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HomeMy WebLinkAboutTIMBERLUX #1 BLK F LT 8 MUNICIPALITY OF ANCHORAGE DJ, ,RTMENT OF HEALTH AND HUMAN SER~,I~ES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Na,.e DISTANCES Add~ess TANK FIELD WELL Township, Range. Sec[ion Manulactu,er~x~ SEPTICj~ I~ Capac,ty ~m[~ga,,onsHOLDiNG ~ ~ ~ ~ ~ ~ ~ ~ original grade Z I ~¢~ ~. O Gravel lenglh Gr~vel w,dth / WELLS PRIVATE ~ OTHER (Identify) ~.~ ~ ~ ~ ~ ~. Scale: [{{~ ~d : ' ~N~INEERSSEAL 17034 Eagle River L~ R~d No. 2~ I Ea;J: ~[';;r, A[~ak~ ~;37Z codify tho this inspection was pedormed according to all 72-0r3 (3/85) F:'I..iYI. !... Z .'::i E¢CHPt :[ D'f' F:' ,, (],, i.:)(]X ~'d'~l (:] H ( l~ I~ i:>i(:~ I'Z ~, ~:~I<: ~}' 9 !:=.;;2 q- ;-.' 7 V-..6 xl, zl. a Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST DATE PERF LEGAL DESCR'PTION: [.~ ~:~ '~K '~P-~U)/~ 1 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18- 19- 20- Township, Range, Section:--~[~.N.~ ~_..'~..~ ~.~-~.~,~¢-, SLOPE SIT~: PLAN I WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? / i)eplh to Water After Monitoring7 /~,. Date:. Reading Date Gross Net Depth to Net Time Time Water Drop PERFORMED BY: PERCOLATION RATE (~0~ (minutes/inch) PERC HOLE DIAMETER __ TEST RUN BETWEEN '~ FT AND Z~ FT CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST DATE PERFORMED: LEGAL DESCRIPTION: ~,c~T (c~ /~/< ~ 1 2 3 4 5 6 7 8 9 10- 11 13- 14- 15- 16- 17- 18- 19- 20- Township, Range, Section: SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? S L IF YES, AT WHAT · O DEPTH? /(.~ p E Depth to Water Alter , / MO~liloriflg? /0 Dale: Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE __ (minutes/inch) PERC HOLE DIAMETER __ TEST RUN BETWEEN FT AND __FT PERFORMED BY: I?0~4 Ea~lle River i.oep Rea~ No. 204 CERTIFY THAT THIS TEST WAS PERFORMED IN Eagle Rlver~ Alaska ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) GAAB-HD-I GR~"~TER ANCHORAGE AREA BOROU~'H I~, ~'J HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE FROM WELL LIQUID CAPACITY MATERIAl NUMBER OF COMPARTMENTS INSIDE WIDTH. GALLONS. INSIDE LENGTH LIQUID DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS. / OUTSIDE DIAMETER ~ OR WIDTH LINING MATERIAL ~-q~.7~/~_,~'""~' d~'//L/,J'"~' DISTANCE FROM WELL NEAREST LOT LINE. TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) LENGTH ,/~ / , DEPTH BUILDING FOUNDATIOF~ TiLE DRAIN FIELD: DISTANCE FROM WELT NUMBER O~ AREA DEPTH: TOP OF TILE TO FINISH GRADE TOTAL LENGTH ~_~-~-OUNDATION~'~ . NEAREST LOT LINE , OF LINES DISTANCE BETWEEN LINES ~ TRENCHI'/WIDTH IN. TOTAL EFFECTIVE SQ. FT. LENGTH OF EACH ~ /~/~ DEPTH OF F LTER MATERIAL BENEATH TILE IN. ABOVE TILE __ r( DISTANCE FROM WATER WELL: TYPE /~/~'/~///'-~/~"/~'/~ )EI)TH ~ ,BUILDING FOUNDATIOI~ SAMPLE -'4'/~ NEAREST LOT LINE ./~O' /-~* NEAREST ~ SEPTIC / SEEPAGE -' ~ OTHER ' . SEWER LINE . TANK _/~)~/ , SYSTEM /-~ CESSPOOl SOURCES DISTANCES: DIAGRAM OF SYSTEM HEALTH AUTHORITY GAAB-HD-2 ~ GREATE1(. ANCHORAGE AREA .)ROUGH HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279-2511 Case No. c-~-1~' SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT MAI LING ADDR ESS ,/'~X ~/'~ RESIDENCE AODRESS,~'~/[~//' 2~'/ ~"~-Y'/¢' LOCATION OF INSTALLATION LEGAL DESCRIPTION ,Lz~7~ ~ ~=~-.