )& s Depression over field (Y/O r 1) Date of adequacy test S` �y $ q 6 Results (Pass/Fail) i+ 0 For S bedrooms Fluid depth in absorption field before test (in.); c Immediately after H660 gal. water added (in.): 3 �f Fluid depth .3 a (ins) Minutes later: Absorption rate = 7 S 0 t g.p.d. ,. Peroxide treatment (past 12 months) (Y/N) ° N k,r ° wnl If yes, give date 72-026 (Rev. 3/96)" D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* Cycles E. SEPARATION DISTANCES Size in gallons "Pump on" level at* *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Se ti holding tank on lot /0 ° 1 t off' level at* On adjacent lots 100 Absorption field on lot / o o -3- On adjacent lots / Public sewer main N /A Public sewer manhole/cleanout Sewer /septic service line Lift station Oo 4 N /A IV 14 SEPARATION DISTANCES FROM SEP HOLDING TANK ON LOTTO: Foundation S Property line S Absorption field S - Water main/service line �} Surface water/drainage i ° ° Welts on adjacent lots / 00 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line f ° f I Building foundation J0 � Surface water /,00 Curtain drain '-' ° KN o w n/ -j A- wc,,� 'To YHA- w F r s tax F. ENGINEER'S CERTIFICATION It Water main/service line 4 , Driveway, parking/vehicle storage area a o f Wells on adjacent lots /00 l certify that I have determined thru field inspections and review of Municipal records in conformance with O HAA gut -dell as in effect on this date. Signature �Z, = Engineer's Name Date S, 13 0 /16 HAA Fee $ - Date of Payment 6 Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number are ROBUT C. COWAN o 'k. CT&E Environmental Services Inc. Laboratory Division Laboratory Analysis Report CT&E Ref.# 962046.962046001 Collected Date 05/24/96 Client Sample ID L3 Hillside View S/D Matrix Drinking Water Technical Director: Stephen C. Ede PWSID 0 Released By Sample Remarks: Parameter Results QC PQL Units Method Allowable Prep Analysis Init Qual Limits Date Date _ Nitrate -N 0.100 U 0.100 mg/L EPA 353.2 05/29/96 EMB Total Coliform 0 0 col/100mL SM18 9222B (DW) 05/24/96 WEP U - Undetected LT - Less than GT - Greater than D - Secondary Dilution i - Below the calibration range .b o� 0 n 200 W. Potter Drive, Anchorage, AK 99518-1605 — Tel: (907) 562-2343 Fax: (907) 561-5301 3180 Peger Road, Fairbanks, AK 99709-5471 — Tel: (907) 474-8656 Fax: (907) 474-9685 CnunonAinn CK17A1 CAnu mCe INI Al A0V A nAi mnonnA o nDMA u I IAlnlc RAARVI AAIn RAlrwIr.ANI NIICRnIIRI NFW .IFRSEY_ OHIO. WEST VIRGINIA TO SUBJECT ( r jt i s { f)r" wr MESSAGE i"t. F. ,?c E:r;.vr Y('mi F R` s , % rr_ O� M N DATE REPLY REDTFORM ® 4S 472 SIGNED SEND PARTS 1 AND 3 INTACT - DADT-I W111 RC DcniDuen.WITU Deoiv DATE POLY PAK (50 SETS) 4P472 'L) f'k'i f -L � tst fAIt A,,(;A(1(M E< , s'',. �r "):5 f hr� 4�� r ix 6� ; r_,'r ,;fizz) r i ; "k� A- r �` � ; � i s� r r., I a r c'Nnr>> rl {, � i. - _ 1 _ - t•] A 1 � i et{ / :-I j ` F` � - SIGNED,/.,--, REPLY REDTFORM ® 4S 472 SIGNED SEND PARTS 1 AND 3 INTACT - DADT-I W111 RC DcniDuen.WITU Deoiv DATE POLY PAK (50 SETS) 4P472 DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN PUBLIC SERVICE OFFICE 555 CORDOVA STREET ANCHORAGE, ALASKA 99501 Mr. Daniel J. Roth Civil Engineer, On -Site Services Municipality of Anchorage Department of Health & Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 TONY KNOWLES, GOVERNOR (907) 269-7505 December 2, 1996 RECEIVED DEC 9 1996 Municipality of Anchorage Dept. Health & Human Services Subject: Lot 3, Hillside View Subdivision, Separation Distance concerns; AWPSA Project Number 9621 -WW -156-455; Review Dear Mr. Roth: I have reviewed the information