HomeMy WebLinkAboutVALLI VUE ESTATES #1 BLK 1 LT 18 Municipality of Anchorage
Community Development Department Page 1 of 2
On-Site Water and Wastewater Program
4700 Elmore St. • P.O. Box 196650 Anchorage,AK 99519-6650•http://www.muni.org/onsite• (907)343-7904
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP181277 PID Number: 015-311-19 ❑ New p Upgrade
Name:
Lorrie Lundquist ABSORPTION FIELD
Address
❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound
6856 Double Tree Ct. ❑ Other
Phone Number of Bedrooms Soil Rating Total depth from original grade
3 GPD/SF Ft.
LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe
Subdivision Block Lot Ft. Ft.
Valli Vue Estates#1 1 18 Fill added above original grade Gravel length
Township Range Section Ft. Ft.
Gravel width Beds:Number of Lines Distance between lines
SEPARATION DISTANCES Ft. Ft.
To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist.between trenches
From Tank Field Lift Station Tank Line Ft2 Ft.
Well 200+ N/A N/A N/A 100+ TANK O Septic 0 S.T.E.P. 0 Holding ❑Other
Manufacturer Capacity
I Anchorage Tank 1000Gal.
Surface Water 100+ N/A N/A N/A
Material Number of compartments
Lot Line 10.1 N/A , N/A I N/A STEEL 2
Foundation 15.0 N/A N/A I N/A NA LIFT STATION
i Manufacturer Capacity
Curtain Drain 50+ N/A 1 N/A N/A I Gal.
1 i
Pump on level at Pump off level at High water alarm at
Remarks
in. in. in.
Pump make and model Electrical Inspections performed by
PIPE MATERIAL House to tank 3034 Tank to 3034
Installer drainfield
A+ Home Services Drainfield CO/MT 3034
Inspector Pannone Engineering Services BENCH MARK (Assumed elevation) 100ft
Inspection ist 30AUG18 d Location and description
dates: 2" 05SEP18
s'° 4' BOTTOM TRIM HOUSE S CORNER
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL ,Enngineer's Stamp
Conditional Approval: Date_ 4°F''
P49]!l � ••�
N '.*
••.•air.1 ;
\ `
••tjeven -.-annoAe
�/
i,,,,•.. CE 8149 .•
Approve: 1/t. ,. 47 Date --Gc —�� •P'''iq, •:.
OFESEV*
Inspection Report_1-1-12.doc
/ I / I
M ----i I I / I /
M I I I I I ,
\IM )QOE � TRE 1 1
j �Ih -�_ Court
M M /M M
/(..\- . I ( , / — // _ � \
/ i \ \l 1 v / > -2\ '1 I 1. I �'�1
N *- 1 e
_I_ 3' \I 1 \ \ \ V'
£ \ \ \ I \
— T —t 725 l \ \\ .� ! O\\ 11 J /
\ / 3 \ \' I \. m \ I` lr
\ \ REMOVED EXISTING SEPTIC TANK BDR 20.6 \� \ I /
- PER MOA CODE sFD Ca 1 0 INSTALLED NEW 1000G SEPTIC TANK
730 \ 1 \ W/ DCO AFTER CONNECTED
\ ;`/ 1... i, I r \ TO DRAIN FIELD (E)
ii \.; �
DRIVEWAY 15.0 i T
_`— /i —
� / 10.1_/ �—
/
I
21 730/ / � � - - - - ..... - - - /_ � ._ ..
\ '' \2,
fii\ 735 / — — 20 / / / /
It), / I / /
\ ~ / — / �� \ /.Jri\ 740 i f'l / / — —
\ Q Q. / — `-3, ---
N,-•, \ '' . 745 'T� / / /
/ ��Q , — O / / Iso CO SSS 760 785
\ l T/ / - /` r- ---
/ t
9 (-(7 J
/ /
A B / — — —
/ / \ `'�� / /
/ / — / ` \ / / /
ECO 14.4 18.5 r / / / I I
T1 24.9 20.4 / / / I
T2 29.5 25.1 / ` �I I ) I I
DCO 30.9 26.2 / I / / I--
/_ -- - - T I — —1—
ABBREVIATIONS
TH TEST HOLE <o' ° W
0_, ,, A
(P) PROPOSED a� _, o�
(E) EXISTING ""
CO CLEAN OUT NO. Vegg __._
—ioo.o— — - ---
MT MONITOR TUBE NO.
