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HomeMy WebLinkAboutBIRCH HILLS TERRACE #2 BLK 1 LT 5Birch Hills Terrace #2 Block 1 Lot 5 #050-141-28 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP251429 PID Number: 050-141-28 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name ROY & THERESA WILLIAMS ABSORPTION FIELD ®Deep Trench El Wide Trench El Bed E] Mound Site Address 17736 N EAGLE RIVER LOOP RD, EAGLE RIVER ❑ Other Phone Number of Bedrooms Soil RatingTotal depth from original grade 4 1.2 GPD/SF 13 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 9 Ft. Gravel depth beneath pipe 4 Ft. Subdivision Block Lot BIRCH HILLS TERRACE #2 1 5 Fill added above original grade VARIES 0'— 0.52 Ft. Gravel length 64 Ft. Township Range Section Gravel width 3 Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES Tol Septic 'Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Lift Station I Tank Field Tank Line 512 Ft' 1 -- Ft. well -- *200'+ 25'+ TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer EXISTING PLASTIC Capacity Gal. Surface Water -- 100'+ Material Number of compartments I Lot Line -- 10'+ NA Foundation-- 1 Q + LIFT STATION Manufacturer Capacity Gal. Remarks *200+ to public wells & 100'+ private wells. Alarm location Electrical installed by Installer NORTHERN EXCAVATION PIPE MATERIAL House to tank Tank to 3034 drainfield Drainfield 3034 CO/MT 3034 Inspector FWC BENCH MARK (Assumed elevation) 100 ft Inspdection 1" 4/16/2026 4/17/26 Location and description 2nd 3`d 4/17/26 4`h 4/30/2026 FOUNDATION FLASHING ON-SITE WATER AND WASTEWATER SECTION APPROVALj. N) ,law AC", •• •, Conditional Approval: Date Adw ' ��'i� .�_ .. .. :� Se tic S sterr�� p Y Approved, `/ "" """':' '. Curtis Huffman % •.128991,• / ✓� 9 f10ci�lF Dat — /� .'G5/2'.����� F��°ROfESS10NP ' Note: this approval does not include well permit requirements. �* (Kev U5/U1/1d) 26. 2 ' 2 9 . 0 ' 4.1 ' 1 1 . 0 ' 12.0 ' 1 2 . 2 ' 12.0 ' 1 2 . 0 ' 26.2 ' 3 6 . 3 ' 4.4' 2 8 . 2 ' 4 B R R E S I D E N C E FIRST WATER CONSULTING PID:050-141-28 PERMIT: OSP251429 BIRCH HILLS TERRACE #2 B1, L5 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Well Decommissioning Log Legal Address: Subdivision Block Lot T R Section Lot On-site Water & Wastewater Section certified contractor performing the well decommissioning: Name: .Signature: . Company: . Well decommissioning date . Method of decommissioning: AMC 15.55.060L 1. 2. 3. Location: Use the space below to provide a drawing of the property showing the following items: •North arrow •Decommissioned well location •Location of other water wells on the property •Two separate swing-tie distances for each well shown on the drawing Note: The swing-tie distances shall be measured from either permanent structures or the property corners. G:\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Well Decommisioning form.doc BIRCH HILLS TERRACE #2 1 5 John Dean Arctic Pump & Well Inc. 4/29/26 ✔ Permit Number:OSP251429 Tax Code Number:05014128000 Work Type:Septic Upgrade Effective Date: Design Engineer: Site Legal Address:BIRCH HILLS TERRACE #2 BLK 1 LT 5 G:0153 Owner:WILLIAMS ROY V & THERESA ANNE Site Mailing Address:17736 N EAGLE RIVER LOOP RD, Eagle River Lot Size in Sq Ft:41146 Total Bedrooms:4 This permit is for the construction of: Disposal Field Septic Tank Holding Tank Privy Non-Public Water Well Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Coodinate with On-Site staff regarding preferred method. 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing 12/15/2025 12/15/2026 FIRST WATER CONSULTING Special Provisions: Two wells must be decommissioned prior to approval of any future COSA application. Expiration Date: þ ¨¨¨¨¨ Issued To: Issued By: Date: Date: 12/15/2025 12/15/2025 FIRST WATER CONSULTING Isatou B Njie MUNICIPALITY OF ANCHORAGE On-Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On-Site Wastewater Disposal System Permit 12'x20' SHED 2 6.2' 2 9.0' 4.1' 1 1. 0 ' 1 2.0' 1 2 .2'12.0 ' 12.0' 26 . 2 ' 36.3' 4.4' 2 8.2' 4 B R R E S I D E N C E FIRST WATER CONSULTING DESIGN CALCS: NO WELLS WITHIN 200' OF PROPOSED SEPTIC FIELD UNLESS NOTED. NO SLOPES >25% WITHIN 50' OF PROPOSED FIELD EXCEPT AS NOTED - SEE SLOPE PROFILE. STAKE PROPERTY LINES, WELL RADII, ESMTS, OR OTHER SEPARATIONS... PRIOR TO CONST. BIRCH HILLS TERRACE #2 B1, L5 STAKE PROPERTY LINES, ESMTS, WELL RADII, WATER LINE, ETC.... PRIOR TO CONST. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251429, Isatou Njie, 12/15/25 26. 2' 2 9 . 0' 4.1' 1 1 . 0 ' 12.0 ' 1 2 . 2'12.0'1 2 . 0' 26.2' 3 6 .3' 4.4' 2 8 . 