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Home My WebLink AboutVALLI VUE ESTATES #1 BLK 1 LT 25Valli Vu states lock I Lot 015-311 Municipality of Anchorage Page DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: Slx~ q ¢ (:~O 6'..~ PID Number: Name:ir~ ~hqr~ Nl~./c Wastewater System: New ~ Upgrade Address: ~7~ po~bl~ T~ (~,~ ~,~ ~1~ ABSORPTION FIELD NO. of Bedrooms: Phone: ~.~ ~ ~ Deep Trench ~Shallowmrench DEed DUound QOther LEGAL DESCRIPTION so, Rating: Total Depth from original grade: J. 0 GPD/Sq. Ft. Lot: __ Block: Subdlv~ion: ~ Depthto pipe boffom from originalgrade: ' Gravel depth beneath pipe Township: iRa,ge: Js~otio.: Fill added above original grade: Gravel ,eng~ ~. ~ Ft. Ft. ~ New g Upgrade Gravelwidth: Number of lines: WELL: Classification (Private. A.B.C): ~Toa Depth Cased To: Total absorption area: Pipe material: Driller: Date Drilled: StaticWaterLevel: Installer: ~ Date installed: Yield:GP~ IPumpset at: FI. I~a~'"g Hoi¢'~°~G~°u"d:Ft. TANK SEPARATION DISTANCES ~Septic ~ Holding D S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity Jn gallons: Fro~ Tank Field Station Tank Sewer Lines Material: Number of Compartments: Well' ~, ~, - . . Surface Water ~'~OO' >~' -- -- - LIFT STATION I Fou"dation I~ ,,- -- -- ~ "Pump Oh"level at: I"Pump °fl" leveler: { High water alarm at: Cu~ain Pump Make & Model I Electrical Inspections performed by: I i Remarks: The ~;n~( ~b~(~ 5eph~ BENCH MARK Location and Description: ENGINEER'S SEAL Inspections performed by: Fla~ 7ecg ~¢ Dates: 1st ~/I¢ ~ ,. w ~ ..~ .¢-- ¢., . :, Reviewed and approved by: Date: ~ -~-~ -~'-t.~ ¢. ,..,..,,.¢ ....... ~ *~-. 72-013 (Rev. 9/9t) MOA 25 PERMIT NO: 950063 PAGE 2 OF 2 PID NO: 01531126 ORIGINAL 1250 GAL. FIBERGLASS SEPTIC TANK LOT 25 BLK. 1 DOUBLE TREE COURT ORIGINAL SOIL ABS. ', TRENCH LEFT IN PLACE~ eH FOR POSS, FUTURE USE I NEW 60' LONG SOIL ABS. TRENCH. WITH 5' GRAVEL BELOW HORIZ. DIST. PIPE ~_T.H. 4 BDRM #1..< HOUSE '~'-' TBM F SWING TIES FROM: COR. "A" COR. "B" TO: S. T. C.O. "C" 21.5' 59' DBL, C.O. "D" 27' 59' TR, M.T, "E" 53' 27,5' TR, C.O, "F" 80' 35.5' C.O. "G" 39.5' 65' M.T. "H" 70' 45.5' PLAN VIEW SCALE: 1" = 30' - 0" GROUND ELEVATION 99.2' SEWER GVL. (5.0 BELOW PIPE BOTTOM OF TRENCH 90.4~ ORIG. 1250 GAL INV J FIBERGLASS 95.6' SEPTIC TANK BOTTOM T.H. #2 M.T. 81.2' ,, ,,'~,~ MAX. WATER LEVEL 82.1' PROFILE VIEW NOT TO SCALE LOT 25, BLK. 1, VALLI VUE EST. SEPTIC SYSTEM UPGRADE AS-BUILT INSPECTION REPORT FLATTOP TECHNICAL SERVICES 14530 ECHO STREET ANCHORAGE, ALASKA 99516 SCALE: AS-SHOWN DRAWN BY TFM MAY, 1995 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PAGE 1 OF PERMIT PERMIT IVtrMBER:SW950063 DESIGN ENGINEER:FLATTOP TECHNICAL SERVICES OWNER NAME:KLABUNDE RICHARD H OWNER ADDRESS:6736 DOUBLE TREE CT ANCHORAGE, ALASKA 99516 DATE ISSUED: 4/27/95 EXPIRATION DATE: 4/27/96 PARCEL ID:01531126 LEGAL DESCRIPTION: VALLI VUE ESTATES #1 BLK 1 LT 25 LOT SIZE: 25715 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CKAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEMUNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS RECEIVED BY: DATE: THEODORE F. MOORE, P.E. PH: (907) 345-1355 G~ & EN~ON~NT~ ENG~EER~G · ENERGY CONSERVA~ON & ~Y~ 14530 ECHO ST. Ap~ 13, 1995 ~CHORAGE, ~KA 99516 M.O.A. DHHS P.O. Box 19-6650 Anchorage, AK 99519 Dear Sirs: The purpose of this letter is to provide the required design narrative in support of our application for a permit to upgrade the wastewater disposal facilities on Lot 25, Block 1, Valli Vue Estates, Unit #1, located at 6736 Double Tree Court. The existing soil absorption trench failed to pass a recent adequacy test. Soils logs, perc test results, a site plan, design drawings and specifications