TYP TYPICAL
—w —w — WATER LINE / 1000g --/%--277--=__—
zC
WELL RADIUS SEPTIC
TANK
—Ss —SS — NEW SEPTIC
NOTES: PANNONE ENG SVC, LLC Date
RECORD DRAWING P.O. BOX 1807 PALMER, AK 996454.9 9/s/zots
PHONE (907) 745-8200 FAX (907) 745-8201 i..• Scale
40107H i
/4 .* 1.. = 50'
•••• • P.I.D. NO
VALLI VUE ESTATES #1 B1 L18 � �\ 015-311-19
DRAWN ACP LORRIE LUNDQUIST ••�}eVet1 •�'Ot1�O• PERMIT NO.
6856 DOUBLE TREE CT. i, CE 8149
�•• OSP181277
SITE PLAN ANCHORAGE, AK '-o� ;,�y Sheet
`�tF�'_ 1 OF 1
MUNICIPALITY OF ANCHORAGE
On-Site Water&Wastewater Program Natc►entm SFr
• / rPO Box 196650 4700 Elmore Road
Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax: (907)343-7997
http://www.muni.org/onsite 'r +
6 zei
1)ehiii orient
On-Site Wastewater Disposal System Permit ��304 8'
Permit Number: OSP181277 Effective Date: 8/21/2018
Work Type: SepticTank Upgrade Expiration Date: 8/21/2019
Tax Code Number: 01531119000
Site Legal Address: VALLI VUE ESTATES#1 BLK 1 LT 18 G:2539
Site Mailing Address: 6856 DOUBLE TREE CT, Anchorage
Owner: AH'NEE PONIPAKE & Lot Size in Sq Ft: 20651
Design Engineer: PANNONE ENGINEERING SERVICES Total Bedrooms: 3
This permit is for the construction of:
❑ Disposal Field El Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 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. Provide notification by calling (907) 343-7904 (24/7).
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
Received By: ' 44.1- _ Jr. --S-3/6Date: w i
Issued By: a"„CO, i • Date: F 21 1 r
EPPLS
A1C
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
Parcel I.D. 015-311-19
Property owner(s) Lorrie Lundquist Day phone
Mailing address 205 E. Dimond PMB 123 Anchorage, AK 99515
Site address 6856 Double Tree Ct.
Legal description (Sub'd., Block& Lot) Valli Vue Estates #1 B1 L18
Legal description (Township, Range & Section)
Lot Size 20,651 Sq. Ft. Number of Bedrooms 3
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(®all that apply)
Absorption Field ❑ Initial ❑ Single Family (SF) ❑X
(w/wo ADU)
Septic Tank Upgrade ❑X
Duplex (D) ❑
Holding Tank ❑ Renewal ❑
Multiple Dwellings ❑
Privy ❑ (SF and/or D)
Private Well ❑
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE !WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
( r, r
(SignatureQII '
property owner authorized age
)
Permit/Rush Fees: 4 a 153 Waiver Fees:
Date of Payment: 3119"1 17 Date of Payment:
Receipt Number: 053(eOE) Receipt Number:
Permit No. QSP 1 S J g--3 Waiver No.
Permit App__-: ._
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP181277, Rebecca Carroll, 08/21/18
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP181277, Rebecca Carroll, 08/21/18
GRE R ANCHORAGE AREA BORt i'GH
~1~/~ Department of Environmental Quality
~ 3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME '? ~.~*~¢' /"¢~, ' MAILING ADDRESS /~'~/''~ ~-> ' ~ ~--
LOCATION
SEPTIC TANK:
DISTANCE ~
FROM W E L L~- ~/~f/~'~
INSIDE LENGTH
M A N U FAC T U R E R~ ~'%,gz-%~*~.
INSIDE WIDTH
LIQUID DEPTH
NUMBER OF
COMPARTMENTS
LIQUID CAPACITY/-/)-/2,/~GALLONS.
TILE DRAIN FIELD:
DISTANCE FROM WELL~I~')'t'¢,¢~Q FOUNDATION . /
NUMBER OF LINES i DISTANCE BETWEEN LINES
NEAREST LOT LINE_~/ ~ TOTALoF LINEsLENGTH[~,'~ ~..~
TRENCH WIDTH~-qN. TOTAL EFFECTIVE
/
'~/2 ~ ABOVE TILE ~/ IN.