-' "~y/:~,~-7~.c['~z,~ / APPLICATION TO INSTALL: SEPTIC TANK ~ ,, SEEPAGE PIT L// , DRAIN FIELD, , OTHER ' TO SERVE THE FOLLOWING FACILITY --'///~>7~,,,~, .7~'~//~ FIN~NCEDTHROUGH L//~ TO BE INSTALLED BY ~ TEST RESULTS ANTICIPATED DATE OF COMPLETION BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT THIS IS TO SERVE AS//~/~- ~-~'~//--~-'~" , PERMIT TO INSTALL A AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED '~,~- ~ AREA~,/~ ~'~ 7~TYPE , SEPTIC TANK SIZE /j~""~-g-&-' TYPE c'zk'~£~-Yz¢-, SEEPAGE DIAGRAM OF SYSTEM HEALTH AUTHORITY OR LICENSEE) DE$IGI~ER I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the above described ~ystem is in accordance with said code. ENCROACHMENT AGREEMENT THIS AGREEMENT, made and entered into this llth day of June, 1987, by and between CHUGACH ELECTRIC ASSOCIATION, INC., an Alaska non-profit electric cooperative membership corporation of Anchorage, Alaska, hereinafter called 'First Party', and Carroll J. and Phyllis Schmidt of Anchorage, Alaska, hereinafter called 'Second Party', WITNESSETH THAT: WHEREAS, First Party occupies an easement on the East side of Lot Eiqht (8), Block F, Timberlux Subdivision, Addition No. 1, Anchorag~ Recording District, Alaska; and WHEREAS, Second Party wishes to construct a leach field for a residential septic system which will encroach approximately Five Feet (5') onto the foregoing easement. NOW, THEREFORE, for and in consideration of their mutual agreements and other good and valuable consideration, the receipt of which is hereby acknowledged, First Party, for itself, its successors and assigns, waives its objections to Second Party's encroachment on the said easement for the purpose men- tioned, subject to the following conditions: 1. Second Party will hold First. Party harmless from liability for any injury or damage to any person or property which may result from such encroachment. 2. The said encroachment will be without prejudice to Firs% Party's full enjoyment of any and all rights it may have in and to such easement. 3. Any facilities or property of First Party which are damaged or destroyed as a result of such encroachment will be repaired or replaced at no cost to First Party. 4. Second Party will comply with all applicable safety codes and regulations. 5. Any expenses which First Party may incur in the relocation or modification of its facilities to accommodate the said encroachment will be paid by Second Party. By its execution of this~ Agreement, Second Party agrees, for itself, its successors, and assigns, that its encroachment upon the named easement as hereinabove mentioned will be subject to the foregoing conditions. IN WITNESS WHEREOF, the parties have caused this Agree- ment to be executed by their duly authorized representatives and agents as of the day and year first above mentioned. CHUGACH ELECTRIC ASSOCIATION, INC. (First Party) V~ick Newland General Manager CARROL~J. AND PHYLLIS SCHMIDT (Second Party) CarrollJ ~ ~cl Phy~is Schm fidt' WYA/smm LSRW/37-8 &: S ENGihiEEtT)]N(3 70154 E:i~ I[:]A{DL,{:iF~,]iVERv AK F:'H(]NE 4+694--2979 PHONE: .~. / . -~:¥.-.-.., I_L:':()JAI_ DI!LSCI::;~:[P-I :[{3N: I...C) I' 8 SEC 34 I_C)/~ S :1: Z [E ~ i. ::'~; ( ~3(~ I:: I' (iR f.~C~f:~[~S ) HAX~ NUMBI~:R OF' BEDRC)OHS~ 4 SOIl.. l.-,fql.l,l,l(Jg ~5' Sr.) F:i'/BR 4~, ,::~t I_ 'lEST DEI:::"IH~ ,t.,, F:'I I'IZGHEST I, tl~lEl:~ ]'ABI.._IZ DEP]'H~ 'TI'I:(S IS AN UF'GRADI~: OF: 4 BEDRC)I~M 'TO '[FIE EXIS'I'iNb SEPTIC; SYSIEH W. DRAINFIELD EI::'F'EC T :[ VI:::: OEP1'H () 4 COVER DI~:I::" [ I-I () 2 T(]TAI.. DEF' '1]'{ 6 I FNGI H 60 W ! D i]-.I 5 S(~ F i. 600 AN ADDI:I ]:OiqAI_ "~ F't. 01::' I:::]:l..L W.[LI [ USED 'YO t~::l~.l,fi-]l-Jl::~l~:- A MINZi"IUI"I C(]VER (::IF:'-;.