are enclosed for your review. The proposed system will be constructed between test holes #1 and #2. As can be seen from the soil log, the native material between 5' and 10' below ground level is a somewhat silty sand with a measured perc rate of 3 minutes per inch. To accommodate observed variability of the soil strata hi this zone, we have opted to base the design of the soil absorption system on the slightly conservative application rate of 1.0 gpd/square foot per day. Thus, this 4 bedroom residence requires a total absorption area of (4 x 150)/1.0 = 600 square feet· The proposed 60 foot long soil absorption trench with 5' of sewer gravel beneath the horizontal distribution pipe has a total absorption area of 600 square feet. The topography of the lot in the area of the proposed construction is rather level, with a slight slope downwards towards the south and west. The proposed project will have no significant impact on present or future water supply and wastewater disposal systems serving adjacent properties, nor will it have any significant impact on reserved space- surface and subsurface, or on drainage. Please give me a call at 345-1355 if you have any questions on this submittal. Sincerely, Ted Moore, P.E. HOUSE ~ ............ ~ ....... ~EPTIC TANK ~ (IF REQUIRED) EXISTING 1250 GAL ~ ~ SEPTICTANK (TO BE ~ ~ ~ // ABs. ~ % ,,~ / SYST. ~ ~ ',, ~ ~5% EXISTING / ~ ~ ~" 801LABS,~ ~ ~ ~ 1%. / / 0 SOIL ., ~ABS. TRENCH. WlTH/~ SEPTIC SYSTEM _ 5' GRAVEL BELOW HORIZ. DIST. PIPE O'MALLEY ROAD R.O.W. .. ~. . ~., ,, LOT 2~, BLK. 1, VALLI VUE EST. · ~}~: 49t~ CA ~'¢[,[ SEPTIC SYSTEM .~"~'~",,.,,,.,,,,., 4 ~';<.~ SITE PLAN ~ ~ %THEooo~6 r. ~oo~; ~ ~P ~C~ICAL SERVICES 1 INCH = 50 PEET ~'~,%~ CE - 3589 ~ ~} ¢ 14530 ECHO S~T DRAWN BY TFM ~%~.. *. · .** .. ~¢~ ANCHO~GE, ~AS~ 99516 APRIL, 1995 .~%:~.~, · NOTE: THIS IS NOT A SURVEYED P~T. ALL LOCATIONS SHOWN ARE APPROXIMATE. -- ~TING 1250 GAL, SEPTIC TANK (REPLACE, IF NOT SOUND) "A" L~ ~:iL~: i.~· MONITOR TUBE ~'~ '~ CLEANOUT :'~--: c{ '1~ 6°J.A. 1' PLAN VIEW SCALE: 1" = 10' - 0" · MONITOR TUBE (PERF, THRU GRAVEL CLEANOUT DIST PIPE 112" SEWER GRAVEL SECTION "A A" SCALE: 1" = 5T- 0" LOT 25, BLK. 1, VALLI VUE EST #1 SEPTIC SYSTEM UPGRADE PLAN AND CROSS-SECTION FLATTOP TECHNICAL SERVICES 14530 ECHO STREET ANCHORAGE, A~K, 99516 SCALE: AS SHOWN DRAWN BY: TFM APRIL, 1995 Flattop Techn~al Serv~es 14530 Echo Street, Anchorage, AK99516 Phone (907) 345-1355 Lot 25, Block 1, Valli Vue Estates, Unit #1 6736 Double Tree Court Wastewater disposal system installation Specifications 1.0 General: i.i The scope of the project consists of abandonment of an existing soil absorption trench and construction of a new 60 foot long soil absorption trench with a total of 5.5 feet of sewer gravel. .1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor deviations from these drawings may be allowed or required by the engineer conducting the inspections. All construction procedures and material specifications shall conform with Municipal and State requirements. AH separation distances shall be in conformance with Municipal requirements, unless specifically waived. 1.3 The contractor shall be responsible to obtain any necessary utility locates, and to work around any buried utilities. 1.4 The contractor shall provide adequate cover material and rough grading over all system components to ensure that proper drainage is achieved after settlement and that there are no residual depressions. Insofar as possible the contractor shall minimize damage to trees and existing lawn areas. 1.5 Unless specifically agreed otherwise, the homeowner shall be responsible for finish grading after the soil is compacted, as well as placement of topsoil and reseeding all areas disturbed by the construction. 