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SUNNY VALLEY LT 4
Sunny Valley Lot 4 #050-354-29 Municipality of Anchorage On-Site Water and Wastewater Program • (907) 343-7904 Page L of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: 05 P 13 15 r PID Number: D5o 3SV-q0(>� Dwelling: X Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: X New ❑ Upgrade Name: Chad ?,00061 ABSORPTION FIELD Deep Trench ❑ Shallow Trench El Bed [:1 Mound Address Wif 71 p ).?-Is3 "kms V,Cr•J fir. C-a fG 9 4.p AK ❑ Other Phone 0011` Logo -0&;& Number of Bedrooms q Soil Rating o•y $ GPD/SF Totaldepthfrom original grade Sa 18*t. LEGAL DESCRIPTION Depth to pipe invert from original grade ✓ ?,., Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot.0 _ Filladdedabove original grade - - - O Ft. Gravel length f f°�•j f ot•1 Ft. Township Range p Section 7 R I W I b Gravel width 3 Beds: Number of Lines Distance between lines SEPARATION DISTANCES Ft. — 16 Ft. Tol Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 1 5q' Flz Z. IS Ft. wellI G �� I.ZQ 1 ! I 17 TANK []Septic S.T.E.P. []Holding ❑ Other Manufacturer-1 -4KCIA 0 G td1Nk Capacity t 1 Ira Gal. Surface Water �' 1{I Ige' ISL Material 544A Number of compartments Z, Lot Line I I 14 t 3 — NA Foundation r i S t 5 r — LIFT STATION Manufacturer D} Nal,,.. TTN k Capacity 'L,yd Gel. Curtain Drain --» �-+ Remarks 5 d,dy-%�f0igt Pump on level at Pump off/ level at High water alarm at -1'HS�CCi�I W1S • c 4 •� in. $5 in. 1511 in. 7 *4 O - d lj I p .� (_ t 3 Pump make and model Electrical Inspections performed by dturoao JkJ Zoo - o Whlker ele`• 0 y l-Jl InstallerC.11•1Li• Tank to PIPE MATERIAL Housetotank P-11-14 drainfield8- ll$S P" I 6�e ryevN Drainfield l7-11$S. CO/MT 0-$411 Inspector PR ou 1: I n A BENCH MARK (Assumed elevation) 1 (U 0 .0 ft Inspection,� dates: 1 jo-Z(r-IS 20 10•-2'1-13 Location and description �' A I I jb9 •�� how C! w 4.rus.� I� V to -29 -l3 0 I o -29-1'; 5-W- Go.-vl o 416 t-PA .e_ COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Conditional Approval: Date ,r'6 ea 5 1Ry,1: Kinney, Jr. �. CIE 7959 ApproveAA1Date a Inspection Hepdrt_s-1-12.doe MILE—HI AVENUE NO WELLS WITHIN 100' OF PROPOSED SEPTIC SYSTEM -------- — — — — — — — — — — — — — — — — — — — — — — -- LOT— LOT 5 / LOT 4 SEE ENLARGEMENT ,FIGURE 2 0 \ �0 j�W 10' UTILITY EASEMENTNNLL R=100' GRAPHIC SCALE 5o 0 25 50 ( IN FEET ) I inch = 50 4t. a, 0 NN O TH-1 fi AS -BUILT LOT 3 �--DISPOSAL FIELD REPLACEMENT SITE 0 n o� N —NEW DRAIN, TYP. OF 0 ' :Ro ey P. Kinney .Jr.. CE7955 0,0' �RPKI LOT 4, SITE PLAN SUNNY VALLEY SUBDIVISON MiN11EdMY11�tI�M,re. 12/12/13 FIGURE 1 11111111 OY1 a M11Ni C INSTALLED 4" PVC 45' BEND 14.91' L.F. 4" PVC FROM HOUSE TO T SWING TIE DISTANCES STRUCTURE A B C ST41 — 10.70' 41.95' MT#1 55.88' 55.05' — MT#2 63.45' 55.53' — HOUSE INSTALL 1-1 4" PVC 90' BEN _ N 1 C.O.# . ST 1 INSTALLED 4" PVC 45' BEN[ 21.8 L.F. 1-1/4" SOLID PVC FROM TANK TO MANIFOLD. SOLID PVC MANIFOLD PIPE SLOPED FROM TEE TOWARDS TRENCH, TYPICAL EACH SIDE � 52• 30' TYP. TH-1 INSTALL 1-1/4" - DISPOSAL FIELD REPLACEMENT SITE (LENGTH 24') T#1 1 ]0' MIN. M2 I PVC 90' BEND / \ 52.0 L.F. 1-1/4" PVC, DRILL 3/16" ORIFACE A 48" O.C. FACING DOWN, XTYPICAL EACH TRENCH. DECOMMISSIONED EXISTING � � Frj EXISTING Sn/VG ° SEPTIC TANK \ U T S�OpF INSTALLED 1500 GAL STEP ANCHORAGE TANK AT 1500 L10 (10GA.) ® DATUM — TOP OF LOWER CONCRETE WALL, WEST SIDE OF HOUSE, SOUTHWEST CORNER GARAGE, EL.=100.00' zo GRAPHIC SCALE 0 10 Zo ( IN FEET ) 1 inch = 20 it AS -BUILT EXISTING TRENCH DECOMMISSIONED PER MOA CODES, REMOVED ALL C.O.'S IH �'•.Rodn...P. Kinney Jr.., t tPr '• 10 , CE7955 q i AW `�%�'ofessidDt-0 �RPKA LOT 4, SITE PLAN SUNNY VALLEY SUBDIVISON IIMY�.dNY,rC. 10/4/2013 FIGURE 2 NOTE: CO#1 12" FROM HOUSE SURFACE MOUNDED TO INSURE DRAINAGE AWAY FROM DRAINFIELD� 1ROUND ( / NATIVE SOIL 3' MIN.) j/ BACKFILL i FILTER FABRIC 1-1/4" PERFORATED PIPE, 3/16" AT '•:(,�?:.•.= 48" O.C., ORIFACES FACING DOWN EL.=110.0' (S. TRENCH) HOUSE EL.=104.75' EL. -105.0' :o•: -;..;o: :q':'°' CO#1 ST#1 MH#1 FINISHED (N. & S. MT#1/MT#2 BELOW PIPE (6.5') GROUND TRENCH) 05 VARIES FROM 1-1/4" PVC UPPER 3' TO 10' SOLID INV. EL.=101.80' 14.91 LF. O% 4" PVC, INV. 00 SOLID LOWER EL.=101.50' N _2q MIN INV. EL.=101.50' D INV. EL.=98.98' < m r INV. EL. =98.25' o INV. EL.=97.95' EL.=95.0' m 30' L.F. EL =95.00' 15 26' L.F. 52' P 1500 GAL STEP °'- ANCHORAGE TANK HIGH GROUNDWATER —\ AT 1500 L10 (10GA.)T z DEEP TRENCH 0 BEDROCK OR IMPERMEABLE BARRIER NOTE: CO#1 12" FROM HOUSE SURFACE MOUNDED TO INSURE DRAINAGE AWAY FROM DRAINFIELD� 1ROUND ( / NATIVE SOIL 3' MIN.) j/ BACKFILL i FILTER FABRIC 1-1/4" PERFORATED PIPE, 3/16" AT '•:(,�?:.•.= 48" O.C., ORIFACES FACING DOWN g DEEP TRENCH CROSS SECTION NTS AS -BUILT OF /v�A� AR�o�dn .. ..P. Kinsey Jr..'. o . 3�� •'• CE7955 �1 @fe�••'�F-.�3• �.� �%i Prof � gpKp LOT 4, PROFILE J �a.. ELE SUNNY VALLEY SUBDIVISON 3 FIG SS MMYE�IYMptlallR�e. 12/12/13 FIGURE 3 6" GRAVEL ''o °'••o. o o. • ' :o•: -;..;o: :q':'°' GRAVEL DEPTH BELOW PIPE (6.5') g DEEP TRENCH CROSS SECTION NTS AS -BUILT OF /v�A� AR�o�dn .. ..P. Kinsey Jr..'