~ I::: I:, OVER ]1"11]: I::'RC)F:'CISE]) UPGRADE. January 18~ 1971 ~lr. Carroll J. Smith Box 2168 Anchorage, Alaska 99501 SUBJECT: Permit and Application for Sewage Disposal System, Lot 8, Block F, Timberlux Subdivision Dear ~lr. Smith: 'April 27, 1970, you obtained a permit from this Department for the installation of a sewage disposal system. As of this date, the permit is still outstanding. Please advise this Department if you have installed, or still intend to install, a sewer system on the subject property m~d wish your permit kept pending in our files. Sincerely, Lynn S. Coad Sanitarian ,o5:,, ! SLOPE TEST SIZE DATE HRS. BIT AND COREHEAD RECORD MUD RECORD r TIME RECORD DRILL STEM RECORD fT. FT. SIZE MAKE FT, 7-10 [J~T AND CO/~EHEAD RECORI~ MUD RECORO TIME RECORD DRILL STEM RECORD MUNICIPALITY OF ANCHORAGE 01' Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 018-271-12 Certificate of On -Site Systems Approval Expiration Date: 10 a-�� 9 y 1. GENERAL INFORMATION Complete legal description TimberlUX #1, Block F, Lot 8 Location (site address) 15341 Curvell Dr., Anchorage, AK 99516 Current property owner(s) Brian Klassen Day phone Mailing address 15341 Curvell Drive, Anchorage, AK 99516 Real estate agent Chris Swires Day phone 830-0073 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Q Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 515 O` D D t Date of Payment /1 0 / a NJ Receipt Number O I P✓D COSA# 05m o'3 Waiver Fee $ _ Date of Payment Receipt Number Waiver # '_&Pj0Lr\_.' 6. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Forge Engineering Phone 907-522-7773 Address 1399 W. 34th Ave Suite 101, Anchorage AK 99503 Engineer's Printed Name Michael E. Anderson, P.E. Date 7/9/19 6. DSD SIGNATURE System #1 Approved for 4 System #2 Approved for Disapproved Conditional approval for bedrooms bedrooms bedrooms, with the following stipulations: OF lrr��ri -fie J NJPTER A�lD � o VVAS-TEVqATER r_0^ = J Cn 1 J \ 1 J�Jii��NT SER��G �����\• By: t, � Original Certificate Date: 7 <V-) "-I The Municipality of Anchorage 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 Checklist blue sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' 60 Yes Community Sewer Manhole/Cleanout > 100' Q Yes if No ft M Yes if No Neighboring Tank > 100' 0 Yes if No ft Private Sewer/Septic Line > 25' Q Yes if No Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' 21 Yes if No Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' Q Yes if No F/ Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' 0✓ Yes if No ft Q Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' Q✓ Yes if No ft Surface Water > 100' ft ft ft ft ft Q Yes if No ft Property Line > 5' Q Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' Q✓ Yes if No ft Private Wells > 100'✓Q Yes if No Water Main > 10'✓0. Q Yes if No ft Community Wells > 200' Q✓ Yes if No. Water Service Line > 10' Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Q Yes if No ft If absorption field is under driveway comment below Property Line > 10' Q✓ Yes if No ft Wells on Adjacent Lots: Water Main > 10' Q Yes if No ft Private Wells > 100' Q Yes if No Water Service Line > 10' Q Yes if No ft Community Wells > 200' Q✓ Yes if No Surface Water > 100'✓Q Yes if No ft F. ENGINEER'S COMMENTS Septic tank to well met separation requirements at the time of install. 1987 upgrade MOA approved to within 5' of property line with utility non -objection letters -see MOA record docs. G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yellow sheet Ilk ................ All « Lh p� ,K,x« K3 ked«K9 3 8K3KK,R8K683K3438K36838KK83Kl3,K,a A38�8�a MICHAEL En ANDERSON AN0f O. 4..