2' 4 B R R E S I D E N C E FIRST WATER CONSULTING DESIGN DETAILS: BIRCH HILLS TERRACE #2 B1, L5 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251429, Isatou Njie, 12/15/25 FIRST WATER CONSULTING BIRCH HILLS TERRACE #2 B1, L5 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251429, Isatou Njie, 12/15/25 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com ! !! December 10, 2025 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC SYSTEM UPGRADE PERMIT LEGAL: BIRCH HILLS TERRACE #2 BLOCK 1, LOT 5 The property owner has requested we obtain a permit to upgrade the failed septic system of the above referenced lot. We propose to remove all biomat material of the existing trench, add MOA sand to maintain elevations, remove end of trench from the BLM easement & augment the trench with a new portion of the absorption field per the attached design to serve the existing 4- bedroom residence. The proposed new trench is to be reconnected to the existing plastic 1300- gallon septic tank. The design is based on the recent test hole conducted on October 24, 2025. No groundwater was observed at test hole excavation but was monitored at 18’ per the attached test hole TH25-1. The existing slopes are moderate at 0-5% at the proposed upgrade location. However, extensive fill has been added previously with steeper slopes downgradient and thus the slope profile shown on the design page 3. The lot is served by public water, and the area are served by both public and private water. 2 wells on property have not been decommissioned properly, and it is proposed to be done prior to IR or COSA issuance. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251429, Isatou Njie, 12/15/25 3030 Sues Way - Anchorage, Alaska 99516 Tel. 907-350-9566 firstwaterAK@gmail.com SOILS LOG - PERCOLATION TEST LEGAL : BIRCH HILLS TERRACE #2 B1, L5 PERFORMED BY: FWC - I CURTIS HUFFMAN CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE & MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 10/31/2025 DEPTH FEET OG SOILS 1 2 3 4 5 6 ORG/FILL 7 8 9 10 11 12 13 GM/sw 14 15 16 17 18 19 20 BOH Reading Date Gross Time Net Time Depth to Water Net Drop 10/24/25 10 min 6” 4 14/16” “ 6” 4 13 /16” “ 6” 4 12/16” “ 6” 4 12/16” “ 6” 4 11/16” “ 6” 4 12/16” PERCOLATION RATE 2 (MIN / INCH) TEST RUN BEWTWEEN 9 & 10 FT PERC HOLE DIAMETER 6” PRE-SOAKED PRIOR TO TEST & ALL READINGS TO THE 1/16TH. GROUND WATER ENCOUNTERED: NO IF YES, AT WHAT DEPTH: NA DEPTH TO WATER AT MONITORING: 18’ DATE: 10/31/2025 TESTHOLE # 25-1 DATE PERFORMED: 10/24/2025 SEE SITE PLAN FOR SLOPE & LOCATION COMMENTS: VERIFY GROUNDWATER MT AT TIME OF CONSTRUCTION PERFORMED FOR: EARLE WILLIAMS 10/31/25 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251429, Isatou Njie, 12/15/25 12'x20' SHED DECOMMISSIONED WELL 6" IRON PIPE 2 6 .2' 29.0' 4.1' 1 1. 0' 12.0' 1 2. 2'12.0'1 2. 0' 26.2' 3 6. 3' 4.4' 28.2' R E SI D E N C E LEGEND EDGE OF GRAVEL DRIVEWAY DECK CONCRETE EDGE OF ASPHALT RECORD DATA PER PLAT #81-202 SEPTIC PIPE WELL WATER VALVE FENCE TIMBERLINE SURVEYING AND MAPPING 17035 BARONOFF AVE EAGLE RIVER, AK 99577 907-242-5320 ryan@timberlinealaska.com FILE NO.: 25.231 SCALE: 1" = 30 FEET DATE: 10/21/2025 SHEET: 1 of 1 MOA GRID: NW0153 SCALE: 1" = 30 FEET(11"x17") 30'0' 60' AS-BUILT OF: ADDRESS: 17736 N EAGLE RIVER LOOP RD, EAGLE RIVER, AK LOCATED IN: ANCHORAGE RECORDING DISTRICT LOT 5, BLOCK 1BIRCH HILLS TERRACE SUBD.ADDN. NO. 2, PLAT #81-202 Municipality of Anchorage Development Services Department �3 Building Safety Division i•�� Onsite Water and Wastewater Program, 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 Page I Of� www ci anchorage ak us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SWO80216 PID Number: 050-141-28 NBTe Roy Williams Wastewater System: ❑ New Upgrade Aa6sas 17736 Eagle River Loop Road Eagle River, AK 99577 ABSOR,yq46N FIELD Pnorr 694.3429 Nunba of Bsaooms 4 D Deep Traa3i O sroikna T O eea ❑Mow ry�O Ouxr LEGAL DESCRIPTION sal RM.V TQai .— na aea GP fit' FI. 13 c 1 La 5 auhdviaun Birch Hilts Terrace #2 DsaD m oaten hen aximl pans Gra a yin Dansam _ FI Fl To~* Rape seaun F, nal gra 134 v La.pm Ft. FI. Well: ❑ New ❑ Upgrade c Nunhaa Dmanneawsatrbs F6 Ft CbsPluaiun IPrnets. A a, t) Taal Dsan Cassa ID Tasi aDwr m rM P nanM Existing Private Ft. FI YL 3c D.W Dab DraNa stn LavN FI Tinna�iw���•F� �y 1 ,✓G�s'J LT ono nua��sa '-7� QQ ! OCS Ywa Pump s canna NagDl noovs cram TANK GPM FI. FI SEPARATION DISTANCES 0 Septic ❑ Holding ❑ S.T.E.P. ❑ Other. To I Septic Absorption Lift Holding lublicTnvate From Tank Field Station Tank Sewer Line Premier Plastics 11300 Ga me 184' -186' 1,100'+ 25'« Mnabi HDPE Nun aCOmpalmama 2 s,eavwain 100'« LIFT STATION Sao saun La Lm 33' -21' 'PianPpn.b v 'Poop M. Nqn was aamn FaaMwun 12' 18' n n Gaon Ne.None Known Pump Max EN Mlil k-PWMa Pabrnisa Dy Remaks Existing tank was pumped, crushed, and abandoned. BENCH MARK Loreim as Deeaptm ,NVAr'� L %IGF /3l Lt0F r,4V Top of concrete near point -A' { Xr '�. ,1( pr -a Volm Y ti�I!