WELL:
TYPE
BUILDING
FOUNDATION
CESSPOOL
APPROVED
CONSTRUCTION
NEAREST NEAREST
LOT LINE , SEWER LINE__
, OTNER SOURCES
DISAPPROVED REMARKS
.DEPTH
SEPTIC SEEPAGE
, TANK SYSTEM
DISTANCE FROM:
DISTANCES: ~/'~ /_./(''
SEWER LINE DEPTH:
PIPE MATERIAL:
LOT SLOPE: '
REMARKS:
Form EQ-032
DIAGRAM OF SYSTEM
G.A.A.B. ~_ j/'l r
INSTALLATION Of: SEPTIC TANK ~ · SEEPAGE PIT W~~
FINANCED THROUGH TO BE INSTALLED BY
GreJ ER ANCHORAGE AREA BO! ~ugH
DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO.
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
PHONE
OTHER
SOIL TEST RESULTS NOTE: THIS PER~IT~IS NOT YRLID WITH~)~JT SOIL TEST
' COMPLETION DATE ANTICIPATED ·
FINAL INSFECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT Final [NSFECTION BY TH'E
DEPARTMENT OF ENVIRONMENTAL~ QUALITY/ AUtHORIT~WlLL~ ~. ~ ~ .BE SUBJECT~.TO. PROSECUTION.~-w~~t~ ~/~ ~ ~x
MINIMUM DISTANCES, REQUIREMENTS
/
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE P]T DRAIN FIELD
SEPTIC TANK TO seepage PIT WALL
SEPTIC TANK SEEPAGE Pit . DRAIN FIELD
TO N REST LOT LINE.
WATER MAIN TO SEPTIC TANK SEEPAGE PIT
DRAIN FIELD
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST lEON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
CONFORM TO BOROUGU RE~ATIONS REGARDING l~LLAt[ON.
VE
28-68 AND THAT THE b
GREATER ANCtlORAGE AREA ~ORDUL
Department of Environment. a] Quali
3330 "C" Street
Anchorage, Alaska 99503
j? ~ .;.g)ll.S hOG 1 EI~.OhA FION 1 ES 1
Performed for__~__~/_~_~__~ .... Date Performed
Lega 1 ~Des c ri p~m~ ~~~ ~ .... ,
This ;orm reports: aoils log~ Percolation test
Dep th
Feet
3-
4-
5-
6-
12-
13-
Was ground water encountered?
If yes, at what depth?
Reading Date Gross Time Net Time Depth to Watm, Net Drop
Percolation r-~ t~e ........... ~-i-n~t-e-.
,Proposed installatioh-:--Se~-~a--ge Pit Drain Field
Depth of Inlet Dept~-o'-U~-~-t-o?n~rC'pit or trench
COMMENTS:
, )
~'~a'-~~+~~-~ ~d By: ;}ate: .................
EQ-040 (6/74)
CT) 0)
V! VJT
`' ) lIO'
MIT
C?
I,- ti
Oo
rn rn
Wo L
V a-
Q
O
U
Z
LL
0
J
Q O
C O
O U
'® E (n
- Q W
Z
U
/a/•)� 06
uJ L
c
Q
O
DO
co
0
O_
Q
Q
a)
U)
a
(n
C
O
O
a)
ca
U
W
NT
N
O
N
ci
0
T11
N
ca
0
C:
0
a
Q
X
W
0
O
O
r
1
r
co�r�./•�
O
U
c0
a_
ti
O
LO
m
co O
� Y
J Q
0)
Y
cu
J L
m L
� U
C/)Q
W ~
LU
C/ Lf_
W �
W W
W
J p
\J �
LO
00
_o
Q cn
U U
m �
as
,�
t
O
U)
W
0
a)
O
CL
CL
n3
cu
U)
a)
C
O
m
X
A
0)
O``
c0
O
CL
N
V
N
O
L
c
++N
�
Q
•�
C
co
t
~
cn
ca
'0
U
L
r_
O
d
O
0
,r
cu
c
a
N
OL
a
uoi i
o
co
2
i
O
U
O
•N
Q
N
JT
N
4)
a)
o
a
O
.y
m
z
`
Q
._.
i
c
•�
>
c
a
m
O
a
CL
a
O
N
Q
O
a)
C
E
x
0
>,
�
d
U)
O
y-
C/)�0
A
O
a
o
U)�^,,
w
E
-500Oa
Q
O
M
0
��
fA
-0
c/)
o
N
O
a
��
CLQ
N
p
c
c
o
a)
v
to
O
N
QQ
`
+�
Z
� o
�c 0
v
i
am.