-43p1 `'•,, 7/9/19 ft ft ft ft t Legal Description: Timberlux #1, Block F, Lot 8 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 7/8/70 Total depth 106 ft Cased to 94 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 13 in. Date of flow test for COSA 6/24/19 Static water level at beginning of test 64 ft. Comments B. TANK DATA Age of tank(s) 32 years Tank type/material SEPTIC/CONCRETE Measured operating fluid level in septic tank 91" ❑ Standpipes/foundation cleanout per record drawing Date of pumping 6/27/19 D. ABSORPTION FIELD DATA 5` Wide Trench Which system tested (date installed) 6/19/1987 ❑ ALL standpipes present per record drawing Total measured depth from grade 7.6 ft (max) Measured depth to pipe invert from grade 3.6 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 018-271-12 Structure served by this system Well production at time of test 4.9 gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes Al N Al Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by FORGE ENGINEERING Date of Sample 7/9/19 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 6/24/19 Results ❑✓ Pass For 4 bedrooms Fluid depth prior to test 2 4 in Water added 787 gal New depth 33 in Elapsed time 1440 min Final fluid depth 22 in Absorption rate 600+ gpd Any rejuvenation treatment (past 12 months) None If yes, enter date • • 0. Municipality of Anchorage On-Site Water and Wastewater Program a ski l (907) 343-7904 Sa cry CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 018-271-12 Expiration Date: /10 —7 ^f 7 1. GENERAL INFORMATION Complete legal description TIMBERLUX#1 BLOCK F LOT 8 Location (site address) 15341 CURVELL DRIVE,ANCHORAGE,AK 99516 Current Property owner(s) CARROLL&PHYLLIS SCHMIDT Day phone Mailing address 1120 HUFFMAN ROAD, STE 24-548,ANCHORAGE,AK 99515 Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 TYPE OF WASTEWATER DISPOSAL: 4. TYPE OF WATER SUPPLY: Individual Individual Well ® Holding Tank ❑ Individual Water Storage ❑ Community ❑ Community Class Well ❑ Public Sewer El Public Water System ❑ WaiverNariance request for: Distance: Received by: / 4i4i - Date: 7-/D -/ 7 COSA to be released to the engineer, unles . _ ise requested by the engineer. COSA Fee $ EjAp - Waiver Fee $ Date of Payment ( ,l 2--ii ii Date of Payment Receipt Number bafgL Receipt Number COSA# Oil 10 (0 Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of Or-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 ARCTERRA CONSULTING,INC. Phone 868-3791 Address 20441 PTARMIGAN BLVD.,EAGLE RIVER,AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 6/2212017 THIS COSA DOCUMENT CANNOT BE USED TO TRANSFER TITLE UNLESS ALL VENDORS(ENGINEERING,SURVEYING,CONTRACTORS,ETC...ASSOCIATED WITH THIS COSA ARE PAID IN FULL AT OR BEFORE CLOSING. Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. 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 inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. 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, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen encroachments,deficiencies or discrepancies exist. a 4 p Ar 6. DSD SIGNATURE TIi /� System #1 Approved for Li bedrooms. - � -- F KENNETH Si. DITET: / System #2 Approved for bedrooms. � rh 7116 F o ,z)-, Disapproved. \ 1" FE5310 N'' Conditional approval for bedrooms, with the following stipulations: ----TPAJvrf C,ci to 1 is �-.0 .Q• ``--rwLay ,(,,Da frUv4 -e )ss�e1 c 4,o csedAe_ _afro A� C ON-SITE (NATER AND 1 1 VI!ASTE1!Il,/\TER o PROGRAM c . `C` G�\` By: �- r Original Certificate Date: — `� The Municipality of Anchorage 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_10-10-12.doc If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: TIMBERLUX#1 BLOCK F LOT 8 Parcel ID: 018.271.12 A. WELL DATA Well type PRVT If A, B, or C provide PWSID # Well Log (Y/N) Y _ Date completed 718/1970 Sanitary seal (YIN)Y Wires properly protected (Y/N) Y(Well is inside house) Total depth 106 ft. Cased to 94 fL Casing height (above ground) 18 in. FROM WELL LOG AT INSPECTION Date of test 7-8-1970 6/1512017 Static water level 65-70 ft. 70 ft. Well production 7-10 g.p.m. 4.4 g.p.m. WATER SAMPLE RESULTS: Coliform 4,1,/ colonies/100 mL Nitrate AD mg/L Arsenic: //J ug/L Date of sample: 6/15/17 