2.0 Septic Tank: 2.1 The existing septic tank may be retained in service, only if it's structural integrity has been verified by the inspecting engineer, and if it has functional cleanout pipes with airtight caps, allowing pumping access to each compartment. Any existing septic tank or seepage pit which is not retained in service must be properly abandoned by thoroughly pumping, removing the top and backfilling with soil. 2.2 ffthe existing tank is found to be no longer sound, a new 1250 gallon septic tank shall be installed. The new tank shall be Municipally approved and shall be set level on undisturbed soil. Each compartment shall be equipped with a watertight manhole cover and a 4" cleanout. If the tank is buried less than 4 feet, it shall be insulated with 2 inches of approved burial type, rigid insulation. 2.3 All pipe connections to the tank shall be equipped with waterproof mechanical couplings. The waste line from the residence to the septic tank shall have a minimum slope of 1/4'" per foot, and the waste line between the tank and the soil absorption system shall have a minimum slope of 1/8" per foot. A cleanout shall be installed within 5 feet of the building foundation, and a double cleanout shall be installed within 5 feet downstream of the septic tank. 3.0 Soil absorption system: 3.1 The soll absorption system shall be constructed by excavating a trench to a depth of approximately 10.5 feet bel6w the present ground surface in the area shown on the site plan. 3.2 The bottom of the excavation shall be level. Any compacted or smeared surfaces shall be raked to allow proper infiltration. 3.3 A total of 5.5 feet of approved sewer gravel shall be placed in the bottom of the excavation with the perforated distribution pipes laid level such that the pipe inverts are no less than 5.0 feet above the bottom of the sewer gravel. Sewer gravel shall be 0.5" - 2.5" screened gravel, with less than 3% passing the #200 sieve. 3.4 Monitor tubes and cleanout pipes shall be of 4" diameter and installed in the locations shown on the design drawings. The portion of the monitor tube extending through the sewer gravel shall be perforated. 3.5 Approved f'flter fabric shall be placed over the entire top surface of the sewer gravel. 3.6 The top surface of the cover material shall be raised a minimum of 12 inches higher than the surrounding terrain to allow for subsequent settlement, and shall be graded to smooth contours. Fill slopes shall be no steeper than 3:1. 3.7 Unless specifically agreed otherwise the homeowner shall be responsible for arranging to have the site finish graded after the backfill material has stabilized, and for placement of adequate topsoil and seed to promote rapid revegetation of all areas disturbed by the construction. 4.0 Inspections: 4.1 A total of 4 engineering inspections will be required during the course of the project: (1) initial stakeout with the contractor to establish the location of the system and to discuss the plans, specifications and construction procedures, (2) after the native material has been excavated to expose the infiltrative surface to ensure that it is level and at the right elevation, and conforms with the soil test information, (3) after the sewer gravel is in place and the distribution pipes have been laid and connected up to the septic .. tank, but prior to placement of insulation or filter fabric, and (4) after rough backfill and grading is complete. The septic tank requires one inspection after it is set level and the piping connected, but prior to backfill. This inspection may be incorporated with any of the above inspections. 