/L J /G� ..nun. 100 lil.l✓//ti/LD FL a shot Tb PES n/tw/ ngineetirg Engineer's Stamp Inspections performed by: 158615. Birchwood Lp. Rd. Dates: 1111 10-7-2008 ° na 2 Development Services Department Approval r��; ,'a?T,CE, Conditional Approval Date: v F. •�c,••< .aerl A. Shafa 7y, + No. 1457-1 Reviewed and approved by: ✓ I viFr/i! Date: O$ ➢Fo''�•.»..• • ��``�e`� PERMIT NO. SW080216 PACE 2 OF 3 Municipality of Anchoro, e DEVELOPMENT SERVICES DEPARTMENT - BUILDING SAFETY DIVISION ON-SITE WATER AND WASTEWATER PROGRAM, 4700 BRAGAW STREET Pn. Box 196650 *Anchor age, Ata stKa 99519-6650 • Telephone: (907) 343-7904 • www.ci.anchorage.ok.us ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 5, BLOCK 1, BIRCH HILLS TERRACE #2 P.I.D. No. 050-141- 33' BLM SECTION LINE RESERVATION LOT 6 to, (irk rrE4s EAGLE RIVLsR \ CAIS,, 'Ai T 00 "i p R .�y DBLI A OBL7 4 STin COT a IYT NEW I300 GALLON NOPE SEPTIC TANK IBN C y. �0 /' P'pP� TA \ \ Q APPROXIMATE 100' WELL LACEY DRIVE LOT 4 1 - 40 ENCI\ 4'4" 7. if r ••IeA• fhafw � ,ti .i PERMIT No. SWO80216 PACE 3 OF 3 Municipality of Anchorage DEVELOPMENT SERVICES DEPARTMENT - BUILDING SAFETY DIVISION ON-SITE WATER AND WASTEWATER PROGRAM, 4700 BRAGAW STREET P Cl. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone (907) 343-'7904 • www.ci.anchorage.ak.us ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 5, BLOCK 1, BIRCH HILLS TERRACE #2 P.I.D. NO. 050-141-28 6.3' JVV of -WK ST1 / ST2 �,— 98.3' FINAL GRADE NEW 94 8' 1 300 GALLON POLYETHYLENE SEPTIC TANK 2" INSULATION 94.5' A B TMT 16.0 15.5 ST 1 18.0 1 6.0 ST2 22.0 17.5' DBL1 24.5 19.0 DBL2 25.5 20.0 C01 1 32.0 19.5 2" INSULATION 94.5' MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & 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: Oct 02, 2008 Expiration Date: Oct 02, 2009 Permit Number: SWO80216 Parcel ID: 050-141-28 Legal Description: BIRCH HILLS TERRACE #2 BLK 1 LT 5 Design Engineer: 0003 S & S ENGINEERING Site Address: 017736 EAGLE RIVER LP N Owner Name: ROY WILLIAMS Lot Size: 41146 SQ. FT. Owner Address: 17736 EAGLE RIVER RD Total Bedrooms: 4 Permit Bedrooms: 4 EAGLE RIVER. AK 99577 - This permit Is for the construction of: ❑ Disposal Field Z Septic Tank ❑ Holding Tank ❑ 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. Received Issued Date: to1 3 ke) Date: A Q EI1jC-aE1j0/ I ,mak C_ Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 ON-SITE SEPTIC/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. bb—o— ILI Fogg' Property owner(s)_W .\\1 arras Day phone 1n94- 3h 2`l iLpG LL Mailing address (oUfm�Z Q4Ax. Lp wu,Aaip Code�- Site address s2„n.,` Zip Code Legal description (Sub'd, Block & Lot) t S R) k 1 E I rt'c l U,ils '�4-r rac E4b* 2 Legal description (Township, Section & Range) Lot Size L4 1, 1 of o_ Sq. Ft. THIS APPLICATION IS FOR (®all that apply) Absorption Field ❑ Septic Tank JR Holding Tank '❑ Privy ❑ Private Well ❑ Water Storage ❑ I certify that the above information Single Family Dwelling and is in (Signature of property owner or Number of Bedrooms THIS APPLICATION IS AN: Initial ❑ Upgrade Renewal ❑ certify that this application is being made for a :able Municipal Codes. Date of Payment: Receipt Number: 3 S) D Receipt Number: (Rev. 11105) S&S\ ;IneeRInG October 1, 2008 ROBERT C. COWAN CIVIL ENGINEERING PH: 907.694-2979 FAX: 907694-1211 NExTHA HORLTY APPROVALS MUNICIPALITY OF ANCHORAGE Development Services Department P.O. Box 196650 OMNSSEWEAT`s Anchorage, AK 99519-6650 Lot 5; Block l; Birch hills Terrace #2 SEWIEREFERENCE: .sPE"CION " 17736 N. Eagle River Loop ENG'REERINGSTUdEg Request you issue a permit to replace the existing collapsed septic tank located AND REPDRTS on the referenced property. A fiberglass 1000 gallon tank was installed in 1977, and a 500 gallon steel add on tank was installed in 1980. At that time, the structure was used as a duplex and has since been converted to a four bedroom single family home. WELLISPEMiON FLM TEST A new 1300 gallon Premier Plastic tank will be installed to replace the existing tanks as shown on the attached drawing. mrenAw This structure and adjacent structures were connected to AW WU public water system in September, 1994. There are no wells on any adjacent property within 100 feet of this septic system. ROAD DESIGN Sincere , SOATEST / PERCOLATION TEST STRLCTURAEa MECN mr& INSPECTIONS ONSITE WASTEWATER DGPOSALSYSTEM DESIGN P.E. 15861 S. Birchwood Loop Road - Chugiak, Alaska 99567 S& ROBERTC. COWAN, P.C-. ROBERTA. SHAFER, F.E. CIVIL ENGINEERS (907) 694-2979 FAX(907)604-1211 " ON-SITE WASTEWATER DISPOSAL SYSTEHI CONSTRUCTION PRACTICES lKALTHAUr1p(yry ti PROV y$ and MATERIAL SPECIFICATIONS MAIa WATER N MN IXTE.