Collected by ARCTERRA B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC 1 CONCRETE Date installed 1970 Tank size 1250 gal. Number of Compartments 1 Cleanouts (Y/N) Y Foundation cleanout(Y/N) Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping 6/15/2017 Pumper_ A+ C. ABSORPTION FIELD DATA Date installed 6/19/1987 Soil rating (g.p.d./ft2 oft2/bdrmJ 150 System type SHALLOW TRENCH Length 60 ft. Width 5 ft. Gravel below pipe 4 ft. Total depth 8.4 ft. (Measured 6/15/17) Eff. absorption area 600 ft2 Monitoring tube Y Depression over field N Date of adequacy test 6/15/17 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 0 _ in. Water added 615 gal. New depth 25 in. Elapsed Time: 1380 min. Final fluid depth 0 in. Absorption rate >= 600 g.p.d Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off" level at in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot *60.65' On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main 75'+ Public sewer manhole/cleanout 100'+ Sewer/septic service line 25'+ Holding tank 100'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 1001+ Wells on adjacent lots 100'± ABSORPTION FIELD ON LOT TO: Property line *5' Building foundation 10'+ Water main 10'+ Water Service line 10'+ Surface water 100'+ Driveway,parking/vehicle storage 104 Curtain drain 50'+(NONE KNOWN) Wells on adjacent lots 100'+ F. COMMENTS *Well is located in half basement with surface drain. Septic tank to well met separation requirements at time of install. 1987 upgrade MOA approved to within 5'of property line with utility non-object letters—see MOA record docs. G. ENGINEER'S CERTIFICATION I certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance -1111.-'116.1%, with MOA COSA guidelines in effect on this date. # OF 9I ` 1 Sy Engineer's Printed Name KENNETH M.DUFFUS - 1,- * # Date 6/22117 * 4 9 Til lin WA trfhl COSA canary sheel_2-6-15.doc r rF KEN NP.:TH M. Wt 4 i6 ) ;o FND 3'BRASS CAP N 80 24'E 3 13'FROM COMPUTED POSITION USING OTHER BOUNDARY POSITIONS W , 185.32 e,• ., N6230' E 1 1 10'unary EASEMENT 1. 1\. 1..L,,--\,• 4 1 ^ 1„ ' o z T , ` s. `til t 1 l 1 t • i 1 1 w 1 w 4. i o 4 0 0 1 • 1 • Sr 1 FIREWOOD SIED F F 1 24f ._ . N 1 'REX 0. DECK .0 A 1 1 1 ' 1 1 k. 1 I G' 1 41111 1u- I. • I. I.£ ORN. YII I' s� $.1 MSE 1 a:: - 1 R1 1 I o I 0 $,• 1 . IO P ip9' vI y ! p I� ms.e1 r' m 8 1 m 1 1 1 E 205 q4 f . N6230' I N 10.f . DRIV _-.- _. - - ECURV _\--1 ------ ooP.�F. OF A�q p(1 p 49 TH is ..-KU0 i) ,�,{-- D AS-BUILT SURVEY 1" = 30 ' 0 n . 0 O NO CORNERS SET THIS DATE DO%, SHANE A.HOLT. oO On• LS-6914 o`O I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY O.1%‘,'Ar ' ,°o SURVEY ORDERED BY; OF THE FOLLOWING DESCRIBED PROPERTY pia Oo �OOo�o�o KAREN DANNENBRINGO LOT 8, BLOCK F, TIMBERLUX SUB. NO. 1( PLAT 66-152) NORTHERN TRUST R.E. ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE INFORMATION HEREON IS FOR THEU5EOFLENDINGINSTITUTiONSSPECIFICALLYTO5HOWANY THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS:AND IS EXIST OTHER THAN NOTED. NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES.IMPROVEMENTS.OR FENCELINES. DATED AT ANCHORAGE,ALASKA THIS 19TH DAY OF EASEMENTS OF RECORD,OTHER THAN THOSE APPEARING ON THE RECORD PLAT,ARE NOT SHOWN _ HEREON(UNLESS INDICATED) _JUNE , 2017. NOTE: FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DE TERMNE PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. HOLT LAND SURVEYING ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE \\---- 9309 GROVER DRIVE \ ANCHORAGE.AK 99607 f 13604, FB 183-21 345-5513 /l MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AN D WATER FACILITY H 8 6-13 2 9 264-4744 Application Date GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 8 