you provided along this Department's file on the facility located on the above -referenced property. Based on a drawing (a photocopy attached), the well that would be in question is the one labeled "WATER WELL FORE PROTECTION". According to information provided to this Department, the source well for the existing Class C Public Water System is located at the other end (north end of lot) of the lot. I hope that this information will be of assistance to you. If you have any other questions, please do not hesitate to contact me. Sincerely, Keven K Kleweno, P.E. Environmental Engineer KKK/ka Enclosure: As Stated 1N000 CRIBBING FOR UNDERGROUND SPRINKLER STORAGE TANK. 5'8955'00"El i5' E ., ri: t6500' r bF, " 24.4' - 1n' 117111 TY � o / 1 (3' DIAMETER METAL LID ed �t ( TO UNDERGROUND SPRINKLER WATER 1) ® STORAGE TANK GREENHOUSE WOOD DECKul WATER: ,WELL' FIi�E F';1ZQT z 8AY WINDOW FA CFAAFNT .i.r �� > W o� ai m CV G? O O N O O O G MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL H87-0185 OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date 1_ GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 3 Hillside View Subdivision Location (address or directions) (b) Property Owner Lee Sanders Telephone: Home Mall llll, 1144i��v -- (c) Lending Institution Telephone — Mailing Address (d) Real Estate Company and Agent /1 J J........ _ (e) Mail the HAA to the following address: or: Check here ❑, if hold for pick up. List contact person and day phone number below. 2. TYPE OF RESIDENCE Single -Family ®X Number of Bedrooms five (5 ) Business 1 3. WATER SUPPLY Individual Welles Community ❑ Public ❑ 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 OnsiteU Public ❑ Community ❑ Holding Tank ❑ 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 72-025 (Rev 8/86) Front 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 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. Name of Firm Address Date Telephone Engineer's Seal This department has received written confirmation from the engineer regarding the Conditional Approval of April 8, 1987. The corrections have been accomplished and an inspection has been completed by the eng"ineer. The subject property meets with Municipal standards and is now approved. for your records. 6. DHHS APPROVAL Attached is a copy of the upgrade Approved for f i ve (5)bedrooms by `" / �"` ` " Date Aucfus t 51 1987 ApprovedXXXXXXXXXX Disapproved Conditional Terms of Conditional Approval 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 courtesyto 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. Page 2 of 2 72-025 (Rev 8i66) Back MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL C� { OF ON-SITE SEWER AND WATER FACILITY J n 264-4744 Application Date 04 " J-% 1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) ;71'o 'a (b) Property Owner Lee Telephone: Home 6MX z�7,,�27Business Mailing Address �'��/✓� ��«� ��'�n? �SG3A (c) Lending Institution Telephone Mailing Address (d) Real Estate Company and Agent Address Telephone 4 Z7�/ (e) Mail the HAA to the followina address: or: Check here ❑, if hold for pick up. List contact person and day phone number below./ 210 ' G�7la 2. TYPE OF RESIDENCE Single -Family. Number of Bedrooms 3. WATER SUPPLY Individual Wel Community ❑ Public ❑ 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 Public ❑ Community ❑ Holding Tank ❑ 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 72-025 (Rev 8/86) Front 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 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. Name of Firm Address 0E�X I� Date c o .v p m c.v A z-- Telephone SZz /�iS 3 �� OF �i!I • 01 trig I••,�9�� *;'49TH HUGH R. SEVAN :1 �'� ` ••• CE7225•••��`% '0, joili lop 6. DHHS APPROVAL -!e'VG CS ,p�-��^ .Q . .".r -'-o' Date 5t _'g $ % Approved for bedrooms by Approved Disapproved Conditional Terms of Conditional Approval J_W_— a 1�2' -4 Q,,,c A.