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HomeMy WebLinkAboutVALLI VUE ESTATES #1 BLK 3 LT 1Valli Vue Estates #1 Block 3 Lot 1 #015-322-09 Municipality of Anchorage Community Development Department Page 1 of3 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 WATER AND WASTEWATER INSPECTION REPORT Permit Number: 0SP101046 PID Number: 015-322-09 Name: David Sullivan WASTEWATER SYSTEM New _117111-7 ABSORPTION FIELD n Deeo Trench n Shallow Trench n Bed n Address 10600 Main Tree Drive, Anchorage, AK, 99507 Mound ® Other IDSF 'Per S&S design. Phone Number of Bedrooms 907-346-2313 Soil Rating Total depth from original grade 4 *2.O GPD/SF *5.0 (Per Design) Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe See dwg. Ft. *0.25 Ft. Subdivision Block Lot Valli Vue Estates #1 3 1 Fill added above original grade Gravel length Township Range Section See dwg. Ft. *20 Ft. Gravel width Beds: Number of Lines iDistance between lines *18 WELL (from logs/tests) ❑ New ❑ upgrad Classification (Private, A, B, C) Total Depth Cas Class "A" Ft Ft. Ft. 7 2+ Ft. Total absorption area Number of trenches Dist. between trenches 300 Ft N/A N/A Ft. Driller Date Drilled Static water Level Ft. TANK ®septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity Premier Plastics 1 1300 Gal. Yield GPM Pumps Ft. Casing height above ground Ft. Material Number of compartments H.D.P.E. 2 Water quality tes' Coliform Col/100mL rsenic ug/L Nitrates mg/L LIFT STATION Manufacturer Capacity Premier Plastics550 Gal. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer From Tank Field Tank Line Pump on level at Pump off level at High water alarm at Timer in. Timer in. 36 in. well 200'+ 200'+ 200'+ - Surface Water 100'+ 1001+ 1001+ - Pump make and IT Electrical Inspections performed by Unknown M.O.A. Lot Line 5'+ 101+ 101+ - NA Foundation 5'+ 101+ 101+ - PIPE MATERIAL D3034 (Assumed) Curtain Drain N/A N/A N/A N/A BENCH MARK Assumed elevation 100.00 Remarks: Location and description This is a limited above ( ground) documentation of Top of garage slab, center of garage door. septic system installation inspected by S&S *Per S&S Design Engineering (Bob Shafer, P.E. who is now deceased). Installer Tweed Excavating Inspection 1s' Unknown dates: En Inspector S & S Engineering/ GEG, Ltd. 2°" 7/23/11 (GEG) c Q F . ,• q *' H COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Conditional Approval: Date '~"'""" "" ` "~~• •"''~• ~~ O: J r c ess: 753 Approved Date/ °?oFEssioN*� 1\Geel\eegfilec\ANCHn C.F\ A 111r FQTAT.Q ­11 nnv ,n nT n.___ _ ., ___.____. ___....r ................ ......L,L,..UN j� w1 Alaspccuun Report PERMIT NUMBER: AS—BUILT DRAWING PARCEL ID NUMBER: OSP101046 015-322-09 APPROXIMATE LOCATION C WATER SERVICE KEYBOX (LOCATED BY GEG, LTD) \ \ NEW 550 GALLON 'o. \ \ FAT ALBERT �\ \LIFT STATION (LS) PER OWNER, A<"yT\ PORTIONOF OLD DRAINFIELD WITHIN 5' OF NEW IDSF WAS ABANDONED. REMAINING PORTION OF TRENCH USED AS ALTERNATE SITE. NEW 18'x20' FLUSHING VALVES F -A 7--R-7 MT1 33.94 29.34 ST1 33.64 32.18 ST2 35.45 33.49 DBL1 36.68 34.90 DBL2 37.27 35.42 DV 31.81 42.62 LS 24.14 43.47 MT2 25.61 52.79 MT3 49.25 98.48 -NEW 1300 GALLON H.P.D.E. SEPTIC TANK PANEL AND AIR COMPRESSOR. 2.2 PSI N AIR COMPRESSOR GAUGE LOCATION AND CONSTRUCTION OF AIR LINE BETWEEN HOUSE AND THE IST IS UNKNOWN. 2 � p�L NTERIOR ALARM "OF GARNESS ENGINEERING GRQUP, Ltd. p; � 4 •�...