Block F Timberlux Subdivision Location (address or directions) 15341 Curvell (b) Property Owner Phyllis Schmidt Telephone: Home 345-1703 Business 279-6441 561-5277 Mailing Address PO BOX 240063, Anchoraqe, Alaska 99524 (c) Lending Institution First National Bank Telephone Mailing Address Southcenter Branch, PO Box 4-2090, Anchorage % Rita (d) Real Estate Company and Agent Address Telephone (e) Mail the HAA to the followina address: or: Check here I-I, if hold' for pick up. List contact person and day phone number below. TYPE OF RESIDENCE Single-Family [~X Number of Bedrooms four (4) WATER SUPPLY Individual Well:lEkx Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite [~x::'Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental attesting to the legality and status. ' · Conservation Page 1 of 2 72~o25 fRev 8/861 Front · 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION AS certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm S & S Engineerinq Telephone Address 17034 Eagle River Loop Road, Eagle River 99577 Date Engineer's Seal This department has received written confirmation from the engineer regarding the Conditional Approval of December 17, 1986. The corrections have been accomplished and an inspection has been completed by the engineer. The subject property meets with Municipal standards and is now approved° DHHS APPROVAL fo'ur ( 4 ) bedrooms by ,'~'~"~--~ /4:~' "~'/~ Date Approved for Approved /'""" Disapproved('/ Conditional Terms of Conditional Approval CAUTION The Municipa;ity of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 fRev 8/861 Back ROBERTA, SHAFER June 25, 1987 CIVIL ENGINEER 694-29Zg MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION, HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION JUN 6 1987 Municipality of Anchorage Department of Health and Human Services 825 L Street Anchorage, Alaska 99501 RECEIVED REFERENCE: Lot 8; Block Fi Tlmberlux Subdivision In December, 1986, you issued a conditional Health Authority Approval for the referenced property. Th~ conditions of that approval have been satisfied and a copy of the on-s~e s~wage disposal syst~, inspection report is attached. E.G,NEEmNOSTUO,ES R~quest~ssue a final HAA at this time. AND REPORTS &FLOWTEST ~~SHAFER, P.E. SITE PLANS ROAO DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN SRB 196X EAGLE RIVER, ALASKA99577 ~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL oF ON-S,TE SEWER AND WATER EAClL,TY 264-4720 12-5-86 Application Date GENERAL INFORMATION (a) Legal Description !include lot, block, subdivision, section; township, range) Lot 8 Block F Timberlux Subdivision Location (address or directions) 153~1 Curvel l ~cl~u.,~,. Telephone: Home -,4~,- 17c~"4 Business ~-2.~1-5277 (b) Applicant Name 9~¢llis ~ '~ "' Applicant Address P~O. Box 240063 ~ncho~ag~ ~.. 09524 (c) Applicant is (check one): Lending Institution D; Owner/builder ~; Buyer ~; Other D (explain); (d) Lending Institution First National Address South Center Bran~_h/At~n (e) Real Estate Company and Agent Address -, ~. Telephone Telephone HOLD (f) 'fCrafh'the HAA to the following address: SR ~-196X TYPE OF RESIDENCE Single-Family [~ Multi-Family [] Number of Bedrooms 4 Other WATER SUPPLY Individual Well ['~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department ol [Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite [~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. _ 72-025 (11/84) Page 1 of 2 ENGINEERING FIRM PROVIDIN~*~*~,~SPECTIONS, TESTS, FILE SEARCH, DA~AND INFORMATION A~ c~rtified by my seal affixed hereto and as of the validation date ShOWn bmow, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or was[ewater disposal system is safe, functional