L
=
U Q
H 0
t
j,
=
d
Q
C
0
(B
U
.Q
Q
Q
0
L
Q
Q
U)
W
J+
U)
N
+-
0
0
a)
m
U
a)
z
O c-)
a '
co
LL O LO
Z
J
a
w
z v
LU
(D a
T
ti
r
J
ti
m Q
CO
U)
U
m W
C)
w z
0 D
z =
D
2
O
o CV
U cn
U
Q) p
-a �
a) �
O O
a
E cu
O U
U
m
C
0
cv
r��
a
7
IT\
(L)
LL
m
^2l .n
W
taE
a) f°
LL a *k
0
O u O
U 0 U
O
a)
a)
a)
O
c
N
_C
(n
(6
a)
O
m
>,
N
0
ca
Q
El
c
(6
v
O
O
_
E
cn
Q
G
3:
U�
O
:--
.�
w
a)
a)
N
�_
O
a)
E
>
V
=o
a
(
U
N
a)
❑
❑
a)
o
m
a
LL
u
>_
Com%
�
L
L
n'
rW^
VJ
O
❑
�
a)
c_'
m
m
>,
-a
0
N
N
>
c)❑
m
0
U
N
>,'C
—
N
a
a
C:
c
>
w
a)
`o
❑�
E]U
m
m Q
ma)
U)
J
❑
OL O
>
L
>
�
U
_
O
'^
N C
o-
a
O
cn
m
V'
r E
0
❑
❑
❑
cu
a
O
r O
❑
❑
C
LU
J
N
O
❑
E t
d
~
a)
ami
}, +-�
Fn
a
cn
?,
cn
m
(D ;,
E
w
Ww
❑
a)
O
N v
w
a
ca
N
~
N
Y
L
0
Q
O
m
�
c}n
v
4-
LL
LL
aa
a)
Md
LU
U
CO
W
v
r_ r
Fn
a
H
O
a)
nw.
a
O
F
H
Q
CO
>
c
cwn
a
a
>
>
cc
N
M
d
LC)
(D
W
m .Z
IT\
(L)
LL
m
^2l .n
W
taE
a) f°
LL a *k
0
O u O
U 0 U
COSA Checklist_June 2022
COSA Checklist
Legal Description: Parcel ID:
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____
A. WELL DATA
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
Date of pumping
Required maintenance completed, if AWWTS
Comments:
C. LIFT STATION
Required maintenance completed
Age of lift station years
Lift station material
Comments:
D. ABSORPTION FIELD DATA
Which system tested (date installed)
ALL standpipes present per record drawing
Total measured depth from grade ft (max)
Measured depth to pipe invert from grade ft (min)
N/A – pressurized field.
Per record drawings, field is insulated.
Monitor tubes go to bottom of effective.
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)
If yes, enter date
Adequacy test date
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 – POST RECOVERY
Effective depth (per record drawings) in
Effective depth used in
Effective depth remaining in
Comments/Deficiencies:
COSA Checklist_June 2022
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well on lot)
Septic Tank/Lift Station on Lot > 100’
Yes if No ft
Neighboring Tank > 100’ Yes if No ft
Absorption Field on Lot > 100’ Yes if No ft
Neighboring Absorption Fields > 100’
Yes if No ft
Community Sewer Main > 75’ Yes if No ft
Community Sewer Manhole/Cleanout > 100’
Yes if No ft
Private Sewer/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 Absorption Field(s) on Lot to: (Please enter distances if less than required)
Building Foundations > 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 > 10’ Yes if No ft
Water Service Line > 10’ Yes if No ft
Surface Water > 100’ Yes if No ft
Wells on Adjacent Lots:
Private 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.
In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in
accordance with ADEC & MOA guidelines and regulations. The reported results describe the performance of the system
under the conditions encountered at the time of the test, and separation distances measured to readily identifiable
features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that
may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside
the control of the evaluator of this system. All systems eventually fail, and satisfactory test results do not guarantee future
performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore, we
cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this
report is for the sole benefit of the owner listed above.
Name of Firm
Phone
Engineer’s Printed Name
Date
C7
9.
.c
Sept
I
90
Lot 21
Note: This lot is served by community water.