�IONL f REFERENCE: Lot 5 Block 1 Birch Hills Terrace S/D #2 f October 1, 2008 GENERAL: SEWER& WATER Vf-.PCCt�CN 1. The scope of this project includes the upgrade of the existing system, with replacement of the 1300 gallon HDPE septic tank to serve the existing four bedroom residence located on the referenced property. CNCINCERING $TUGS$ ANOREPORT$ 2. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal W `' L V4PCCT10t+ Regulations. a FLOWTEST 3. The contractor shall be responsible for obtaining any necessary underground utility locates. $i TC rv,AV 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil „C„DuS:GN settling. S. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners SCE TES' installing their own systems must also receive prior approval from the Municipal Health Department. PCRCCLAT.ON TEST SEPTIC TANK INSTALLATION: 1. A septic tank is to be constructed by a certified septic tank manufacturer. $; nuc rwLU a Construction shall include two 4" cleanouts for pumping access. W:CMNN.CN. a�.PCCT:0N:S 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. CNS;TE WA.TFWATF.R GSPOSN. SYSTEM MQIRN 1i361S.Birclneoodl.00pRoad —Chugiak,Alaska 99167 Page 2 Lot 5, Block 1 ,Birch Hills Terrace SID 02 October 1, 2008 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Septic tanks installed with less than 4 ft. of cover shall be insulated S. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 11. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipal approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pip Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. Page 3 Lot 3, Block 1 ,Birch Hills Terrace SID 02 October 1, 2008 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, its gradation specifications muse conform to current M.O.A. or D.E.C. requirements, which ever requirement applies. INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: 1. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre -construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTORANSTALLER MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 LStreet -Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME XA/ f. fj� 0 A-1 PHONE Z��� ElNEW UPGRADE MAILING AD—DR SS 71 rr{Q LEGAL DESCRIPTIV It LOCATION /y/-� NO. OF BE6ROOMS z Well 1• f Absorption area 1,4 Dwelling- / -A PERMIT NO. r, DISTANCE TO: / -. � _Y a. ZQ LU-- Manufacturer y�{� ���, idJ. / y ;S- a i No. of compartments Li . capacity in gallons IF HOMEMADE: Insi length ----- Width Liquid depth O Z DIANCE TO: Well Dwelling PERMIT NO. O Q 2 I– Manufacturer ? Material Liquid capacity in gallons Well Foundation Nearest lot line PERMIT NO. w= DISTANCE TO: J u. Z No. of lines Length ofe line Total len th of lines Trench width Distance between lines P Z w inches HTop of tile to finish grade t al beneath the Total effective absorption area inches Length Width Depth PERMIT NO. w C7 H Type of crib Crib diameter Crib depth -- Total effective absorption area wa w � DISTANCE TO: Well Building foundation N earest lot line Class Depth Driller Distance to lot line PERMIT NO. J J w DISTANCE TO: Building foundati w= ' f 1e4, li a Septic tank Absorption area(s) OTHER w v PIPE MATERIALS jvi/ R SOI L TEST RATING r INSTALLER � %� REMARKS i Ai P AMV el( )Z?(-) c7c; - �1�iL° cZ�L ale.f) 1-14' a? APPROViED ev. 3/78) DATE LEGAL r•1 u r -a I +— • " l___ 1. 1 °-r• , 1-1 Y i."i 1 ..a 1 . " 1— s r—r-7 '_7 C_ - DEPARTMENT DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 ' L =TF'EET, ANCHORAGE, AK. 995 Cl E t_._ L H r -a c• Co r-4 — _• I T E E L•1 E ' F' E Fr P1 I T PERMIT NO. i APPLICANT LOCATIOFJY'- LEIiALr(-c.k t4 i 7 -,e fits CA r e f4�-� LOT SIZE dl TAPE FEET t TYPE OF SOIL ABSORPTION SYSTEM I S : « r ` j Y �-,- CI c� " < 0 n MAf' I MUM NUMBER OF BEDROOMS = L( SOIL RATING (SQ FT,' BP > = THE RE17U I RED SIZE OF THE SOIL ABSORPTION SYSTEM IS - THE : THE LENGTH DIMENSION I S THE LENGTH -*,'Ir-4 FEET) OF THE TRENCH OP DF'A I NF I ELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE i iF THE GROUND AND THE BOTTOM OF THE EXCAVATION i I N FEET). THERE 1= 1.40 'SET WIDTH FIR TRENCHES. THE GRAVEL DEPTH 15 THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXC:A'v'ATION CIN FEET?. F*E=-0 U I F:EC1 := EF'T I r- TRr.ak �. I a: E: PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFOF'M THIS DEPARTMENT D+PING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. ----- TL•Jr_+ f` > I +__lr4:EFHF:E F"E:LA I I EC ---- BACKF I LL I NG OF ANY SYSTEM WITHOUT FINAL IN'SPEC:TION AND APPROVAL BY THIS, DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWRGE DISPOSAL SYSTEM I iOkl FEET FOR A PRIVATE WELL OR 150 T� � 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PPI %v ATE SEWER LINE IS :'5 FEET AND TO A COMMUNITY SEWER LINE 15 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN _70 DAYS. OF THE WELL COMPLETION. OTHER. REQUIREMENTS MAY APPLY. SPECIFICATIONS ANC? CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE ARE PROPER INSTALLATION. F'EF'rri I T E: =:F' I F:E'= C?E+_ EME:EF• :H: A . 