4.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently far in advance to ensure the availability of the engineer. ITEST HOLE LEGAL DESCRIPTION: DATE PERFORMED: PERFORMED FOR: FLA'I-FOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 SOILS LOG -- PERCOLATION TEST LOT 25, BLOCK 1, VALLI VUE ESTATES, UNIT #1 APRIL 6, 1995 RICHARD KLABUNDE (feet) 1- 17- Pt. GP Coarse loose rounded gravel SP/SM Somewhat silty sand Variable consistency Lenses of GP, GM, & SP GP Coarse, loose rounded gravel Similar to shallower stratum SP/SM Somewhat silty sand Similar to above SM Gravelly silty sand Becoming denser with d~pth Scattered lenses of SP SLOPE Depth to Groundwater Date No groundwater 4/6/95 Pt,F7 Or~ SITE PI. AN Clock Net Time Percometer Net Drop Date Reading Time (minutes) Reading (inches) 4/6 12" Presoak 27 1/2 Add water & start 10:54:30 23 3/8 #1 10:59:30 5 20 7/8 2 1/2 Add water 11:00 23 1/2 4/2 11:05 5 21 2 1/2 Add water 11:05:30 23 1/2 #3 11:10:30 5 21 2 1/2 Add water 11:11 23 1/2 #4 11:16 5 21 1/16 2 7/16 PERCOLATION RATE 3 (minutes/inch) PERC HOLE DIAMETER ?,, TEST RUN BETWEEN 8.75 FTAND 9.25 FT Strata surfaces and composition vary significantly within short distances. Perc test hole located 5' South of T.H, #1 M.T. showed COMMENTS: that cleaner strata dip significantly deeper in softs south of test hole. PERFORMED BY FLA'I-rOP TECHNICAL SERVICES. , '~...~.~ ~ ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATEi CERTIFY THAT THIS TEST WAS PERFORMED IN ITESTHOLE# 2 LEGAL DESCRIPTION: DATE PERFORMED; FLA'I-rOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 SOILS LOG -- PERCOLATION TEST LOT 25, BLOCK l, VALLI VUE ESTATES, UNliT #1 APRIL 6, 1995 PERFORMED FOR: RICHARD KLABUNDE (feet) 1- 2- Pt SM Reddish silty sandy loam SP/SM Gravellysomewhatsiltysand Damp, non-cohesiva Scattered lansesofML Lenses offine sand SLOPE Depth to Groundwater Date 17.5' 4/6/95 Iv, f' ,//ts/5~T SITE PLAN 18 19- 20- COMMENTS: Clock Net Time Percometer Net Drop Date Reading 'rime (minutes) Reading (inches) 4/6 12" Presoak 27 1/2 Add water & Start 11:55:30 23 1/2 gl 12:00:30 5 21 9/16 I 15/16 Add water 12:01 23 7/16 #2 12:06 5 21 1/2 1 15/16 Acid water 12:06:30 23 1/2 #3 12:11:30 5 21 9/16 1 15/16 ML Dense silt PERCOLATION RATE 3 (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN 6.5 FT AND 7,0 FT SP/SP material slightly cleaner than that encountered in T.H.#1, generally. PERFORMED BY FLATTOP TECHNICAL SERVICES. I ~;'-~ ~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ~ //.~ / ~',~ ' , MUNICIPALITY OF ANCHORAGE ) DEPAR'~MENT OF HEALTH & ENVIRONMENTAL PRoTEcTION ENVIRONMENTAL ENGINEERING DIVISION · 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT CZ' EW NAME ~ PHONE MAILING ADDRESS Material No, o~mpartmonts ~ Liq. capacity in gallons I Wi /,~ ~0 IF HOME.DE: In~ ~ / , ~ PERMIT NO. ~C~ TO: Well Dwellin~ = I ~ O Z < Manufactur~~ ~ ~~ ~d ~y~ns ~ ~ DISTANCE TO: ~ Om'*tU{i'l; ,¢[ Foundation Nearest lot line PERMIT NO, ~ Distance bet een lines Total length Trench width inches lotal effective abso[ ti~n area ~ NO' Of 'in'¢'~ Length °' eac~i~ . ~,r,~ Top of tile to finish grade Material beneath tile ~ DISTANCE~TO: Well Bu~~ Nearest lot line ~ Ci~sJ ' ~ Depth Driller OTHER REMARKS V 72-01; (Rev. 3/78) PERMIT NO. ~PPLICANT ~OCATION LEGAL DE~RRTMENT 0~' HERLTH RND ENVIRONMENTRL F'ROTEL. TION _ ~ ~/~]~ 825 "L" STREET., 'RNCHORRGE, BK. 99501 ~'~ ,' 8L~-. 