. o . 3�� •'• CE7955 �1 @fe�••'�F-.�3• �.� �%i Prof � gpKp LOT 4, PROFILE J �a.. ELE SUNNY VALLEY SUBDIVISON 3 FIG SS MMYE�IYMptlallR�e. 12/12/13 FIGURE 3 180 180 160160 ................................................ 1 ............................. 140 EXISTING GROUND WIDE TRENCH CROSS SECTION H: i'=so' v: i"=20' i OF AZ � ......... , /* ;.rl /.../ m %.Rodn P. Kinney Jr..' 0�4R 1 a°r CE7955 q / '';fee '••/212-✓.����/ AS -BUILT �RPKI LOT 4, CROSS SECTION rv�owy k SUNNY VALLEY SUBWASON 12/12/13 FIGURE 4 MATERIAL TO BE 120N3T REMOVED BX OWNER .................DISPOSAL FIEREPLACEMENT 120 SITE (LENGTH 24')EL.=105.0'100 FINISH GROUN2.5' FROM INVERT .........36'9MIN. 100 COVERryc�.OVER TRENCH�<IN. ROAD80 DEEP TRENCHDETAIL, 80 .FIGUR....................... TH-1, B.O.H.=86.0' 60 60 WIDE TRENCH CROSS SECTION H: i'=so' v: i"=20' i OF AZ � ......... , /* ;.rl /.../ m %.Rodn P. Kinney Jr..' 0�4R 1 a°r CE7955 q / '';fee '••/212-✓.����/ AS -BUILT �RPKI LOT 4, CROSS SECTION rv�owy k SUNNY VALLEY SUBWASON 12/12/13 FIGURE 4 10 -Dec -2013 06:41 AM ENSTAR Natural Gas Company 9073347711 WALKEN ELECTRIC CUNT WALKER 2/2 aAQLE Phone 6964964 Call N 3236304 small CiintAlangWi,com To: Chad V. Rofidal 22133 Lake view Dr. Eagle River AK 99577 Date: 11-25-13 Ref: Permit: Colville st, This is to certify that on site sewer lift station at above mentioned property has been wired in accordance with the standards of the National Electrical Code and manufactures specification. Systems were checked and performed as specified in the systems manual. Clint walker 1.)evelopment Services bepartm, ent Building Safety. bivision -,Moe On -Site Water & Wastewater Program Zood 4700 Elmore P "N X, Z, P.O. Box 196650 Mark Begich Anchorage, AK 99507 S A f C T Y Mayor www.muni,org/onsite (907) 343-7904 Pump Installation Log 3111111 l�llillillilill 91 111111111111122i� Parcel Identification Number: Legal Description \j Proper Owner Name & Address: 22133 Lake View Dr. ll Chad Property Eagle River, AK 99577 L Ll 01� I 1 11 Pump Installation Date: 5-8-2013 Pump Intake Depth Below Top of Well Casing: 110 Pump Manufacturer's Name: Goulds Pump Model: 7SBO5422C Pump Size 1/2 hp Pitiess Adapter Burial Depth: 10 feet Pitless Adapter Manufacturer's Name: Martinson Pitiess Adapter Installer: Unknown Pump Installer Name: Sullivan Water Wells 5 Attention: The pump installer shall provide a purnp installation log to the DSD within 30 days of pump installation. >> .q TC' -i tri ;u o t S 0 m �t/9 ���Z f U) m C < 0 LJ c� i O_ t mtJ1rq Vii!? ZEI o p mCat I m 0 L �' c ` 0 j C 3 `< X m cs C7 0z J (nC3 {b m > C=a trt 0 > M z 5�o ;t x A m OMZ >(n Y ` 0 C7 > df tt9G7 tit f t 0 � iM X-ara0067 0 —1 m W Cl CJ C7 70 m ;a C A �t c� > ;u m c PrTi r C�7 m X m z z m rn Fol C? CJ"a -CS te') m Com} z --a Ma m M D to M M c� r - m O tv On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP131379 Tax Code Number: 05035429000 Work Type: Septic Permit Effective Dates: October 16, 2013 to October 16, 2014 Design Engineer: RODNEY P KINNEY ASSOC INC Subdivision: SUNNY VALLEY Site Legal Address: SUNNY VALLEY LT 4G:0057 Owner/Address: ROFIDAL CHAD VINCENT 22133 LAKE VIEW DR EAGLE RIVER AK 995770000 Site Mailing Address: 22133 LAKE VIEW DR, Eagle River This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank i° -27-13 !o 0eD Lot Size in Sq Ft: 71438 Total Bedrooms: 4 N Privy N Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received Issued By 4 Municipality of Anchorage P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 hftp://www.muni.orn/Onsite Development Services Division On -Site Water and Wastewater Program **** VARIANCE/WAIVER REVIEW **** Waiver#: OSP131380 COSA#: Permit#:OSP131379 PID#: 050-354-29 Legal Description: Sunny Valley L4 Engineer: Rodney P. Kinney Associates, Inc Applicant: Chad Rofidal Your request for a waiver of the required 50 feet horizontal separation from the absorption field to the excessive slope has been approved. The approved separation distance is 25.0 feet. This waiver approval applies to the proposed absorption field only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of nonobjection have been received from the owner(s) of the affected adjacent property. ® Adjacent properties are not affected by this waiver. ............................................................................... Waiver is Granted: X Waiver is not Granted: Date:l '�Z Approved by: Nyi�✓// — Name of Reviewg ..........................................................EXE .................. Rec#: 16877 Amount: $200.00 Date Paid: 10/11/13 **** VARIANCEMAIVER REVIEW **** MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION I Parcel I.D 05035429 Property owner(s) Chad Rofidal Day phone (907)440-0636 Mailing address 22133 Lake View Drive, Eagle River, Alaska 99577 Site address 22133 Lake View Drive, Eagle River, Alaska 99577 Legal description (Sub'd., Block & Lot) Sunny Valley, Lot 4 Legal description (Township, Range & Section) T14N , R1 W , Section 16 Lot Size 71438 Sq. Ft. Number of Bedrooms t'{ APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑X Initial ❑X Single Family (SF) ❑X (w/wo ADU) Septic Tank 19Upgrade ❑ Duplex (D) F-1Holding Tank ElRenewal F-1 Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ r RUSH! a�, v� Y Water Storage 1:1i THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: 50 foot setback distance from cut slope of 25% or greater Distance: 25 feet certify that the above information is correct. I further certify that this is in accordance with applicable Wnicipal Codes. owner or autr Permit/Rush Fees: 4 70 Date of Payment: !0161/!3 Receipt Number: gg'yiw Permit No. O S 101,31.37->o Permit App_ :1L.c: Waiver Fees: 4060 Date of Payment: l Receipt Number: 100'-Wi Waiver No. 6SP/31M Rodney P. Kinney Associates, inc. Consulting Engineers g Surveyors October 14, 2013 Municipality of Anchorage Development Service Department On -Site Water and Wastewater Program 4700 Elmore Road Anchorage, AK 99519-6650 Attention: Deborah Wockenfuss Subject: Sunny Valley, Lot 4 Septic Tank and Absorption Field Replacement Dear Ms. Wockenfuss: Please reference our letter dated 10/10/13 and your view comments dated 10/14/13. The homeowner has reconsidered the number of bedrooms proposed and indicates that the renovation will be adjusted to four (4) bedrooms instead of five (5). As discussed with you, please accept this letter as a re -submittal of our previous design. The attached drawings show the locations of the structure in relation to the existing and proposed on-site well and sewer system as well as other features within 200 feet of the proposed disposal system per AMC 15.65.030. We are requesting your review and approval to install a new septic tank and absorption field to replace the existing on-site septic system. Attached are the following documents. 1. Permit Application 2. Site Plans, profiles and details, 3. MOA handout for construction requirements, 4. Soils log and percolations test The adjacent properties consist of single family homes with on-site well and sewer systems. We have confirmed that no wells exist within 100 feet of the proposed absorption field. The adjacent properties should not be affected by the location of the proposed improvements in regards to wells, septic systems, reserved space, and drainage. The property generally slopes to the south. The septic system is located outside of any travel ways. The proposed absorption field is to be located on what is currently 25% to 30% sloping ground; however, the soils in this area will be removed to create a flat open space east of the home. A cut slope greater than 25% is located downhill from the proposed absorption field as shown in the attached site plan. Due to terrain limitations, we would like to request a waiver of the 50 -foot setback requirement for the subsurface disposal field from any change in slope 25% or more. The new absorption field was designed using a 25% hypothetical line located 2.5 feet above the invert of the distribution piping of the absorption field and does not intersect the toe of the cut slope thus meeting the minimum requirement of 35 feet setback; per MOA Memorandum- Slope Setbacks 16515 Centerfleld Drive s Suite 101 ■ Eagle River, Alaska ■ 99571 907.694.2332 1 Fax 907.694.1807 0 www.rOka.net Sunny Valley, Lot 4 Septic Tank and Absorption Field Replacement Page 2 of 2 from >25%, April 7, 2004. See attached Figure 4 that shows a scaled cross section of the proposed absorption field with the hypothetical line and distances. There are no current signs of effluent daylighting in the road cutbank south of the existing absorption field. We proposed to use a Deep Trench absorption field. The MOA requires absorption systems with a design length greater than 50 feet to be entered at midpoint. Two (2) 52 feet trenches are proposed. Since this system will be pressurized, it is our understanding that entering at the end is acceptable in -lieu of the midpoint. The replacement absorption field is based on the assumption that an advanced wastewater treatment system meeting Category III treatment standards is used. The replacement site for the field is shown in Figure 3 and cross section in Figure 4. Calculations for sizing the replacement field are provided in Figure 5. Regarding the depth of the test hole, the beginning surface elevation at the test hole is at El. 105', the same proposed ground elevation at the absorption field. The test hole was excavated to a depth of 19 feet below this grade or 9 feet below the proposed bottom of deep trench. The test hole is depicted in Figure 4. Please call (907) 694-2332 if you have any questions. Sincerely, RODNEY P. KINNEY ASSOCIATES, INC. Rodney P. Kinney, Jr., P.E Project Engineer Enclosures GENERAL NOTES: 1. CONSTRUCT DEEP TRENCH SYSTEM PER MOA HANDOUT, ATTACHED. 2. NO WELLS WITHIN 100' OF ABSORPTION FIELD. 