and adequa[e ' for the number of bedrooms and type of structure indicated herein. I further verity 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, ormnances, and regulations in effect on the date of this inspection. Name of Firm S & S ENGINEERINC,, Telephone ¢¢ ¢,~'--Z¢';~ ¢' SRB 196X Address Date EAGLE RIVER, AK 99577 A soil test is required to determine ground water level and to verify soils for a system upgrade. If the water table is not influencing the existing crib, then an upgrade of the absorption area for three bedrooms will be required. If the existing crib is determined to be in non-compliance than the absorption area will require upgrading for four bedrooms. A conditional approval is recommended under the above conditions. Engineer's Seal DHEP APPROVAL Approved Disapproved Conditional Terms of Condiiional Approval ./~¢~"' .~.p,~.~i~/~w.~.w~'~-w-z'z~-~ /.- '" ,'~,~'_/~',/., '~ , ,!I ~ i/i/i CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 MUNICIPALITY OF ANCHORAGE (Md~r/ HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: f,ot R P,l~nk P q~imh~"ln~ ,~./r~ WELL DATA Well Classification Private Well Log Present ON) Total Depth 106' Cased to Static Water Level 58' Casing Height Above Ground 12"+ Electrical Wiring in Conduit (Y~ * Separation Distances from Well: Depression Around Wellhead (YJ~J If~ A, B, C, D.E.C. Approved (Y/N) N/A Date Completed 7-8-70 '"' Yield Depth of Grouting UK Pump Set At UK Sanitary Seal on Casing ~YN) No To Septic/Holding Tank on Lot tOO'+ ; On Adjoining Lots 100'+ To Nearest Edge of Absorption Field on Lot _ 100'+ ; On Adjoining Lots 100'+ To Nearest Public Sewer Line N/A To Nearest Public Sewer Cleanout/Manhole - N/A To Nearest Sewer Service Line on Lot 30 ~ + Water Sample Collected by S&S Engineering ; Date 1.2-7-R6 Water Sample Test Results Satisfactory --' Comments * Well loeah~d in insulatm~ w~ll ho~-~ ~nnn~tc~ tn hn,~- A four hour yield test was performed and it was determined that the well will produce in excess of 0.104 gpm per BR. B. SEPTIC/HOLDING TANK DATA Date Installed 1-29-79 Size 1250 "' Standpipes (~N) 'Yes Depression over Tank (YJ~) No Pumping/Maintenance Contract on File~t~7- Holding Tank High-Water AlarmWWN)-- Separation Distances from Septic/Holding Tank: To Water-Supply Well _ [OQ~+ To Property Line _ 10' + To Water Main/Service Line 50' + Course .N/A Air-tight Caps (~N) N./A No. of Compartments 1 Foundation Cleanout (Y/~ No Date Last Pumped ] ; for .......... Temporary Holding Tank PermitJo~ To Building Foundation 20'+ To Disposal Field 20'+ To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026(11/84) MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAl. PROTECTION RECEIVED C.. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed 1-29-?] Width of Field ].2' UK Square Feet of Absorption Area Depression over Field (Y~_~ Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well 1 GO' + To Building Foundation Lot N/A To Water MaiR/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments __ Type of System Design Length of Field 12' Depth of Field _ 10'+ Gravel Bed Thickness 2BB ,,~ Standpipes Presentt~/N) No Date of Last Adequacy Test A~quah~_ fn~ ] h~c]r'~nm Seepage Pit ] 2-9-86 To Property Line 10'+ To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) N/A ~/A 30'+ Soil test--to be perform~pgrade: Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments N 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 th~ I~,~;~jl~l~ji~ or conformed to all MOA and HAA guidelines in effect on the date of this inspection, Signed ~ ~--'J 9~X Date /2- -/~ / Company~l~~ MOA No. Receipt No. ~.~:~¢,/ ¢ Date of Paym.ent /-.~,// Amount: $ ~"]~ / Page 2 of 2 72-026 {11/84)