�,�, t_��� _.:,m�� CpNSULTANTS & GENERAL CONTRACTORS- 3X1 flNTRkCT'ORSVALLI -3ri11 E TUDOR ROAD. SURE 101 • ANCNORAOE, A1C 99507 • PlbNE (8(I7)337-61]9 • FM (90)1399-32{8 • WEBSITE w .9a xn9�xeein99� PREPARED FOR: PHONE NUMBER: PAGE NUMBER: DAVID SULLIVAN 907-346-2313 2 OF 3 � '', P LEGAL DESCRIPTION: DRAWN BY: TYPE OF WORK: UE ESTATES S/D #1; BLOCK 3, LOT 1 A.J.G. DATE. O�444C AS BUILT DRAWING OF NEW SEPTIC SYSTEM 8/15/2011 ' �Zx ;ar ess. 5 b�.lt' PERMIT NUMBER: AS -BUILT DRAWING PARCEL ID NUMBER: — OSP101046 015-322-09 MIZIR41 TOP OF TANK AT INLET = 97.38 (CALCULATED) \2" INSULATION FM�T (PER DESIGN)? I I 7 TOP OF TANK AT FINAL GRADE = 99.56 OUTLET = 97.28 (CALCULATED) 7Top F RISER = 100.34 MT NEW 1300 GALLON "PREMIER PLASTICS" SEPTIC TANK TTOM OF TANK AT - BOTTOM OF TANK INLET = 92.05 OUTLET = 91.9! (SHOT BY GEG) (SHOT BY GEG) ":::A\t MVnijCiYi•11v1t1 R TOP OF SAND—/,•a'' ".�� y,� = 95.76 BOTTOM OF SYSTEM—/ = 93.76 (CALCULATED) BASED UPON DESIGN REQUIRING 2' OF ISF SAND TUBE OUTLET FINAL GRADE 99.45-99.55 ON (PER DESIGN) FILTER FABRIC (PER DESIGN) LINE (PER DESIGN) VAULT ESIGN' GRAVEL (PER DESIGN) TO IDRAIN FROM LIFT STATION GARNESS ENGINEERING GROUP, Ltd. _. CONSULTANTS& GENERAL CONTRACTORS - - ••••••• ••••••••• ....�• 3901 L 30008 sw9, suite 10, • MCWWE• M 99301 • PHONE (90))331-6179 • FM (907)3]8-3216 • Wf891fE: ww.Wmr,eM^arin9.com PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ••••••...rss: DAVID SULLIVAN 907-346-2313 3 OF 3 Q e r y ,arn LEGAL DESCRIPTION: DRAWN BY: Q. CE-795�j v�� VALLI VUE ESTATES S/D #1; BLOCK 3, LOT 1 A.J.G. 0i4ra^ '•8�2!�.� oAo�a Pdo TYPE OF WORK: DATE: �4OOo��opro fes sl000\�o PROFILE AS BUILT OF NEW SEPTIC SYSTEM 8/15/2011 [K9V. U1,M1 49 TH SHANE HOLT,. �a°'i LS -6914. . ' a` O� ph.aa.A60 USE NOT TO BE USED FOR POSITICI IIN6 Al EASEMENTS OF RECORD, OTHER THAN HEREON (UNLESSINDICATED) NOTE: FENCELINES THAT MAY APPEAR PROPERTY LINES OR POSITION ADDITI ANY PAYING SHOWN HEREON MAY BE I A"UILT SURVEY V = 30' NO CORNERS SET THIS DATE I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY LOT 1, BLOCK 3, VALLI VUE NO. 1 FICALLYTOSHOWANY ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE EASEMENTS: AND IS VISIBLE IMPROVEMENTS SITUATED THEREON ARE NITHIN . OR FENCEMES' THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS ARENOTSHIOWN MST OTHER THAN NOTED. TO DETERMNE DATED AT ANOXWE,ALASKA THIS _13TH_ DAY OF _TUNE ,3011. HOLTLANDSURVEYINS NDIORICE. 60D HTSHVIEW DRIVE 11599, FB 14631 ANCHORAGE.AK 99515 3466513 On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP101046 Tax Code Number: 01532209000 Work Type: Septic Upgrade Permit Effective Dates: June 10, 2010 to June 10, 2011 Design Engineer: S & S ENGINEERING Subdivision: VALLI VUE ESTATES #1 Site Legal Address: VALLI VUE ESTATES #1 BLK 3 LT 1 G:2538 Owner/Address: SULLIVAN NEAL & NANCY LIVING TRUST SULLIVAN N & N/TRUSTEES PO BOX 110097 ANCHORAGE AK 995110097 Site Mailing Address: 10600 MAIN TREE DR, Anchorage This permit Is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank Lot Size in Sq Ft: 21024 Total Bedrooms: 4 N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either. A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Special Provisions: The Engineer needs to do an additional test hole prior to the construction of the septic field. Construction may proceed at your own risk before the 7 day water monitoring is complete. Please submit stamped and signed results with the As -built Inspection Report. If the results require a design change, construction of the system will stop pending On -Site review and approval. Received Issued By M1116- lll.illy tit' Aile lrui'flge bodoolowit bavl�bs bepatllfleN t bulldind Salely blvlslotl Ou* On-SlleWaletaitdWastehalerPrograrn 470o South btaga* SI. PA. box 19005o Anchotage, AIC 99sig-mso WwW.cl.ancbotagb.A.us (907) M-790,1 ON-SITL SI=WEh/WLLL Pr-RMlr APPLICA'1 ION colt A SINoLL VAMILY bWELLING 05Pl01oy6 Parcel I.U. 67/t5� 32 Z C) q 000 / C' ' Pennil Number SW ` 3q6 -Z3 /3 Properly ownersLyaAe:4 Se(111u ( h bay phone�� Mailing address (i) �D6 �%tO �7C!