3. NO KNOWN IMPACTS TO ADJACENT PROPERTIES (WELLS, SEWER SYSTEMS, RESERVED SPACES AND DRAINAGE). INSPECTIONS REQUIRED BY ENGINEER AND MOA FOR BOTTOM OF TRENCH EXCAVATIONS AND TOP OF PIPE AS WELL AS SEPTIC TANK PRIOR TO BACKFILL. DO NOT PROCEED WITH WORK UNTIL INSPECTION HAS BEEN COMPLETED BY ENGINEER. ENGINEER TO CALL MOA ON—SITE WATER AND WASTEWATER AT (907) 343-7904 FOR INSPECTION. DEEP TRENCH SYSTEM, CALCULATIONS AND SIZING BEDROOMS: 4 GRAVEL DEPTH: 6.5 FEET APPLICATION RATE: 0.45' TANK SIZE: 1500 GALLONS par Por RPK DRAINFIELD LENGTH: -5� (MIN.) TOTAL FORMULA FOR TRENCH LENGTH: 1150 SQ.FT./BEDROOM x NUMBER OF BEDROOMS APPLICATION RATE I- 2xGRAVEL DEPTH = LENGTH 150 SQ.FT./BEDROOM x 4 BEDROOMS 0.45 ] - 2x6.5 = 102.6 FT. (SAY 104') USE TWO (2) TRENCHES AT 52' EACH REPLACEMENT FIELD SIZING: 150 2 SQ.FT./BEDROOM x 4 BEDROOMI _ 2x6.5 = 23.07' FT. (SAY 24') GAL/SQ. FT.* * PER AMC 15.65.350 OF AL"-%s��'I 'CQ 9TH p '.Rotl y P. Kinney Jr.. �y CE7955 qP1% f � m ' (&RPKA LOT 4, GENERAL NOTES SUNNY VALLEY SUBDIVISON 11MY1.�111VItsIq�Mlle 10/3/2013 FIGURE 5 LOT 7 1 LOT 6 1 LOT 5 1 LOT 4 MILE -HI AVENUE 33' SECTION LINE EASEMENT LOT 5 f WELL / I 100' 1 10' UTILITY 1 LOT 4 LOT 3 EASEMENT \ EXISTING \ DRAINAGE r/e o 1 FIELD DRI WELL EXISTING 1 � SEPTIC TANK r� I \ /+� \ I WELL 100, WELL EXISTING — — - - — SEPTIC TANK LOT 6 LOT 8 LOT 7 /I OF `kk 9TH .......... 0,,xl......... GRAPHIC SCALE / 100 0 50 100 , 15 '.Roney P. Kinney Jr.. ( IN FEET) `�elP+ofessi� 1 inch = 100 ft. �RPKALOT 4, SITE PLAN pwl��wylq� SUNNY VALLEY SUBDIVISON 10/3/2013 FIGURE 6 MILE—HI AVENUE NO WELLS WITHIN 100' OF PROPOSED SEPTIC SYSTEM LOT 5 I / LOT 4 SEE ENLARGEMENT ,FIGURE 2 0 \ o / 10' UTILITY EASEMENT N \WELL R=100' HOUSE �qk£ O TH-1 0 o N N LOT 3 DISPOSAL FIELD REPLACEMENT SITE 0 M O� 0 NEW DRAIN, TYP. I /...: .....� <Ilw GRAPHIC SCALE /g 50 0 25 50 II ,p Ro9ney P. Kinney Jr.: 24 'I k. CE7955 q ' ( IN FEET) �� f'rofessio!!-;vVp' 1 inch = 50 ft. �RPKA LOT 4, SITE PLAN SUNNY VALLEY SUBDIVISON pilVtaMYbpq�bt,lle. 10/3/2013 FIGURE 1 HOUSE INSTALL 4" PVC 45' BEND 8.5' L.F. 4" PVC SOLID - INSTALL 4" PVC 45' BE Fw oklz INSTALL 1-1/4" PVC TEE SLOPE SOLID PVC MANIFOLD PIPE FROM TEE TOWARDS TRENCH, TYPICAL EACH SIDE DISPOSAL FIELD REPLACEMENT SITE �5' (LENGTH 24') INSTALL 1-1 4" \ PVC 90' BEN 52' 1 / MT#1 1 10' M1A 6.5' �•� S7 1 ;�? 30' TYP. TH-1 • o _ ^z MH#1 MT#2 f INSTALL 1-1 /4" • / O PVC 90' BEND / 1-1/4" PVC, DRILL 3/16" ORIFACE AT 48" O.C. FACING DOWN, D ATYPICAL EACH TRENCH. DECOMMISSION EXISTING f.Yjsn SEPTIC TANK \ UT 'k op', 1500 GAL STEP ANCHORAGE TANK AT 1500 L10 (10GA.) ® DATUM — TOP OF LOWER CONCRETE WALL, WEST SIDE OF HOUSE, SOUTHWEST CORNER GARAGE, EL.=100.00' GRAPHIC SCALE 20 0 10 20 ( W FEET ) 1 inch = 20 ft. DECOMMISSION EXISTING TRENCH PER MOA CODES, REMOVE ALL C.O.'S // /o��� OF ALS'') 9TH I a V6 '. Rod> ey P. Kinney Jr.." 04 e°y •'. CE7955 q A dv. rs- jo Yltlw Aw 1i'' 't+'ofessi O!$ 2 �RPKA LOT 4, SITE PLAN SUNNY VALLEY SUBDIVISON ��'�� 10/4/2013 FIGURE 2 ST#1 MH#1 FINISHED MT 05 CO#1 12° FROM HOUSE SURFACE MOUNDED TO INSURE DRAINAGE AWAY FROM DRAINFIELD GROUND 36" (MIN.) 1-1/4" PVC UPPER NATIVE SOIL /j/ BACKFILL SOLID INV. EL=101.75' 4" PVC 07 SOLID INV. m 00 LOWER EL.=101.50' _2%' INV. EL=101.50' D m r INV. EL.=98.25' 0 INV. EL.=97.73' INV. EL.=97.63' 5 30' L.F. EL —95.00' _ 26' L.F. LT 52' a 1500 GAL STEP o' ANCHORAGE TANKHIGH GROUNDWATER Z AT 1500 L10 (10GA.) Z DEEP TRENCH O BEDROCK OR IMPERMEABLE BARRIER- CO#1 12° FROM HOUSE SURFACE MOUNDED TO INSURE DRAINAGE AWAY FROM DRAINFIELD GROUND 3' (MIN.) NATIVE SOIL /j/ BACKFILL 6" GRAVEL ' "o ° �'o. o o. • ' . FILTER FABRIC 1-1/4" PERFORATED PIPE, 3/16" AT 48" O.C., ORIFACES FACING DOWN GRAVEL DEPTH BELOW PIPE (6.5') DEEP TRENCH CROSS SECTION /Aw OF... F.. AL4�all �* 9TH *� s... ,A '. Rodn y P. Kinney Jr.: 24 CE7955 q % e, 'r� ®. \� 1'+'oressSovsN.� � RPKA LOT 4, PROFILE S •a. SUNNY VALLEY SUBDIVISON ELEVATIONS IIMVtdll➢Iplg7t�re 10/3/2013 FIGURE 3 140 .......................:................ 140 EXISTING GROUND WIDE TRENCH CROSS SECTION H: 1'=50' V: 1"=20' OF �\ /i��.•'9 S SII i ...... II 16 '. Rod6ey P. Kinney 1'0Jr. CE7955 ti &6PKALOT 4, CROSS SECTION mayp.b ylod Kh SUNNY VALLEY SUBDIVISON 10/3/2013 FIGURE 4 MATERIAL TO BE 120 ................ . DISPOSAL FIELD :.... ........................ REMOVED BY OWNER 120 REPLACEMENT SITE (LENGTH 24') :EL.=105.0' 100 FINISH GROUND,5� PROVIDE 36." mor sg 2.5FROM INVERT 100 CTO � TC14 OVERENCH 35' MIN. ROAD 80 DEEP TRENCH, SEE 80 DETAIL, .FIGURE .3 _ . ....................... TH-1, B.O.H.=86.0' 60 60 WIDE TRENCH CROSS SECTION H: 1'=50' V: 1"=20' OF �\ /i��.•'9 S SII i ...... II 16 '. Rod6ey P. Kinney 1'0Jr. CE7955 ti &6PKALOT 4, CROSS SECTION mayp.b ylod Kh SUNNY VALLEY SUBDIVISON 10/3/2013 FIGURE 4 Municipality of Anchorage Development Services Department Building Safety Division �r On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.ci.anchorace.ak. us (907) 343-7904 Rodney P. Kinney, Jr. rd`s. CE 7955 CX, . Soils Log - Percolation Test I "`kyi.N'0_- Performed For: (�Ii,) Ct{{ P4 [ �c6 ( Date Performed: Q —7,9 " � 3 Legal Description: 5yano V.2) I C_� Loi 9 Township, Range, Section: `<- t �{ P4 k I tA) Se -e- I dg Slope Site Plan 0. 1®5,®29 I - 11- 12- 13- 14- 15- 16- 17- 18 - - 10- 11- 12 -13 -1415- 16 -17 -18 - COMMENTS COMMENTS n �AV-av I // [} e�W .11 S' fol Id W t I "` WAS GROUND WATER g ENCOUNTERED? yr® 5 Oen cc'j \ > Net Drop IF YES, AT WHAT DEPTH? IVA Depth to Water After q Monitoring? 