6,' ) ~LH:,K~ P~C:]FJC _.ON~T SR~ BOX 1~1 _~,_0~ OFF DOUBLE TREE L 25 B i V~LL] VUE 5/D LOT 51ZE 25eec SQUARE :EET TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RBTtNG (SQ FT?BR)= 100 THE REQUIRED SIZE OF THE SOIL RBSORPTIOW SYSTEM tS: [:'EF']'H= itO L E I'-.I,]-i T H = 4"1 G F-: FI"-..' E L [:,EPTHI:= 5 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF 'THE TRENCH OR DRAINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BETWEEN THE SURFRCE OF THE GROUND AND THE BOTTOM OF THE EXCAVRTION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFRLL PIPE AND THE BOTTOM OF THE EXCRVRTION (IN FEET). I~-" E~]'~. i_l I REC-, SEPT I C 'l-I-]l'-.IK S I ZE= 1258 PERMIT BPPLICANT FIRS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJRCENT TO THIS PROPERTY RND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. T ~-..!~.]~ ( 2 ) INSPECT I I]ll'-,! S RF..'E REQL~ I BACKFILLING OF ANY SYSTEM WITHOUT FINRL INSPECTION RIND RPPROVRL BY THIS DEPRRTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTRNCE BETWEEN R WELL RND ANY ON-SITE SEWAGE DISPOSRL SYSTEM IS 100 FEET FOR A PRIVBTE WELB OR 150 TO 200 FEE'[ FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. OTHER REQUIREMENTS MRY RPPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVBILABLE TO INSURE PROPER INSTRLLBTION. PER:t-1 I T E~--',F' I RES [:.,EL]-E~-18ER __::i... I CERTIFY THRT l: I AM FAMILIBR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN RCCORDBNCE WITH THE CODES. ~: I UNDERSTBND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. ~NT R~PRCIFIC CONST ? oo : 0 0 I 2 ~: 4 ALL ELEVATIONS TAKEN FROM SURVEY OF THE PROPERTY. AREA OF LOT ~,:5-, 71~~, SQ.FT. TOP FOLJNDATION WALL ELEVATION pl~L_u D?~TI PREPARED FOR.' L~,~F~Y do~d~od-A,~, p~.c:pic cod ~ ~ I Il is the responsibilily of the owner or builder~ prior to construction, to verify proposed building grade ~,slallvs to finished grade and utility connlcl* ions nnd to delermine the exiltence of ions which do hal appear on thl rl¢Ord- ed subdivision plot. DES. BY: 0 Ep CHK. BY: v,/,~ ~ SHT. NO. I c~ I WAKON REDBIRD 8~ ASSOCIATES CONSULTING ENGINEERS 600 WEST 53RD. Anchorage, Alaska. 99502 Municipality of AnchoraGe Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 EImore Road P.O: Box 196650 Anchorage, AK 99519-6650 'VCv'¢W. m LI FII.O~ ~10~ ~S~t~ (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEHS FOR APPROVAL A SINGLE FAMILY DWELLING Parcel I.D. 015-311-26 1. GENERAL INFORMATION Expiration Date: '~' ~ ~ ~'/'~....- Complete legal description VALLI VUE ESTATES S//D #1; BLOCK 1, LOT~5 Location (site address) 6736 DOUBLE TREE COURT * ANCHORAGE, AK * 99507 Current Property owner(s) Mailing address COLLEEN CAREY Day phone 346-3502 6736 DOUBLE TREE COURT * ANCHORAGE~ AK * 99507 Lending agency Day phone Mailing address Real Estate Agent Mailing .address Unless otherwise requested, COSA will be held by DSD for pickup. ~NUMBER OF BEDROOMS: 4 CLAIR RAMSEY W/ DYNAMIC PROPERTIES Day phone 3111 C STREET * ANCHORAGE, AK * 99503 261-7554 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well [] Individual On-site · Individual Water Storage [] Individual Holding tank [] Community Class A Well · Community On-site [] Public Water System [] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. STATE,~ENT OF !NSPECT~ON BY ENG!NEER As ~ertified by my seal affixed herefo and as of the validation date shown below, t verify that my investigation, based on,~rocedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, ~,as,~,a,er d, spo~a, s~v.~m ,s ..... s,,~,v,o ~h~t the on-site water sugDIv and/or ~' ,~ ~, , ~ o t ,o*,~ . ~ (are) ~¢.,,'e, f,.,ncfi~n~f and ~d~.q,c. te for the number of bedrooms and type of structure indicated herein. I furt,ber verify that based on the infon~ation obtained from the Municipsfity of Anchorage files and from my investigation and inspection, t,ffe 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 GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 5701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 /t Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date '~/~-'Z., f .. Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, cons c ien tio us en gin eerin g ana l ys is o f th e s ys tem in a ccor dan ce w i th A D E O and M O A ~='~ . DSD Guidelines&Regulations. The reported results described 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 H_ . septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. ~. / i TheseconditionsareoutsidethecontroloftheevaluatoroftbesystemoSatisfact°rytest results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide vOh~.' ".~/ /C~-7.°/53 any warranty or future estimate of how long the system will continue to meet the (}~,~'~'e/. °~/° ' ~"'fv operational requirements of the ADEC or MOA DSD. The content of this report is for ~e~ Pr the sole benefit of the owner listed above. Any reliance upon or use Of this report by any '~'%%.,~,'~:~"-~'~ &therpersonorpartYisnotauthorized, norwillitconferanylega'l'rightwhats°ever'. SIGNATURE ~. ON-SITE . DSD ~-/'~'/ Approved for__J-~L~ bedrooms. Disapproved. % PROGRAM .' "' :.: %%... ..... Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory (Rev, 11/05) · ,¢~ Arsenic ,~.dv.so y Maintenance Agreements Supplemental Engineer's Report Other /)/~¢,~~ Original Certificate Date: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 EImore Road P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: VALLI VUE ESTATES S/D #1; BLOCK 1, LOT 25 Parcel ID: 015-311-26 A. WELL DATA Well type COMMUNITY Date completed Total depth __.ft. Date of test Static water level Well production If A, B, or C provide PWSID# 210605 Well Log (Y/N) Sanitary seal (Y/N) Wires properly protecte~.~J Cased to ft. Casing he__round) in. FROM WELL LOG AT I..blSPECTION ~~.p.m. g.p.m. Arsenic: __ ug./L. Date of sample: Nitrate mg./L Collected by: B= SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/FIBERGLASS Tank size 1250 gal. Number of Compartments 2 Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO Date of pumpin! ~ ,:~ Pumper Date installed Cleanouts (Y/N) High water alarm (Y/N) ONE STOP SERVICES 1978 YES N/A ABSORPTION FIELD DATA Date installed 5/18-19/1995 Length 60 ft. Total depth *7.8 ft. Eft. absorption area 600 ft2 Monitoring tube YES Date of adequacy test 7/8/2011 Results (Pass/Fail) PASS Fluid depth in absorption field before test 0 in. Water added 1400gal. Elapsed Time: - min. Final fluid depth 0 in. Any rejuvenation treatment (past 12 mo.) (Y/N & type)- I'BELOW EXISTING GRADEI Soil rating ~r ft2/bdrm) 1.0 Width 2.5 .ft. System type TRENCH Gravel below pipe 5 ,ft. Depression over field NO For 4 bedrooms New depth 0 in. Absorption rate >= 600+ g.p.d. NONE KNOWN If yes, give date - D. LIFT STATION "~ ' Date installed "Pump on" level at Size in gallons Manhole/Access (Y_.¥.~_) ~ in. "Pump off" leveLa~. High water alarm level at in. Datum ~ Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Meets alarm & circuit requirements? On adjacent lots ICOMMUNITY WELLI Absorption field on lot On adjacent lots ~ Public sewer main ~..~r manhole/cleanout Sewer/septic service lingo ..~-~'~ Holding tank ~nt areas. Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Water main 10'+ Water service line 10'+ Wells on adjacent lots 200'+ Absorption field 5'+ Surface water. 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation. 10'+ Water service line 10'+ Surface water 100'+ Curtain drain NONE KNOWN Wells on adjacent lots 200'+ Water main 10'+ Driveway, parking/vehicle storage 10'+ F. COMMENTS 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. Engineer's Printed Name JEFFREY A. GARNESS Date "~/~."Z..