Lot 19
Wood fence encroaches 0.6±
0
0
0
N
N
c.�
0o Lot 20
0
0
Z
REVISED Septic System25- 4
RECERTIFIED 6-19-24
AS -BUILT NO CORNERS SET THIS DATE
7223
`�\\ %,% t
�� OF ''
• W X • ... L '
'� P• • • •S
,
.. �' '�49th 9
�. •
f
0 •
pN620364611W
Anchorage Recording Precinct, Alaska, and that the
DOUBLE TREE Cco ouRT
UJ
p
Q 9 46
0
R=1430.00 L=93.2
and do not overlap or encroach on the property lying
UJ
!-u co
—►
m
CO
Mr
IC
IE
°
D
N
N o �-
LOT 18 °'
I co
��' • • • • �J AM
� �'� ••...•• �o �
0 0 <-
Z o�
( w
t EssIoNA
`-
Lo co
I1 t�
I >
°
this 12th day of December , 1975.
EASEMENTS OF RECORD, OTHER THAN
p`
FB 24-15 pg 58
FRED WALATKA & ASSOCIATES L.L.C.
THOSE SHOWN ON THE RECORDED
FB 18-6, pg 44
O co
C. Cfl 31.4
'` �o -0
C7
9.
.c
Sept
I
90
Lot 21
Note: This lot is served by community water.
Lot 19
Wood fence encroaches 0.6±
0
0
0
N
N
c.�
0o Lot 20
0
0
Z
REVISED Septic System25- 4
RECERTIFIED 6-19-24
AS -BUILT NO CORNERS SET THIS DATE
7223
This drawing is a representation of conditions found at the time the mortgage location survey was performed. This document does not constitute a boundary
survey and is subject to any inaccuracies that a subsequent boundary survey may disclose. The information contained on this drawing shall not be used to
establish any fence, structure or other improvements unless otherwise noted. This drawing shall only be used for a single property transaction. Use of this
drawing by the original client or by others at a later date without the consent of Elizabeth L. Walatka is a violation of Federal Copyright law. Unless gross
negligence is discovered, the liability extent of the preparer is limited to the amount of fees collected for services in preparation of this product.
`�\\ %,% t
�� OF ''
• W X • ... L '
'� P• • • •S
,
.. �' '�49th 9
�. •
f
0 •
I hereby certify that I have performed a Mortgagee's inspection
in accordance with ASPLS Standards of the following
described property: LOT 18, BLOCK 1,
VALLI VUE ESTATES UNIT No. 1
Anchorage Recording Precinct, Alaska, and that the
• • • •� • • •
0
improvements situated thereon are within the property lines
and do not overlap or encroach on the property lying
00 ' '
adjacent thereto, that no improvements on the property lying
.• lizabeth L. Walatka•. /
adjacent thereto encroach on the premises in question and
8036 — LS • ,,,�
that there are no roadways, transmission lines or other
ALE: 1"=40'
SCALE:
��' • • • • �J AM
� �'� ••...•• �o �
visible easements on said property except as indicated
p p y p
t EssIoNA
`-
hereon.
Dated at Anchorage, Alaska
this 12th day of December , 1975.
EASEMENTS OF RECORD, OTHER THAN
p`
FB 24-15 pg 58
FRED WALATKA & ASSOCIATES L.L.C.
THOSE SHOWN ON THE RECORDED
FB 18-6, pg 44
Engineers and Surveyors
PLAT ARE NOT SHOWN HEREON
UNLESS OTHERWISE NOTED.
BE
FB 75-9, pg 49
907-248-1666 -
This drawing is a representation of conditions found at the time the mortgage location survey was performed. This document does not constitute a boundary
survey and is subject to any inaccuracies that a subsequent boundary survey may disclose. The information contained on this drawing shall not be used to
establish any fence, structure or other improvements unless otherwise noted. This drawing shall only be used for a single property transaction. Use of this
drawing by the original client or by others at a later date without the consent of Elizabeth L. Walatka is a violation of Federal Copyright law. Unless gross
negligence is discovered, the liability extent of the preparer is limited to the amount of fees collected for services in preparation of this product.
IMPLAMN
R DS If
coS
c.
•i � Municipality of Anchorage
On-Site Water and Wastewater Program <
(907)343-7904 SAI C T
Certificate of On-Site Systems Approval Q C�
Parcel I.D. 015-311-19 Expiration Date: O - C
1. GENERAL INFORMATION
Complete legal description Valli Vue Est. #1 B1 L18
Location (site address) 6856 Double Tree Ct. Anchorage, AK 99507
Current Property owner(s) Lorrie Lundquist Day phone
Mailing address 205 E. Dimond PMB 123 Anchorage, AK 99515
Real Estate Agent Day phone
2. TYPE OF DWELLING:
Q Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well ❑ Individual
Individual Water Storage ❑ Holding Tank ❑
Community Class Well ❑ Community ❑
Public Water System EJ Public Sewer ❑
WaiverNariance request for: Distance:
Received by: AO (3j ; , 1. , Date: - I fl
COSA to be released to the - == . -ss otherwise request-• by the engineer.