14 A L 0 P 'b 05 Date: 10 - 2 — f�a N Ir Reading Date Gross Time Net Time Depth to Water Net Drop 0 9-Z3 -I.3 'b 05 4 1 Io — 1 a-23-13 3;,: 30 .„;„ 5 9 �" I' - 1b Z e�-2 -l? 4;05 3v mr. Ca b�t(a o 13%Ilip 3 73-13 y :34 3 s t ;n �ltm" 81 1 (I+) � 3-r3 6,DS 3o MSN t3 /a t, ,y m• lif# PERCOLATION RATE o (minuteshnch) PERC HOLE DIAMETER L. � TEST RUN BETWEEN FT AND lZ FT�. -b appev. –S' h®lary Dr09'AP01 ® nrre,dta plan PERFORMED BY: ?.p a K I v7 r, l od e—I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFF CT ON THIS DATE. DATE: Pump Selection for a Pressurized System -Single Family Residence Project Kinny Design Parameters Discharge Assembly Size 1.25 inches Transport Length 25 feel Transport Pipe Clan 40 gpm Transport Line Sim 1.25 inches Distributing Va Ive Me rid None Transport Velocity Max Elevation Lift 9 feet Manifold Length 16 feel Manifold Pipe Claw 40 Manifold Pipe Size 1.25 inches Numberof Laterals per Cell 2 Lateral Length 65 feel Lalecal Pipe Claw 40 Laleml Pipe Sim 1.25 inches Orifice Sim 3116 inches Crifice Sparing 4 feet Residual Head 5 feel Flaw Meter None Inches Add -en' Fticli on Losses 0 feet t:alOulations Minimum Flow Rate per Orifice 0.97 rpm Numbest Clifloes per Zone 34 feel Total Flow Rate per Zone 33:8 gpm Number of Laterals per Zone 2 feel % Flow Differential lsULast Orifice 7.9 % Transport Velocity 7.3 fps Factional Head Losses Loss through Discharge B.0 feel Los In Transport 3.5 feel Los lhmugh Valw 0.0 feet Los in Manifold 0.6 feel Loss In Laterals 0.9 feel Loslhrough Flowmeter 0.0 feet 'Addan'Frielon Losses 0.0 feet Pipe Volumes Vol of Transport Una 1.9 gals Vol of Manifold 1.2 gals Vol of Laterals per Zone 10.1 gale Total Volume 13.3 gals Minimum Pump Requirements Design Flow Rate 33.8 gpm Total Dynamic Head 27.1 feet MLOA Orenm Svetmm�' Ircmrwrolc G..nP^6dR Uy,lx ua,ual.: ua��..• PumpData PF3005 High Head Effluent Pump 30 GPM, 112HP 11 5123D 1O 60H;200/ 3O60Hz tt Net Discharge (gpm) System Curve; Pump Cure: — Pump Optimal Rangea Operating Potato Design Point() MUNICIPALITY OF ANCHORAGE twi QLiS[TD Hea( I and Environmental Protec 'on `d Fourth Floor West 4� 825 L Street Anchorage, Alaska 99501 264-4720 INSPECTION REPORT ON-SITE SEW/1,O[: DISPOSAL SYSTEM NAM, E_ C�``�C-��-�- yMAILING ADDRESS_.3Z!1'� "1` �,f-``l}------.-.___ PHONE LOCATION '�'��-1+iT _\\E - - LEGAL DE.SCRIPTIO0--4 SEP -TIC TANK: DISTANCE yNUMBER OF FROM WELL -- —p— MANUFACTURER9SLW4IEs MATERIAL S-_lber'G LR$S_ _COMPARTMENTS_�._� INSIDE LENGTI-I _..I Y.IJS_____ INSIDE WIDTH H__NI �_ _ :_ LIOUID pEPTH _ >_N.____.. LI<)U ID CAPACITY -0 , GALLONS. TILE DRAIN FIELD: TOTAL LENGTH DISTANCE FROM WELL _1,C0 —FOUNDATION ___-NEAREST LOT " LINE __OF LINE _� % Of Lines --E DISTANCE BETWEEN LINES lA j. -.__TRENCH WIDTH IN. TOTAL EFFECTIVE 0 ABSOHPI ION AHLA _.__ —_ SQ. FT. LENGTH OP EACH LINE DEPTH OF FILTER QQ DEPTH: TOP OF TILE TO FINISH GRADE _� MATERIAL BENEATH TILF___L_____IN. ABOVE TILE / ..1N. SEEPAGE PIT DIAMETER _—OR WIDTH—, LENGTH_, Log Crib Rings Crib Size: DIAMETER -__DEPTH-_._ DISTANCT-: FROM: WELL _______.__ TOTAL EFFECTIVE_ BUILDING FOUNDAITON __ ` NEAREST LOT LINE . ABSORPTION AREA (WALL AREA) $�, FT. ass: Depth: Al Distance To: Lot Line l.dg: Sewer Line: ip — d e Materials: of Bedrooms: istaller: C+D marks:j ' ! \�S \4S 0 t I 1 { -Ili _ I ; ` I I I I ! ' I ! el DATE3_l1APPROVED.- � Owl 0-.1 ho X 10 3: R" 0"I R.. 1 1 F�-" ����(D F';� F-0. #::i i ` , DFPRRTMENT O� �EHLTH HMD ENVIRONMENTAL Fv ECTION 4� 825 /L>��TREET/ ANCHORAGE, AK. 995�~/ 8]'��r L{�L� ' -- /7 279-251:1. tl[/ \ ���I.> �V-4_too I -y- FOE �FEE �1E F�`.: ������1'� x� PERMIT NO. ( 77885 . / APPLICANT J A CuNsryucum 3400 MOUNTAIN VIEW 279-2589/ LOCATION |LEGAL L4 PLATT 36 SUNNYVALE SUBD LOT SIZE 64000 SQUARE FEET TYPE OF SOIL HBSORBT]ON SYSTEM IS: TRENCH |MAXIMUM NUMBER OF BEDROOMS SOIL RATING (SQ FT/BR)= 145 |THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: ��- I - g --h — ft. 01 ���C -F I - 1= 12 Es �3 u- ci--.. R._. n m F" -r F-4 — e,� THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFTELD. THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH 15 THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). |I so m OVA u I in: m On ns'; p- - F I C-': 'T' H=i 1r4 Ft �X 2" 11HE — f1LCEO C -J CD ����C-H�� -_ -_ -__-_~--- __ __ �F-0. to Ft FA CR EK F -*"L- I V..A]F cy 1=4 -F- X 1-1104 ~--�~�--- 8 PACKAGE PLANT MAY BE INSTALLED AT THE PERMITTEE/S OPTION SUBJECT TO THE FOLLOWING CONDITIONS: 1. EITHER H CLASS I OR lI NSF APPROVED PLANT MAY BE INSTALLED. 2. H CONTINUOUS MAINTENANCE AGREEMENT IS REQUIRED. IF H MAINTENANCE AGREEMENT IS NOT KEPT CURRENT YOU MAY BE REQUIRED TO ENLARGE THE SOIL ABSORPTION SYSTEM HND/OR YOU MAY BE SUBJECT TO PROSECUTION. -1 - #3 If, > X P41001 c_-V*Xm:.