>'oSs��'f'o.w f/�.G-L. '{b h.sGGf" GQG or_ -�Q•VG Cs) b CAUTION wW,4_- A1L7- 1,7...,/y /9,, 14B? 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. Page 2 of 2 72-025 (Rev 8/86) Back MUNICIPALITY OF ANCHORAGE (MOA) MUNICIPALITY OF ANCHO#§#LTH AUTHORITY APPROVAL (HAA) ENVIRONMENTAL SERVICES DIVISIOJ;HECKLIST - FEBRUARY 1984 264-4744 APR b 1987 Legal Description: A. WELL DATA RECEIVED Well Classification _"Iiexlo� If A, B, C, D.E.C. Approved (Y/N) o v/O'Gw Well Log Present (Y/N),,.)� Date Completed ��-� Yield Total Depth 1104� Cased to Depth of Grouting Static Water Level ��' S f��'�' �' 5t• Pump Set At All Casing Height Above Ground Zn Sanitary Seal on Casing (Y/N) e—'/ Electrical Wiring in Conduit (Y/N) N Depression Around Wellhead (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot rC7•® '� ; On Adjoining Lots /on To Nearest Edge of Absorption Field on Lot �a t ; On Adjoining Lots To Nearest Public Sewer Line �n' To Nearest Public Sewer Cleanout/Manhole N� To Nearest Sewer Service Line on Lot� A Water Sample Collected by Water Sample Test Results Comments V B. SEPTIC/HOLDING TANK DATA > ; Date ��557 Date Installed 9 X�P- A Size 10-} 49 No. of Compartments Z Standpipes (Y/N) Air --tight Caps (Y/N) /�Founndation Cleanout (Y/N) Depression over Tank (Y/N) /�/ D& aZ 47petl '`"g" -r Pumping/Maintenance Contract on File (Y/N) Nlo4 ; for Holding Tank High -Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply Well To Property Line Temporary Holding Tank Permit (Y/N) To Building Foundation �� f To Disposal Field To Water MaK�Service Line N,Z To Stream, Pond, Lake, or Major Drainage Course AGotnments a t F. Page 1 of 2. 7262t(#ax 6'1YFrQn1 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Type of System Design Date Installed Length of Field o a` Width of Field _ Depth of Field O Gravel Bed Thickness Square Feet of Absorption Area Standpipes Present (Y/N) —� Depression over Field (Y/N) Date of Last Adequacy Test !:e:fo/- T7 Results of Last Adequacy Test �0,0 Separation Distance from Absorption Field To Water -Supply Well To Property Line To Building Foundation 20 7` To Existing or Abandoned System on Lot On Adjoining Lots �� t To Water Main/Service Line To Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course n✓lz' To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION /()/,1p Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at ** Check Permitted Bedroom Rating Against HAA Request ** Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA I certify that I have chec ce , verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. SignedZ,//�� / Date Company MOA No. Receipt No. 0 d OC' CJ OF A\iq,,� Date of Payment 7 ,,;"��;•''•••• ''•� zoo ° 0 *'.4Fs� r a al *I Amount: $ l " 5l e�••••• ..• ••••$* / .HUGHR.BEVAN ;w Page 2 of 2 e� • • CE 7225 •.'N$•`"00 Flo AWAw 72-026 (Rev 8/86) Back P.Ck Box 112852 BEVAN ENGINEERING Anchorage, AK 99511 Approved Well & Septic Engineers (907) 5211383 (907) 25&0584 April 6� 1987 Municipality of Anchorage Department of Health & Environmental Protection 825 '/Ln Street Anchorage, Alaska 99501 Re a Use Sanders, Health Authority Approval Application Lot 3 Hillside View Subdivision Gentlemen � During the period from March 27 to April 1, 1987 I performed research1, site investigations, wall flow testing; and