COSA Fee $ -M1,400
1,400 Waiver Fee $
Date of Payment —1 ((O lit Date of Payment
Receipt Number Receipt Number
COSA# £S(e ic-apea 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 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 lime of installation.
In conducting an adequacy test.I attempt to provide a thorough,conscientious engineering analysis of the system in accordance with MoA COSA
guidelines and regulations.The reported results describe the performance of the system under the conditions encountered at the time of the test,
and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil
condition,ground water levels that may fluctuate during the year,and the water usage of the family being served by the system.These conditions
are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future
performance of the system,nor do they guarantee that there are no hidden defects or encroachments.Therefore we cannot provide any warranty
for future performance, nor can we estimate remaining life of the system.The content of this report is for the sole benefit of the owner listed
above.
Name of Firm Pannone Engineering Services LLC Phone (907) 745-8200
Address P.O. Box 1807 Palmer, AK 99645
Engineer's Printed Name Steven R Pannone Date 9/6/2018
d CP..
*:49X =*
6. DSD SIGNATURE •••• ••l
•
System#1 Approved for-3 bedrooms ••Vieven antioAe
•
• • CE 8149
System#2 Approved for bedrooms ',•�,' •
• •�,
Disapproved
Conditional approval for bedrooms, with the following stipulations:
0N-SITE
TEK P\ND
- \r`tRSTEwPTER
y
2ROGRI\M c:
•
•
•
By: Original Certificate Date:7- - Ll�
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 j. c
If more than 1 septic system is on the lot:
COSA Checklist# 1 of 1
Structure served by this system 1
Certificate of On-Site Systems Approval Checklist
Legal Description: Valli Vue Est. #1 B1 L18 Parcel ID:015-311-19
A. WELL DATA
Well type Community If A, B, or C provide PWSID# City Well Log(Y/N) N/A
Date completed N/A Sanitary seal (Y/N) N/A Sanitary properly protected(Y/N) N/A
Total depth N/A ft. Cased to N/A ft. Casing height(above ground) N/A in.
FROM WELL LOG AT INSPECTION
Date of test N/A N/A
Static water level N/A ft. N/A ft.
Well production N/A gpm N/A g p m
WATER SAMPLE RESULTS:
Coliform N/A colonies/100 mL Nitrate N/A mg/L
Arsenic N/A ug/L Date of sample: N/A Collected by: N/A
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/Steel Date installed 9/5/2018
Tank size
1 000 gal. Number of Compartments 2 Cleanouts(Y/N) Y
Foundation cleanout(Y/N) Y Depression over tank(Y/N) N High water alarm (Y/N) N/A
Date of pumping NEW Pumper N/A
C. ABSORPTION FIELD DATA
Date installed 9/29/75 Soil rating (g.p.d./ft2 or ft2/bdrm) 125 System type Deep Trench
Length 20 ft. Width 3 ft. Gravel below pipe 10 ft.
Total depth 14 ft. Eff. absorption area 375 ft2 Monitoring tube Y Depression over field N
Date of adequacy test 8/8/18 Results(Pass/Fail) Pass For 3 bedrooms
Fluid depth in absorption field before test 0 in. Water added 450 gal. New depth 0 in.
Elapsed Time: 180 min. Final fluid depth 0 in. Absorption rate >= 450 g p d
Non Known
Any rejuvenation treatment(past 12 mo.)(YIN& type) If yes, give date
D. LIFT STATION
Date installed N/A Size in gallons N/A Manhole/Access(YIN) N/A
"Pump on" level at N/A in. "Pump off'level at N/A in. High water alarm level at N/A in.
Datum N/A Cycles tested N/A Meets alarm&circuit requirements? N/A
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot N/A On adjacent lots N/A
Absorption field on lot N/A On adjacent lots N/A
Public sewer main N/A Public sewer manhole/cleanout N/A
Sewer/septic service line N/A Holding tank N/A
Animal containment areas N/A Manure/animal excrete storage areas N/A
SEPTIC/HOLDING TANK ON LOT TO:
11
Building foundation 10 + Property line 10 + Absorption field 10'+
Water main 5'+ Water service line 25 + Surface water 1001+
Wells on adjacent lots 100 +
ABSORPTION FIELD ON LOT TO:
101Property line + Building foundation 1 + Water main 1 +
Water Service line 25'+ Surface water 1001+ Driveway, parking/vehicle storage 101+
Curtain drain Unknown Wells on adjacent lots 100'+ •
F. COMMENTS
The monitor tube only extends six feet into the field.