*_.fi1`A"5 FAFREEE BHCKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS |DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 200 FEET FOR H PUBLIC WELL WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS- OF HYSOF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE �AVAILABLE TO INSURE PROPER INSTALLATION. I CERTIFY THAT I I HM FAMILIAR WITH THE REQUIREMENTS FOR DN -SITE SEWERS AND WELLS AS SET FURTH BY THI 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 !R SIDENCE IS REMODELED TO INCLUDE MORE THAN ] BEDROOMS. ` SIGNED:__V0�����-.' APPLICANT J H CONSTRUCTION �ISSUED B - - Iva 0 4 0 & E CEO�,-,cCHNI CAL Et DEVEL-PMENT 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:�%f✓'� r r Tel. No. Mailing Address: 5'z1ego /0,S; Z X9'63 Legal Description: Lar 41 PJH7-7- �� ��r✓���,����� �r����_ Depth (feet) Soil Characteristics 0 1 3 �. 4 5 6 7 8 9. 10 11 15 16 A/// iii r —/Z' /' 5;rt_ e� - �c��✓�Gr.r 77 Al j—vo A% J� lf/ rr✓ �y r✓/ir Ground Water Encountered: Yes No I,' If yes, what depth Proposed Installation: Seepage Pit Drain Field Comments: Performed by: * a /� � �/` Date: L' % WELL LOCATION V WATER WELL LOG �S FOSS DRILLING 1336 Ingra Street Al k O1 Anchorage, as a 995 USE OF WELL Rom g--� _ SIZE OF CASINGDEPTH OF HOLEFT. CASED TO ,��� FT. STATIC WATER LEVELFT. YIELD_ _GAL.PER.MIN. WITH % 1) FEET OF DRAWDOWN, REMARKS DATE COMPLETED 1� PUMP TO BE SET AT �GG/✓ _Lt ojjQ LQt o-2 �to-V 7Lto Rp �t 0JAC5 Jl MUNICIPALITY OF ANCI DEPT. OF HEALTH F. n n-..ili-�N Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval Parcel I.D. 050-354-29 Expiration Date: 8-1-13 Complete legal description Sunny Valley, Lot 4 Location (site address) 2213.3 Lake View Drive, Eagle River, AK 99577 Current Property owner(s) Keybank National Assoc. Day phone None Mailing address 4910 Tieddmann Rd, Ste B, Brooklyn, OH Real Estate Agent Listing: Barbara L Huntley 2. TYPE OF DWELLING: nx Single Family (w/wo ADU) n Duplex 171 Multiple Dwellings (Single Family and/or Duplex) Day phone (907)273-7269 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well El Individual R Individual Water Storage 1771 Holding Tank 1771 Community Class Well 1771 Community 171 Public Water System R Public Sewer 17 WaiverNariance request for: Distance: Received by: Date: 5--3c-)3 COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 4 C1 0 - ;2 6 o Date of Payment a 4_ Receipt Number C-) COSA# Waiver Fee $ Date of Payment Receipt Number Waiver # 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 Rodney P. Kinney Associates, Inc. Address 16515 Centerfield Drive, Ste 101 Eagle River AK 99577 Phone (907)694-2332 Engineer's Printed Name Rodney P. Kinney, Jr., PE Date 5-23-13 Sys -re ,S NO -Y 1tv c©eA tLa,nce \N11 'A cVv Tev\t codes but does Nod"o.eo.T, -"a e o,. hec,It � rtsk ts1nc �Ue71sc 0.� `Yt�ts tr»e /p/�� e ®maem,ma 4. 6. DSD SIGNATURE J 00* pa 9 ae`m mo�e"asmomaema System #1 Approved for bedrooms �m m a m m a m a 4 a m m a s a a m a System #2 Approved for bedrooms e a Ro ney P. Kinney, Jf. , Disapproved �,,�nea ��77��,� am°� AO e° ; 7semm Conditional approval for 3 bedrooms, with the following stip Silo: m4Ki� C, * -t;e 1� 1, $? - 1-- i _3 By: 0_4 , Z�aOriginal Certificate Date: " 3 f The unicip y o A rage Development 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 X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet r c Sunny Valley, k��1 Legal Description: `^ ' `~^^~x' �-~^ ' A. WELL DATA Well type Ind. |fA,B.orCprovide PVVS|D#KJ8 Date completed 11_16-77 Sanitary seal (YYN)Y Total depth 125 ft. Caaedho5O t. FROM WELL LOG Date oftest 11-1��-77 '' '~ '' Static water level 47 VVeU1WATER SAMPLE RESULTS: produoion g -p -m- Coliform bnn co|oniNitrateO1OOmL Nitrate mg/L Arsenic . D ^ug/L Date ofsample: 5-8-13 B. STANK DATA |�t��}|-4nC� T��� TankType/W1ahaha| ' Anch. Tank Tank size 1500 � goi Number ofCompartments 2 Foundation cleanout (Y/N)Y Depression over tank (YYN) N TANK Data of pumping Pumper ' .' ` Ifmore than iseptic system ismn the lot: COSAChecklist #o__ Structure served by this system Well Log (YYN)Y Wires properly protected (YYN)_._______ Casing height (above ground) 12 jn. AT INSPECTION 5_8-13 53.3 2.13 ft. NIM Collected by: Cole Sullivan Date installed 10-��_1��*d '~ ^-~ ~ \/ C|manou�(//N)_,______ 10-28-13 045GPD�/F 7-R�[lr� Da\ein�uUed________ Soil rating (g4d���or�z8�nn)_________. System type Trench j04C}����'\ �� S Length `—�� /�� Width~ �� Gravo|be|mwpipa�.5 ft. 1a(a�) 1��� YNTo�o|dop�h,ft. E�.absorption area _^ft� K1onihnringtube ____ Depression over �a|d�~_ navv�e|d Date nfadequacy test NA, Reau|ta(Paau/Fai|)---- For----bedrooms F{uiddopthinubonrptinnfie|dbaforetant---- in. VVateradded---- ga|. Newdopth---- in. Elapsed Time: ---- min. Final fluid depth ---- in. Absorption nahy >= ----- g.p.d. � Any n�uvanaUontreatment (past 12mo.)