Loading...
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,