//J COSA Fee $ Date of PaYment Receipt Number (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number o ,~SEM£NT ( SEE NOTE} g 00~09 I,, AA ,,00 ,~'0 O0 N MUNICIPALITY OF ANCHORAGE : DEPARTMENT OF HEALTH & HUMAN SERVICES. Division of Environmental Services On-Site Services Section P.O. BOx 196650 Anchorage,Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # ~? 5'~t'/ ~-~ 1. GENERAL INFORMATION Complete legal description ,~,o HAA# ~{;;~c~ ~ t~A c~ ~-~ Location (site address or directions) Property owner /~ ).c/~ ~-~ ~ I~( ~ ~/~ ~'¢ Day phone Mailing address ~7 3~ D~/¢ ~¢~ delft, ~c~o~. Lending agency F~ ~~ - ~P: E~ Day phone Mailing address ~OO~ '~" ~¢~, ~,~ ~o~ Agent ~nn ~rn~ ~ R~[~ Day phone Address . 7~O0' ~,n~ ~.~' ~c~o~ ~ Unless othe~ise requested, H~ will be held for pickup.~ . 2. NUMBER OF BEDROOMS: ' -' ~ '-3:"'- :'~'PE OF ~N~;i-ER SU'~'I~¢L¥.~'-?~ - Individual well .... : Community well ~-- I"r'l ~o ....... Public water ' <~ ~ NOTE: ff community well system, provide written confirmation from Stat~ ADEC attest- e lng to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank ' * ~ ' :- 'Commun'i~.O~-~ite Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. - ..... -' :" ~ 72~25 tReY, Il91) FrOnl MOA~21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verity that my investigation of this Health Authority Approval application 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 Address / ~/5-~(~ Engineer's signature ~"-~-~ Phone :~ Y J-- Date DHHS SIGNATURE ,X Approved for ¢ Disapproved. Conditional approval for ~.=~,'. CE- 3589 bedrooms. bedrooms, with the following stipulations: ': Additional Comments Date .,.The., ~u-~ cipa, ty of.'/~f~ct~orage,..~., Department of Health and Human Services (DHHS) issues Health Authority · 'Appr°val, -. Certifica~,..¢~,, based,, . only. upon the representat ons g yen n paragraph 5 above by an ndependent profe~onjal'engmeer rsg~stersd m the State of A aska The DHHS does this as a courtesyto purchasers of homes and theft lend~ng restitutions m order to satisfy certain federal and state requirements. Employees of DHH$ 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. - , 72-025(P~w. 1/91) Back MOA#21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lc, f'&~ ~11~ ~., ~/,~lli ~/~ E.~. Parcel I.D. 015311 ~[ A. Well Data Well type "/t" Log present (Y/N) Total depth Sanitary seal (Y/N) If A, B, or C, attach ADEC letter. ADEC water system number. Date completed Driller Cased to Casing height Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION Date of test Static water level Well flow Pump level1 SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line .g.p.m. ; On adjacent lots ~ ,~,~-~° o ; On adjacent lots z Public sewer manho e/c eanout Petroleum tank WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate Other bacteria Collected by: B. SEPTIC/HOLDING TANK DATA Date installed IO Cleanouts (Y/N) ¥ High water alarm (Y/N) N. Date of pumping .5-/I~/?.5' Tank size ! ~3'0 v~/ Compartments Foundation cleanout (Y/N) Y' Depression (Y/N) N Alarm tested (Y/N) - Pumper Z)~'~',~/,' ~'~"~-'~J" SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot '~ To property line ~ 5' ' Sudace water/drainage On adjacent lots Absorption field I$' 72-026 (3/93)° Frcnt Foundation 13' ' Water main/service line ~. ~-$ ' CONTINUED ON BACK PAGE C. LIFT STATION N.A., Date installed Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots D. ABSORPTION FIELD DATA Date installed ~/ t) /)5" Length ~O' Width Total absorption area d'OO ~' Date Of adequacy test N, A. ( n ~ ~) Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) N SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot tV,/~, To building foundation On adjacent lots ~> Sudace