1_=-A E ID I CERTIFY THAT i: I AM FAMILIAR WITH THE REQUIREMENTS FOR CIN -SITE SEWERS AND WELD As 'ET FORTH BY THE MUNICIPALITY OF ANCHORAGE. : I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 2: I UNDERSTAND THAT THE ON-SITE '=EWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN Z BEDROOM',. APPL I CANT I SSUED B','-- - - / - - (_ �- , ��, _C?ATE_ _ NAME LOCATION �._ GREA i ER ANCHORAGE AREA BOR_/UGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM s� 4!2V - MAILING ADDRESS__". PHONE`" 'LEGAL DESCRIPTION SEPTIC TANK: -0 r' _ NUMBER O DISTANCE F FROM WELL MANUFACTUREMATERIAL_ ------COMPARTMENTS 1 INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH ___.—LIQUID CAPACITY � ���"GALLONS. SEEPAGE PAF-: r �-¢--�-�--�� - -- 13 NUMBER OF PITS DIAMETER --OR WIDTH LENGTH_! f� DEPTH1 — LINING MATERIAL CRIB SIZE: DIAMETER --DEPTH 'hD15TANCE FROM: WELL f TOTAL EFFECTIVE BUILDING FOUNDATION NEAREST LOT LINE ABSORPTION AREA (WALL AREA) _ SQ. FT. ADDITIONAL ABSORPTION WELL: TYPE CONSTRUCTION _ BUILDING NEAREST NEAREST FOUNDATION LOT SEWER LINE CESSPOOL _ OTHER SOURCES APPROVED___ DISAPPROVED-- REMARKS DISTANCES: INSTALLED BY: PIPE MATERIAL: LOT SLOPE: REMARKS: Form No. EQ -031 DEPTH, DISTANCE FROM: SEPTIC % SEEPAGE i TANK—��`'l�; SYSTEM %r, �?a ` D�WMM OF SYSTEM DATE APPROVED GJA.A.B. owl k .1 p"4 1 k 17 11 .0 R.-1 -1 - KWA DEPHRTMENT .� HEHLTH HND ENVIRONMENTAL , ROTECTION 2516 E, TUDOR RD , ANCHORAGE. HK. 99507 276-2221 �� '��'� � // /(��_y� R101-05� lF�� ��EFhiEN�� ������rI� U PERMIT NO. ( 76494 ) HPPLICHNT LARRY PERSONBX 718 EAGLE RIVER 99577 694-2222 ON LOCHTI'-- LOOP RD LEGHL L5 B1 BIRCH HILLS TERRACE #2 LOT SIZE 44000 SQUARE FEET TYPE OF SOIL HBSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = ] SOIL RATING (SQ FT/BR)- 140 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: �K 1�" -1- 1-1= A- GN L__ ENE 00 CIA K 1-1= 136, CIA IT: 10"%j ENE R.. L> ENE F" ir FA= � THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD. THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND HND 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). F 12 E EGER F=" -Y- 1: 10 -r q m K n3 X if EE= J, (21 fit Ch C3 FA L . L. C3 r4 5�� BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPHRTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR H PRIVATE WELL OR 200 FEET FOR H PUBLIC WELL SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. k" EE FT P1 31l- "w"K 1L. 1 1> F0 C::u F��!! 1(:_*::fl ENE 1=1 K 1=7 Fit K:) 1-1 X !15 "OvKj IV: I CERTIFY THAT 1: 1 HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ]: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS TO INCLYDE MORE THAN ] BEDROOMS. SIGNED.______[^�. _..... ... APPLICANT LARRY PERSON � ISSUE[) BY..... ..... ... ` Ito' r / �- � ( / ,J Ef E GEO . ECHNI CAL & DEVEL.rPMENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster Earl Ellis 694-2774 SOIL LOG 688-2280 Soils Et Foundations Land Development Performed for: Name: Tel. No. 601/J` ZZZ2— -Mai1in Mailing Address: Legal Description: --moi _ \—:�> Depth (feet) Soil Characteristics 0 1 3 --1 --- �L - 5 .- 5 6 Aso 7- 8— I 0 10 71-1 7 1 e� 6ti� )wiz. 12 13 14 15 16 Ground Water Encountered: Yes No \// If yes, what depth Proposed Installation: Seepage Pit Drain Field ✓ Comments: � N. c Performed by: Date: �? 1A 'N2\%, June 1976 Larry rerfson General Deli racy rLagle River, Alaska 99577 5w)Jects Well La, Q-1 ;N1 IT rrace recoras 940w t:,-Aat Chir. depA%rtwarLt. has act reCOL-un.-A a Well latis ofa the su,,Jeet property. t t, rc.qwiras well lra,��a to L44-1 SWimittet." .#ithin tlairty (1�)) days after drilling imt cowpleted'. The well CA1,110�i�slderad for approval by thig U6part- -ejopt v,a wc-.11 loj is roaelvw.J. we>uld yt�,u Pif'vwse Ser,44 or tic' 'wirry a copy of tzhu wt -Al io.",- to tl-a of, iiaaltb, &.,-io f ,�4ar so wo t-aay A-10C-ei,4t yt.'-mr Clora out. lirour 1pervalt* if yon � 4 . d r I Ir-laCk' 3, vq.