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and Q' 4
review of Municipal records that the above systems are in *14€1 TH i% %It
conformance with MOA COSA guidelines in effect on this date. ,
Engineer's Printed Name Steven Pannone ' •• n O!ie
Date 9/6/2018 CE 8149 •
..c�:,
COSA canary sheet_2-6-15.doc
DOUBLE TREE COURT 7223
0 N62o36'46'rw oM —
A,Lu • tkv 9.46 R.1030.00 L=93.26 O
7CL! L-1 00
CO
j r
0 N LOT 18
D ^per
Oor
l Z toe)
t6 tJ
O `,Lo
1 �c
00
¢
2`s� pO
Lot 19
CD 31.4 c:3
ii C
IO
;.yam 200 \�pyOs� °'%a 29.5---- N
toc
\\ .51(1)-
''".•••14,':: :::7,?:-.•!:.;:;,,,%i•:.
r.0� 'i!1•.;\}..• yell--
Lit 0
•?' Z
VG.
Tt76'
7,, O o Lot 20
Lot 21 7.s' \
S0 c�asso\
Note: This lot is served by comminity water.
RECERTIFIED 8-31-18 ( ()
....
��N .N ` AS-BUILT NO CORNERS SET THIS DATE
OF -6/ � ) I hereby certify that I have performed a Mortgagee's inspection
...7.i:.. • •QS �A of the following described property: LOT 18, BLOCK 1,
i •49th �` •4- t VALLI VUE ESTATES UNIT No. 1
• •
• // Anchorage Recording Precinct,Alaska,and that the
-.. . •
�4�%y improvements situated thereon are within the property lines
and do not overlap or encroach on the property lying
/ �,•. lizobeth L. Wolatka:Pc,
adjacent thereto,that no improvements on the property lying
/ 2- •• •• 8036 - LS -•�� - adjacent thereto encroach on the premises in question and
iI Fpm•,• ,• y� " that there are no roadways,transmission lines or other
o"R • • • . • '�• visible easements on said property except as indicated
SCALE: 1"= 40' r o'csslow�l- �� hereon.
4%N XN.rN. Dated at Anchorage,Alaska
EASEMENTS OF RECORD,OTHER THAN q-5-l8 this 12th day of Deecember,1975.
THOSE SHOWN ON THE RECORDED FRED WALATKA 8 ASSOCIATES,L.L.C.
PLAT ARE NOT SHOWN HEREON. FB 18-6, pg 44 Engineers and Surveyors
UNLESS OTHERWISE NOTED FB 75-9, pg 49 BE 907-248-1666
MUNICIPALITY OF ANCHORAGE
DIVISION OF ENVIRONMENTAL HEALTH
DEPARTMEN~ OF HEALTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR RE~J~TH AUTHORITY APPROVAL CERTIFICATE
1. General Information
Application Date
(a) Legal Description (include lot, block, subdivision, section, township, range)
Location (address or directions)
(b) Applicants Nam~ ~"~-~ /.~L~ ,}D~$ Telephone - Hom_._~e Business
Applicants Address_,~
(c) Applicant is (check one) Lending Institution ~ ; ~ener/build~r~--~;
Buyer ~; Other~ (~plain); .
(d) Lending Institution /
Address ___&~
(e) eal [state Co. Agent /
Telephone
Address
(f)
Telephone
Mail the HAA to the following address:
Type of Residence
Single-Family~/'
Number of Bedrooms
Other (describe)
Water Suppl~
Individual
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 l ~------~[' Public ~--~ Community [~ 'Holding Tank ~
Note: If community well system, must have written confirmation from the State
Department o[ Environmental Conservation a[testing to the legality and status.
[Page 1 of 2]
Engineering Firm Providin~ Inspections~ Testsz File Search, Data and Infoz~atton
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 ~mstewater 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 inspectioa, the on--site water supply and/or wastewater disposal
system is in compliance with all Municipal and State codes, ordinances, and regula-
tions in effect on the date of this inspection.