water ~> Curtain drain tVo,, ~ E. ENGINEER'S CERTIFICATION Manufacturer Manhole/Access (Y/N) "Pump off" Level at .Cycles tested Soil rating (GPD/FF) I. o Gravel thickness Cleanout present (Y/N) Y Results (pass, fail) P Sudace water .System type '"Fr~ , 5'. ¢' Total depth ~'. g ' Depression over field (Y/N) for '¢ Bedrooms After test If yes, give date On adjacent lots ~ ?..4,o' Property line To existing or abandoned system on lot Cutbank h/. ,,1 Water main/sen/ice line Driveway, parking/vehicle storage area '7~ ' I ce~'fy that I have checked, verified, or conformed to all MOA and HAA guidelines in of this inspection. Signature .~-~ Engineer's Name 7--)~ ~o~/c,~'d F. /"'/¢,'o ,""~ Date HAA Fee $ Date of Payment Receipt Number 72-026 (3~93)* Back Waiver Fee $ Date of Payment Receipt Number DATE ~ DAT~ .i~ [~/ JJ DATE DEPARTM OF HEALTH & ONMENTAL PROTECTION ENVIRONMENTAL SANITATION DIVlSIO~'V Telephone 264-4720 0,E0 4: 't980. REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES MAILING ADDRESS PROPERTY RESIDENT {If different from above) PHONE MAI LING AD DR ESS , 4. R~ LTO R/A~ P"O~ 6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS [] One [~ Four [] Other__ ~ SINGLE FAMILY [] Two [] Five [~] MULTIPLE FAMILY [] Three [] Six ! 7. WATER SUPPLY [] INDIVIDUAL* COMMUNITY [] PUBLIC UTILITY 8. SEWAGE DISPOSAL SYSTEM [~ INDIVI DUAL/ON-SITE~ [] PUBLIC UTI LITY * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975, For wells drilled prior to that date, give well depth (attach log if available.) .~EAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY I. TYPE OF RESIDENCE NUMBER OF BEDROOMS [~ SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO ,[~/F0u R E3 SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY (Z~/PUBLiC DATE DRILLED UTILITY Connection Verified LOG RECEIVED 3. SEWA'GE DISPOSAL SYSTEM PERMIT NUMBER E~-D~LVI DUAL/ON -SITE DATE INSTALLED [~P"~ B LI C UTILITY Connection Verified ~ INSTALLER I~)~el)tic Tank or [] Holding Tank Size: / ~._¢~'1;~ If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCESwELL TO: Septic/Holding Tank AbsorptiOn Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS [] CONDITIONAL APPROVAL {letter must accompany certificate) [] DISAPPROVED ~ATE BY 72-010 (Rev. 6/79) DEPT. OF H2ALTH & MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL PROTECTION DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street - Anchorage. Alaska 99501 JUL~ 1 3 1979 ENVIRONMENTAL ENGINEERING DIVISION Ta,apho.a 264-.720 .... RECEIVED REQUEST FOR AppROvAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1, Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER j PHONE MAILING ADDRESS PROPERTY RESIDENT (if different from above) 2, t1~ MAILING ADDRESS PHONE PHONE 3. LENDING~..~. ~'~ C..INSTIT TIO, N MAILING ADDRESS 4. REALTOR/AGENT PHONE MAILING ADDRESS B. LEGAL DESCRIPTION 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] One [~ Four [] ~ SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY [] Three [] Six Other 7. WATER SUPPLY [] INDIVI DUAL* * ATTACH WELL LOG. A well Icg is required for all wells drilled [~ COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTI LITY depth (attach Icg if available.) 8. SEWAGE DISPOSAL SYSTEM [~ INDIVIDUAL/ON-SITE** **If individual/on-site, give installation date./O -/- ~.. If system is over two (2) years old an adequacy test is required [] PUBLIC UTI LITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY (" Connection Verified L~Septic Tank or []HoldingTank Size: i~--~ If Tank is homemade SOILS RATING MANU TOTAL ABSORPTION AREA MATERIAL ~.~ I WELL TO: 5, COMMENTS ~'APPROVED FOR Z~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED 72-010 (Rev. 3/78)