� aily question;A0, or you �nava not as :�O` your w"i 91 call ug at 276-2221rextax--ision 263 Or 2 U 41:�, to s c, i,--tr ere.'AY, , ' oentso Coni=-;! w IIAIJj ix DEPARTMENT OF HEALTH HND EPSV IRUNMEN(AL PROTECTION 2510 E. TUDOR RD., HNCHURRGEo HK 99507 276-2221 01F E t.. V F"' FEE Fit 1*1 X A PERMIT NO C76045) LARRY PERSOU. GEN DEL — E. R. 6 9 4 2 2 2 LOCHT101.4 LACY & E R LOOP LEGAL. L5 Bi BIRCH HILLS TER #2 LOT SIZE 42000 SQFT MINTMUM Vol�,'.14-IN(,"L FROM WE: TO ANY SEPTIC TANK?PACKHUE PLHN'T OR SOIL HOSORPTION SYSTEM 15 100 FT FOR A PRIVHTEMELL AND 200 FT FOR 0 PUBLIC WELL. HEIL LOGS MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 PHYS OF THE HELL. COMPLETION, SPECIFICATIONS AND CONSTRUCTION DIMORHMS LIRE AVAILHULL TO INSURE PROPER I ON. I CERTIFY THAI I AM FAMILIAR WITH THE REQUIREMENTS FOR ON—SITE SEWERS HND WELLI�'-'-'; AS SET,OR TH BY THE MUNICIPHLITY OF' ANCHORAGE AND WILL INSTALL IN ACCORDANCE WITH THE CODE. ISSUED BY. LOG OF DRI UNG by A & L DRILU"G COMPANY - . , - OWNEROF LAND .__l'.,_.j_.'-'--=------------ ---------- f, — .6,%; ---------- -- ------------ DEPTH OF WELL ------ 'AO / ---------- ---------------------------------- ADDRESS ------ ----------------- -------- ----------- -------- --------- ---------------- ------ - STATIC LEVEL OF WATER FT. --------------- ------- WELL SITE ell 4� DRAW DOWN FT - ----- ------------------- ------------------ ------- -------------------------- DATE—STARTED ------- --------- A -'OTS. PER HR. r �i ell ------------------------------------------------------ _ DATE—ENDED ------------- --------- ......... KIND OF CASING ---- -- -------- ------------------ ...... -------- ............... KIND OF FORMATIO1 : FROM--------------- . ---- _FT. TO ------ -------------- FT .............. FROM------ ----------------- FT. TO ----------_--- -------- FT. ---------------------- FROM-----`' -------- -----FT. TO ----- -------------FT.------- ------------ ..... FROM ---------- ---------.._.FT. TO ------------ -----------FT.---- ----------FT------ — _..- FROM-------- FT. TO -_'21-7 --------- FT_f�.*�___,,, FROM ------------------------ FT. TO --------------- FT `` fA Gf�'r°'�'�."FROM -------- FT. -------- FROM -------- �_J_ --------- FT. FT. .............. . FROM----------- --------- _FT. TO------- --------------_FT.-- ----------- ...... ..... FROM--- •• .-- FT. TO ------------ FT. ---.t ----------------- ....... FROM------- -------------FT.TO ------------------------ FT..__------------- ------_- FROM ...... I --- ------ _ FT. ----------- --- ------ ...... FROM� ----------------------- FT.TO ---------------- ------- FT ------------------------------- FROM------------- ----------FT. TO ----- ------------------FT.---------- --------- --- FROM ------------------------FT. TO_ --------------------- FT ------------------------------ FROM------------------------FT. TO--------- ------- ---FT.------- ----------. ..- ------- FROM -_------------------.FT. TO ------------------------ FT ------------------------------- MISCL. INFORMATION: DRILLER'S NAME - ----------------------- u 5. LEGA-L{-DESCRIPTION DATE RECEIVED INSPECTION APPOINTMENTS TlrviE TIME TIME DATE DATE DATE ❑ SINGLE FAMILY ❑ One 4l Four ❑ Other INSPECTOR INSPECTOR INSPECTO� MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPT. OF I C_ALTH & 825 L Street - Anchorage, Alaska 99501 • ENVIRONMENTAL F;'.OTECTION ENVIRONMENTAL SANITATION DIVISION JUL_ 3 0 1980 Telephone 264-4720 8. SEWAGE DISPOSAL SYSTEM pp LL ��// REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEAK(fidIyI&D DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROP RTY OWNER ❑ PUBLIC UTILITY PHONE, 0/ -- �a MAILING /V AnnDD ESS 504&a PROPERTY RESIDENT (V different from above) PHONE v 2. B Vo PHONE vz­ MAILING AD S 3. LENDING INSTITUTION PHONE MAILING ADDRESS l- a' 4. REALTOR/AGENT PHONE v 7 z MAILING ADDRES 2d u 5. LEGA-L{-DESCRIPTION G D Lcr�5 STREET OCATI ON `' L" 6. TYPE OF RESIDENCE NIOMBER OF,BEDR, QO,,MS ❑ SINGLE FAMILY ❑ One 4l Four ❑ Other ❑ Two ❑ Five MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SUPPLY i� INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled COMMUNITY © -VA Nysince June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE** Iq 7-7YEAR 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) ` ZZ)o ���� 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ TWO ❑ THREE ❑ FIVE ❑ OTHER ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ 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: 1000 If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS UJ --'APPROVED FOR� BEDROOMS ❑ CONDITIONAL APPROVAL (letter mus ac ompany certificate) ❑ DISAPPROVED DATE 72-010 (Rev. 6/79) Ann Person, P.O. Box 1715 Ea rrle River, Alaska 99 577 Denr PIs. Person, DAVID A. SLENKAMP MECHANICAL ENGINEER 694-9055 August 4, 1980 ROBERT A. SHAFER Reference: trot 5; Block 1; Birch Hill Terrace No. 2 `subdivision CIVIL ENGINEER 694-2979 At ,your request, a sewer system adegix cy test was performed on the ref— erenced property on August 1 and 2, 1980. The septic tank was pumped and verified to have a cnunci.ty of 1000 nnll.ons. The absorption trench was tested by a continuous flow of 50/. 