(Y/N&type) '~ |fyes, give date ________ D. LIFT STATION Date installed 11-2�_1�\ od ~ '~ "Pump 45in Datum bottom of tank WELL ONLOT TO: Size ingallons 250 "Pump 35Cycles tested NA Septic tank/lift station cmlot 116y Absorption field onlot 129' Public sewer main ' " KJ' & ` Sewer /septic service 97/Animal containment areas 1OO'f Manhole/Access (Y/N)\, in. High water o|ann level ok���____ __ Moots alarm & circuit requirements? `, Dnadjacent lot10O/f � '~~ Onadjacent lot100'f � '~~ Public sewer manhole/cleanout NA Holding tank NA Manure�mima exoro�oe�orogeoreao100'+ /a SEPTIC/HOLDING TANK ONLOT TO: 11/ Building foundation 51on Property linWater main e NA Water service line 50' 1D0'f VVe�ona�ocen ��_~^�_` ABSORPTION FIELD 0NLOT TO: Property line 19/ 15' Water Service line 65'Curtain drain NA Surface water 1DO`f r '"" Wells on adjacent lots 100'+ Absorption field 101 Surface water 1DO'+ �� Water main ' ~ ` ��. Driveway,parking/vehiclentorao�� F. COMMENTS New septic system installed October 28th to 31st, 2013. / certify that /have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA CO3Aguidelines ineffect onthis date. [�O�D8VP ��iOD2V Jr.��� En�inee/nPrintedNama ~ P. '` ' Date ~ '-1z1 �-�R in. Rodney P. Kinney Associates, inc. Consulting Engineers s Surveyors May 24, 2013 Municipality of Anchorage On -Site Water and Wastewater PO Box 196650 Anchorage, Alaska 99519-6650 Attention: Mr. James Crewdson Subject: Sunny Valley, Lot 4 - COSA Approval Dear Mr. Crewdson: On behalf of my client, Mr. Chad Rofidal, buyer of subject property, we are applying for a conditional Certificate of On-site Systems Approval (COSA). Please reference our telephone conversation on May 23, 2013, and the attached COSA documentation. The property is currently for sale and owned by Keybank through foreclosure. Mr. Rofidal's offer to purchase the property has been accepted by Keybank. The purchase agreement requires Mr. Rofidal to acquire an approved COSA; however, Keybank will not allow any improvements to the property prior to sale. The existing well pump does not operate. Bill & Cole Sullivan Water Wells was able to remove the failed pump and install a temporary pump to perform a pump test, see attached pump test results. Water samples were taken at the time of the pump for testing. The water sample results indicated no coliform, nitrate or arsenic. The well is currently inoperable at this time. A truck with water tank was mobbed to the site. An adequacy test was attempted by injecting approximately 500 gallons of water into the trench to determine if the trench would accept effluent. The absorption trench accepted all of the water with no backflow into the septic tank. Water levels in the trench could not be monitored due to lack of monitoring tube. The intent of the new owner, Mr. Rofidal, is to install a new pump and enclosed wire for the well and to improve or replace the existing septic system in accordance to MOA requirements prior to occupying the home. Sincerely, RODNE P. KINNEY SOCIATES, INC. Rodney P. Kinney, Jr. PE Attachments 16515 Centerfielg Drive ■ Suite tet ■ Eagle River, Alaska ■ 99571 907.694.2332 0 Fax 907.694.1807 1 www.rpka.net MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH \ CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL \Cjq-3 OF ON-SITE SEWER AND WATER FACILITY 264-4720 J �S' Application Date � ✓ - 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) L* ''t/✓inv I/�v $ l(v -7-14- AJ P I W Location (address or directions) (b) Applicant Name ?10.n e Dc-, y7 Telephone: Home 3.3 7 R9 62 Business X79 oS3 j Applicant Address (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder ; Buyer ❑ ; Other ❑ (explain); (d) Lending Institution I r}�u' ron., � ;icy r fa C✓F % Telephone 27�` Address G 7 zz:- Al A L'b (e) Real Estate Company and Agent fir IF 1 Address Telephone (f) Mail the HAA to the following address: Cc-// Q79 OS3i- 2. TYPE OF RESIDENCE Single -Family Multi -Family ❑ Other Number of Bedrooms 3 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 f:f_ 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(11/04) �i `�� 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 J (c t C,— — heey nTelephone 3 � x-711 Address 71 '). ') K S vJ J Date , L21 Z a 6 WATER WELL NOTE: This Health Authority Approval inspection merely certifies that the subject water well produced 150 gallons per bedroom per day and that certified laboratory tests showed no presence of coliform bacteria in a sample of that water. No warantee®��,°°°°°.,T or certification is expressed or implied concerning the long terms °... °o adequacy or safety of the water supply. ON-SITE SEWAGE DISPOSAL SYSTEM NOTE: This Health Authority Approval V leer- err t �✓° °°°. inspection merely certifies that the subject on-site sewage disposal 6C �o°D1EIL Hn.wTt;Oen:_ system accepted at least 150 gallons of water per bedroom per day A o CE -4369 °° 0 as determined by methods approved by the Municipality of Anchorage` °°°„ °°`°f, ° AJ vl, . , Department of Health and Human Services. No warantee or certification is expressed or implied concerning the long term ya• P P 9 9 adequacy of the on-site sewage disposal system. Construction data reported on buried system components is from MOA files and .was not verified during this inspection. DHEP APPROVAL cG�-S Approved for o o bedrooms by to Approved ��-�- Disapprove Conditional Terms of Conditional Approval CAUTION 531alg4_ The Muncipality of Anchorage Department of Health and Envirohmenfal Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations givemin paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11/84) :N/C/$4[f MUNICIPALITY OF ANCHORAGE (MOA) QW�R Nf y 1 9 4 HEALTH kgGl CHECKLIST - FE (HAA) FEBRUARY 1 84 SEP A[ PROTECTION 264-4720 R g � Legal Description: Si P J/Ca 14 A) i In% A. WELL DATA E('E�VED Well Classification ��yA7� If A, B, C, D.E.C. Approved (Y/N) 4ve ox Well Log Present (Y/N) )IM _ Date Completed —A, -'7'7 Total Depth ATs z Cased to .S0 Depth of Grouting Static Water Level jOl�Z Pump Set At AfA- W6WN Casing Height Above Ground �Z Sanitary Seal on Casing (Y/N)'/GS Electrical Wiring in Conduit (Y/N) ND Depression Around Wellhead (Y/N) y� Separation Distances from Well: i To Septic/Holding Tank on Lot On Adjoining Lots To Nearest Edge of Absorption Field on Lot /�?R On Adjoining Lots /60 To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected by oma— Date R-076—'89 Water Samp Comments B. SEPTIC/HOLDING TANK DATA Date Installed /x-30' %% Size 1c1f�b!,%A e. No. of Compartments C_ Standpipes (Y/N) yGS Air -tight Caps (Y/N) No Foundation Cleanout (Y/N) !tha Depression over Tank (Y/N) A/0 Date Last Pumped Pumping/Maintenance Contract on File (Y/N) to" for Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) e" Separation Distances from Septic/Holding Tank: To Water -Supply Well /% z To Building Foundation /3 To Property Line �5� To Disposal Field 5 i t To Water Main/Service Line 3d To Stream, Pond, Lake, or Major Drainage CourseI— Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 1,w �07 Type of System Design ,)'i' eAlC/I Date Installed &0" 7 Length of Field —_P21? Width of Field Depth of Field /Z Gravel Bed Thickness 91_ Square Feet of Absorption Area Standpipes Present(Y/N) 9= Depression over Field (Y/N) /✓o Date of Last Adequacy Test ?'a7- R2� Results of Last Adequacy Test "lam ron S Separation Distance from Absorption Field: To Water -Supply Well To Property Line To Building Foundation Lot On Adjoining Lots To Existing or Abandoned System on _� — ' A -- To Water Main/Service Line &0 � To Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course 11610 /1;; -- To Driveway, Parking Area, or Vehicle Storage Area ao Comments D. LIFT STATION J / !v 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 Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify tlhj��efied, ad,formed to all MOA and HAA guidelines in effect on the date of this inspection. SignedDate �/_,9 166 Company /l%�aw i�0YKC MOA No. �Z9 � � .v�narAV4 Receipt No. _ bhp a •° e , "YJ Date of Payment � n"r'9 Amount:$ �' a.°• CE • 4359 ty Page 2of2� eV 72-028 (11/94) EAGLE River area MUNICIPALITY OF ANCHORAGE DEPARTMEN��OF HEALTH AND ENVIRONMEN7J,)PROTECTION 825 L Street, Anchor.a0e, Alaska 99501 _ 264-4720 - Date Received: November 23, 1977 #1: Time m #2: Time #3: Time Date .3n-�] /, uc� Date _ Date Insp Insp — Insp — REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILI'T'IES 1. Lending Institution Request: Bank of Alaska o St _National Mailing Address: Post office Box 3-3859 99509 Phone: 2. Property Owner: _ Donald L./Dianne M. Daigh Phone: Mailing Address: 705-Muldoon—Road #47 99504 3. Legal Description: Lot 4 Sunny Valley Subdivision 4: Single Family Residence: (x) Multiple Family Residence: ( ) 5. Well. System Permit # , 6 Construction Number of Bedrooms: Number of Bedrooms: Three ie Chapman 279-2506 272-5544/211 her work Individual Well (x) Conununity/Public System ( ) Sewage Disposal System Permit # Septic Tank Size Absorption Area Depth of Well Well Log on File ( ) Bacterial Analysis On-site System (x) Installed Public Utility ( ) Installer Manufacturer Soils Rate 7. Distances: Well to Septic Tank to Sewer Line to Nearest Lot Line Nearest Lot line Material to Absorption Area Absorption Area J'age�7`wo Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Faciliti.cs Legal Description: _ Lot 4 Sunny Valley Subdivision Comments: Affadavit Attached: ( ) Letter Attached: ( ) Approved: Department Worksheet: (.w Date: Date: `�.,/� NNICIPAUTY OF - ANG�`J�AG@ �(ViUNICIPAL!T`/ OF ANCHORAGE DEPT. 07AL pKOHTECT(ON . - ENVIRONM • DEPARTTJIENT OF ENViRONNWNTAL QUALITY F*1 � � ei 197 251.8 Tudor Road ` (�\ Anchorage, Alaska 99503 REQUEST FOR APPROVAL OF _ INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO _- _ VA —, FHA _ _ CONY XXXX _ 2. Property Owner: Donald L. Daigh and Dianne M. Daigh ---S. Daigia Mailing Address: 705 Muldoon Road 1147, Anchorage, AkDay Phone 272-5544 Ext 211 3. Name of Buyer: __ Same _._. Mailing Address: Day Phone 4. Name of Lending Institution: National Bank of Alaska , 5th Avenue Branch, Mortgage Loan e� Mailing Address: P.O. Box 3-3859, Anchorage, Ak 9950:Phone 279-2506 Ext 28 Attn: STEPHANIE CHAIVZdAZj 5. Name of Realtor or Agent: _ N/A Mailing Address: Phone _ 6. Legal Description: Lot 4, Sunny Valley Subdivision Location: 000 Lake View Road , Eagle River, Ak 7. Type of facility to be inspected: Well and Septic Tank 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 unknown 9. Sewage Disposal System Type of System: Public Utility _. Individual (on-site) XXX If Individual, date of installation unknown EQ -037 (1/74)