absorption field testing pursuant to Health Authority Approval on the above referenced lot. I performed a well flow test and found the well production to be 1.3 gallons per minute (gpm). This exceed the 0.5208 gpm required for a 5 bedroom home. I took a water sample for coliform analysis and the results were satisfactory. I performed an absorption test on the septic system and determined that it absorbed at a rate of 600+ gallons per day (gpd)" This exceeds the 600 gpd required for a 4 bedroom home. The septic tank was pumped and the volume removed was 1250 gallons" The owner plans to upgrade the septic system to 5 bedrooms this coming construction season. , To my knowledge I have assembled all of the information requested on HAA Application and Checklist. I am submitting this data to you for your review. Please contact me if I can provide any additional information" (ph 522�1383) Sincerely, Hugh R. Bevan F". E. Attachments HAA Application HAA Checklist Sewer As -built Original Soils Investigation Well Log Total Coliform Analysis Septic Pumping Receipt cc Lee Sanders 87210~dws man_.---- , o.p Co P ¢¢a 000 c�oa a WA � flv -5?P -Ira -4.r 4,2-/ k -,-c v �- 336.'oO ^. ,�5, Z3srs v ,C' Z- -'__ 6/hof 2/.�.� • _- - z r�1670 Ayr 0 OF Ak 'W Co •,y j s tj e«ee e•s+e+e CRAIG L- AZZEeeewsee e.e: ee« Q :�Y ao�r✓f�.e 4538-S EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT, ARE NOT SHOWN HEREON, Jr V so' - O -lei ,may �/�� vCs-� Ids < �/ `! •" AS -BUILT NO CORNERS SET THIS DATEr NY% `fit I hereby certify that 1 have performeda•�Mastyayees on of the following dna ibed _ - � 5 L�vpe�� 1�perty ' Anchorage Recording' precinct, Alaska, aridethat the' improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on prop- erty lying adjacent thereto encroach on the premises in question and that there are no roadways, trans- mission lines or other visible easements on said prop- crty except as indicated hereon. Dated at Anchorage. Alaska this �5 thrl ay 0•i9a•6. r. 7 rNSRTrnV ). AoVi Tr...e_.. M 5. LEGAL DESCRIPTION n Z o 7� (3 �''�� S�`�j:_- SLI ez5 DATE RECEIVED INSPECTION APPOINTMENTS � `�✓�pF-`. � � TIME TIME TIME DATE DATE DATE ❑ Two ❑ Five ❑ MULTIPLE FAMILY ❑ Three ❑ Six INSPECTOR INSPECTOR INSPECTO since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIOpp�I� DEPT. OF HEALTH & 825 L Street - Anchorage, Alaska 99501 tNVIRONMENTAL PROTECTION • ENVIRONMENTAL SANITATION DIVISION NOV 5 1980 Telephone 264-4720 RR FF (('�� 11,, REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER`FA1@I�I VE DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER PHONE 419-0 MAI LING ADDRESS e�-A, s- c3 I PROPERTY RESIDENT (If different from above) PHONE 2. BUYER 67 PHONE MAILING ADDRESS 3. INSTITUTION PHONE dLENDING MAILING ADDRESS ( / /T� 4. REALTOR/AGENT PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION n Z o 7� (3 �''�� S�`�j:_- SLI ez5 STREET LOCATION (' � `�✓�pF-`. � � t'/1.51 [� �� 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS ❑ FAMILY ❑ One 0 Four Other SINGLE ❑ Two ❑ Five ❑ MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SPPLY INDIVIDUAL* *ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM X INDIVIDUAL/ON-SITE** Z�7kfl YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY Cl INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑Septic Tank or ❑ Holding Tank Size: &ISO If Tank is homemade give dimensions: SOILS RATING .old TYPE OF TANK MANUFACTURER TOTA L ABSOR PTI ON AR EA MATERIAL +� 1 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS Ct'APPROVEDFOR V BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE c to -SO BY —0—.