Name of Firm /%.~ -~o ~
Address___~7 fr2 --2 ~ 5 ~ /
Date X,/~ ~ ~Z~
(ENGINTJER SEAL)
DHEP Approval
Approved for ~ bedrooms
Approved ~ Disapproved
Terms of Conditional Approval
Telephone
CAUTION
THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEA~TH AND ENVIRONMENTAL PROTECTION
(DHEP) ISSUES HEALTH AUTHORITY A~PPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT-
ATIONS 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 REQUIRE-
MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ~NALYZE DATA BEFORE A
CERTIFICATE IS ISSUED° THE MUNICIPALITY OF ANCH01LiGE IS NOT RESPONSIBLE FOR ERRORS
OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK.
(DUEP
RR4/ej/D18
[Page 2 of 2]
7-19-84
MMNf~f~AI.J~y OF ANCHORAO~
Df. PT, OF HEALTH &
MUNICIPALITY OF ANCHORAGE (MOA) ~-i%IVI~,OI~IMENTAL PROTECTION,
HEALTH AU'mORZTY aPPROVAL (HAd) ,1111 27~1984~. ~
CHECKLIST - FEBRUARY 1984
Legal Description: ~ V [ ~
Wall Classification ~/~/,,~;~i3AII?'~/ If A, B, c~ C, D.E.C. App=oved(Y/N) ~.~
esent
Static Water 1 ~/~ ~ ~t At .~]/~
Casing ~i~ht ~ G~nd ~/~ Sanlt~ ~al on Casing
Elec~i~l wi=lng in ~nduit (Y~) ~/~ ~ession ~ound ~lmead (Y~)~/W
Sep~ation Distance ~ ~11:
To ~Ptic~olding Ta~ ~ ~t ~f~' + ; ~ ~joining Lots ~'
To ~a~st ~-of ~so~tion Field on ~t ~' ~ ; ~ Adjoining ~ts
To ~est ~blic ~= Line ~/~ To ~est ~blic
Clean~t~a~ole ~/W~ ~ ~est ~= ~vi~ Li~ on ~t
Water S~le coile~e~ By ~/~ ; ~te ~/~
Wate~ S~le ~st ~suits ~/~ /
/
C~J~Je~ts
Be
SEPTIC/HOLDING TANK DATA
Date Installed ~-~-72~ Size /COd) OW6 No. of Cu,~a~tm~nts
Standpipes (Y/N) V~ Air-tight Caps (Y/N) ~ Foundation Cleanout (Y/N)
Depression ove~ Tank (Y/N)~) Date Last Pumped ~-/~ ~ ~
Pumping/Maintenance Contract on File (Y/N)~//~; for
Holding Tank High-Water Alarm (Y/N)~47/,~ TeapotsI~; Holding Tank Permit (Y/N)/~;//~
Separation Distances furore Septic/Holding Tank:
TO Water-Supply Well (-~'~ ! ~/~
TO P~operty Line
To Water Main/Service Line
Co,..~se /'6///'$
TO Building Foundation ~-
To Disposal Field /~'
To Stream, Pond, Lake, c~ Major D~ainage
Cc~ents
[Pa~e 1 of 2] 2-15-84
Ce
ABSORPTION FIELD DATA
Soils Rating in Absorption Strata /~c; ~. Type of System Design
Date Installed
Width of Field
Square Feet of Absorption A~ea
Depression over Field (Y/N)
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well ~,.~¢~ To P~operty Line
Length of Field ~{{~ ~
D~pth of Field ~.~'
Gravel Bed Thickness /~ ~
Standpipes P~esent _(Y/N) %/~
To Building Foundation ~ '
Lot ~f~/d /f>~P~£? ; On Adjoining Lots
TO Water Main/Service Line ~,~,~ To Cut~(if
To St~e~ond~ke/~ ~jo~ ~aina~ C~se
To ~iveway, Parking ~ea, ~ Vehicle St~a~ ~ea
To Existing or Abandoned System on
Date Installed
Si~ in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes(Y/N)
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test.
Meets MOA
Confronts
** Check Permitted Bed~oc~ Rating Against HAA Request
I certify that I have checked, verified, Or conformed to all MOA HAA Gui
on the dat ' ' '
KB1/d5/s
'n effect
[Page 2 of 2]
2-15-84
DEPT. OF ENVIRONMENTAL CONSERVATION
SOUTHCENTRAL REGIONAL OFFICE
4'37 "E" STREET, SUITE 200
ANCHORAGE, ALASKA 9950i
BILL SHEFFIELDt GOVERNOR
7'elephone: (907)
Address:
274-2533
PWS I,D.
To Whom It May Concern:
on file in this ,
Water System is in compliance with the State Drinking
Water Regulations. .
Sincerely,