7,911 -ons over a period of 2/. hours. At the conclusion of the test there was no mensuxnbl.e rise in the water level in the sump at the end of the trench. It can be concluded from this test that the absorption trench is currently adequate for a four bedroom duplex. however, the septic tank capacity is inndeauate. An additional 500 {a11on capacity septic tank may be added to the existing system to make the entire system adequate. The septic tank and absorption trench are in excess of 120 fent from all existing wells. A permit to add the septic tank to .your system will be obtained from the Mi.ni.cipality of Anchorn.rfe and. Gibbs Construction has agreed to perform the work during the week of August /. through 5, 1950. If we may be of further assistance, please do not hesitate to ca1.1. Since�,,o;y, BERT A. STJA 'P. , P.E. S/ss cc: Century 21, 'leritn ge Home ATTF,'NTION: Margie Lugo Alaska Housing Municipality of Anchorage Department of Enviornmentnl Health and Protection SRB 196X EAGLE RIVER, ALASKA nicipality of Anchora,ge- 825 "L" S_I.REET ANC;HOHAGE, ALASKA (907) 2G4-4111 GFORGF M. SULLIVAN, MAYOR fRFPAR I MLN I M III AlH ANO ENVIROKIMFNTAL PROTFUION August 6, 1980 Anna Person % Margie Lugo Century 21 - Heritage Homes 207 East Northern Lights Boulevard Anchorage, Alaska 99503 Subject: Lot 5 Block I Birch Hills Terrace Subdivision Approval for your individual sewer and water facilites cannot be granted until the following items have been completed: stall additional 500 gallon septic tank to isting 1,000 gallon tank as per permit issued August 4, 1980. e top of the well casing sealed with a sanita. al so that it is water tight. e water analysis report be delivered to this partment from Chem Lab, 5633 B Street, for r review. If there are any further questions, please call this department at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw cc: National Bank of Alaska % Sue Benedetti Pouch 7-025 99510 \ NICIPALITY OF ANCHORAC- DEPARTM.1N. HEALTH AND ENVIRONMEi +L PROTECTION 825 L Street, Anchoraap.. Alaska 99501 264-4720 Date Received: February 14, 1978 #1: Time t #2: Time #3: Time Date �4p_A Date Date Insp Insp Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. Lending Institution Request: United Bank Alaska Mailing Address: Post Office Box 59 99510 Phone: 27/a-1911/240 2. Property Owner: Anna Person Phone: 27(o-1911/240 Mailing Address: Post Office Box 718 99510 3. Legal Description: Lot 5 Block 1 Birch Hills Terrace Addition#2 4: Single Family Residence: (x) Multiple Family Residence: ( ) 5. Well System: Individual Well (x) Permit # Construction Number of Bedrooms: Three Number of Bedrooms: Community/Public System ( ) Depth of Well 100' Well Log on File`-- ) Bacterial Analysis 6. Sewage Disposal System: On-site System (x) Public Utility ( ) MI) Permit # Installed 1976 Installer Septic Tank Size Manufacturer Absorption Area Soils Rate _ r Material 7. Distances: Well to Septic Tank to Sewer Line to Nearest Lot Line to Absorption Area Nearest Lot line Absorption Area MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO VA FHA CONV XX 2. Property Owner: Anna Person I CE.. - Mailing Address: PO Box 718 Day Phone: 276-1911 ext 240 3. Name of Buyer: N/A Mailing Address: Day Phone: 4. Name of Lending Institution: UNITED BANK ALASKA Mailing Address: P_0 Box 59 Phone: 276-1911 ext 240 5. Name of Realtor or Agent: N/A Mailing Address: Phone: 6. Legal Description: Lot 5 Block 1, Birch Hills Terrace Add #2 Location: 3/4 mile Eagle River Loop Road 7. Type of Facility to be Inspected: Residence No. Bdrms. 3 8. Water Supply Type of Supply: Public Utility Individual XX If Individual, number of dwellings presently served 1 If Individual, depth of well 100, 9. Sewage Disposal System Type of System: Public Utility Individual (on-site) XX If Individual, date of installation July, 1976 1.3 /5;�7S` a �ia,u�/ 72-003(3/76) C.��'✓ �'/ `(�1��.f�/' V� Page Two Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 5 Block 1 Birch Hills Terrace Addition #2 Comments: Affadavit Attached:n( ) Letter Attached: ( ) Approved: Date: .Z -�22 � 0 Disapproved: Date: Department Worksheet: y CK -09a :o zh6 od!) - 11VW 1VNOIIVN831NI M03 ION T G(T (apla aay/u aas)—0301AOdd 39MA03 33NVHRSNI ON OOOC wa©ZI sd �4 ....... ....... - ................ .. (pajinbaa eat w4xa) AH3A1130 1V103dS POS .' ...............................-......'.-............ A1N0 33S_M0.0V Ol HIA1130 ° _ 049 " Aluo aassaJppe 01 AJaAliap 1111MS301303AH3 S OGE - PaaaA!IaP DJ04M PUP MP 'W64M 01 sMoyS 'Z 13 A $S9 """"'" Aluo aassaippe 01 Alanllap 4IM PSI PaaaAllaP a1eP Pue IU64M 01 SM 4S '1 NH013H S33A 1VN011100V HOA MIAMS 1VN411d0 -� 1000 dIZ ONV 31M M'O'd 'ON (INV 133H1S ( 31VO HO NHVW1SOd 01 1N3S (93elsod snld) •50C---j{qW 031JIJ-833 M®J IMAH MUNICIPALITY OF ANCHORAGE Development Services Department Phone: (907)343-7904 On -Site Water & Wastewater Section Fax: (907)343-7997 Certificate of On -Site Systems Approval OSC261161 Parcel ID 050 -141-28 Expiration Date: 8/14/2026 Legal description BIRCH HILLS TERRACE #2 BLK 1 LT 5 Site address 17736 N EAGLE RIVER LOOP RD Current property owner(s) WILLIAMS ROY V & THERESA ANNE X The On-site system(s) is/are approved for 4 bedrooms By: Conditional approval for bedrooms, with the following stipulations: Comments or conditions: Original Certificate Date: 6/1/2026 Thisficate of On -Site Systems Approval (COSA) is intended to demonstrate the subject s�m(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Service Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's submittal. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other MUNICIPALITY OF ANCHORAGE Development Services Department _: Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 050-141-28 Complete legal description BIRCH HILLS TERRACE #2 BLOCK 1 LOT 5 Location (site address) 17736 N EAGLE RIVER LOOP ROAD EAGLE RIVER, ALASKA 9957 Current property owner(s) WILLIAMS ROY V & THERESA ANA Day phone 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: ❑ Private Well serving # dwelling units ❑ Other Non-public well as regulated by MOA ❑ Water Storage ❑■ Community Well or Public 4. TYPE OF WASTEWATER DISPOSAL: M Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel M Plastic ❑ Concrete ❑ Fiberglass Age 18 - See advisory if steel or fiberglass older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑■ Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ ' Waiver Fee $ Date of Payment y Date of Payment COSA # SC_ z �'( Waiver # COSA Application_Apr2025Acc COSA Checklist copy.docx COSA Checklist Legal Description: BIRCH HILLS TERRACE #2 BLOCK 1 LOT 5 Parcel ID: 050-141-28 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA – Public Water/ Community Well Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank 47” Date of pumping 8/14/25 Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. DISPOSAL FIELD DATA Which system tested (date installed) NEW FIELD ALL standpipes present per record drawing Total measured depth from grade 13.5 ft (max) Measured depth to pipe invert from grade 9 ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes (MT) go to bottom of effective (ED). If not, state depth into effective Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) N If yes, enter date Adequacy test date NEW FIELD Results Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate gpd FIELD STATUS – NEW FIELD ED (per record drawings) 48 in Effective depth (ED) used 0 in Effective depth remaining 48 in Comments/Deficiencies: Approximate total measured depths from existing grade. COSA Checklist copy.docx E. SEPARATION DISTANCES From Well on Lot to: (Please enter distances if less than required) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Disposal Field on Lot > 100’ Yes if No ft Neighboring Disposal Fields > 100’ Yes if No ft Sewer Line/Main > 100’ Yes if No ft Sewer Manhole/Cleanout > 100’ Yes if No ft Sewer Service/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Disposal Field(s) on Lot to: (Please enter distances if less than required) Tank to Foundation > 10’ Yes if No ft Field to Foundation > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main/Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 05/20/2026 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & 05/20/26 12'x20' SHED 2 6 .2' 29.0' 4.1' 1 1. 0' 12.0' 1 2. 2'12.0'1 2. 0' 26.2' 3 6. 3' 4.4' 28.2' R E SI D E N C E LEGEND EDGE OF GRAVEL DRIVEWAY DECK CONCRETE EDGE OF ASPHALT RECORD DATA PER PLAT #81-202 SEPTIC PIPE WATER VALVE FENCE TIMBERLINE SURVEYING AND MAPPING 17035 BARONOFF AVE EAGLE RIVER, AK 99577 907-242-5320 ryan@timberlinealaska.com FILE NO.: 25.231 SCALE: 1" = 30 FEET DATE: 5/4/2026 SHEET: 1 of 1 MOA GRID: NW0153 SCALE: 1" = 30 FEET(11"x17") 30'0' 60' AS-BUILT OF: ADDRESS: 17736 N EAGLE RIVER LOOP RD, EAGLE RIVER, AK LOCATED IN: ANCHORAGE RECORDING DISTRICT LOT 5, BLOCK 1BIRCH HILLS TERRACE SUBD.ADDN. NO. 2, PLAT #81-202