/SJ T2(�D2 , An/c /f �J e, Sl Mailing address (2) /✓nnt7 • b 09 //005% 7 AC Zip Code O'1 j-/ / Legal description (Lot, block & Sub'd.) La/Z 91k 3 Uq Vue. Es T #� Legal description (Section, 7oWhSliip & hange) Lot Size Acres/Sq.rl. tills APPLIcAtIbN Is rbh: Sewer Only Sewer and Well Sewer Upgrade VIS MOPIEHOY CONTAINS: I lot tub SWirnndng Pool therapy Pool I cb111fy (hal the above Intortn: b1ligle rimily bmlllnd and Is Number of bedrooms 4 (� Well Only IJ Water Storage ❑ [� Jacuzzi p Water Soflening Unit CI bottect. luither cetlily on lhal this applicatiIs being Inade for a tdance 1111 applicable Municipal Codes. (Slgnaluto of Propetly owh& ot(a oriz&rr1dnnl) Petmll trees: Walvbt rbes: bale of Paytnenl: -/ ✓-) bale bl Payinenl: hecelpl Numbet: 0 p hecblpl NUTAO: (Rev. 121Co) June 9, 2010 HEALTH AUTHORITY APPROVALS MUNICIPALITY OF ANCHORAGE Robert A. Shafer, P.E. CIVIL ENGINEERING PH: 907-694-2979 FAX: 907-694-1211 SOIL TEST /Ir'btrert W Shafer, P.E. v PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSAL SYSTEM DESIGN 15861 S. Birchwood Loop Road, Chugirk, Alaska 99567 On-site Water and Wastewater Program P.O. Box 196650 Anchorage, AK 99519 SEWER & WATER MAIN EXTENSIONS Attn: Deb SEWER &WATER INSPECTION , , REFERENCE: Lot 1• Block 3• Valli Vue Estates This letter is a supplement to our letter May 28, 2010, based upon our conversation June 9, 2010. ENGINEERING STUDIES ANDREPORTS It is anticipated that a portion of the IDSF may be placed over a portion of the old absorption trench. Based upon the municipal documents reflecting inspections when the original absorption trench was installed, we would anticipate 5 feet of cover over the old trench. Therefore, if the old trench is encountered during the construction of WELL INSPECTION a FLOW TEST the IDSF, any impermeable material, such as visqueen, will be removed so that the old trench can receive approximately 10% of the filtered effluent from the IDSF. We do not anticipate this to be of any concern and believe it may even help the old trench to rejuvenate over a period of time. SITE PLANS If you require additional information, please contact us. Sincer , ROAD DESIGN SOIL TEST /Ir'btrert W Shafer, P.E. v PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSAL SYSTEM DESIGN 15861 S. Birchwood Loop Road, Chugirk, Alaska 99567 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER 8 WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSAL SYSTEM DESIGN Robert A. Shafer, P.E. CIVIL ENGINEERING PH: 907-694-2979 FAX: 907.694-1211 May 28, 2010 MUNICIPALITY OF ANCHORAGE Development Services Department P.O. Box 196650 Anchorage, AK 99519 REFERENCE: Lot 1; Block 3; Valli Vue Estates S/D It is requested that you issue a permit to install a new I.D.S.F. septic system to serve the existing four bedroom house. A test hole was excavated and percolation tests performed by Construction Test Lab. The approximate locations of the test hole is located on the attached site plan. At the time of excavation on 5/6-7/76 water was not found. The existing trench is saturated and the existing septic tank jet acmtion system has not worked for some years. The edge of the proposed I.D.S.F. may be located above a portion of the existing trench, this will require the contractor to excavate down and remove the filter fabric/visqueen in that portion prior to constructing the field. Due to the topography on this lot there is no other site suitable for the upgrade of this system. All lots in this area are served by public water. We do not anticipate any adverse effects on neighboring septic systems, reserve areas or drainage patterns by the installation of the proposed innovative septic system. The construction of this system will not prevent any future development on any of the adjacent properties. If you requite agitional information, please contact us. Shafer, P.E. 15861 S. Birchi%ood Loop Road, Chugiak, Alaska 99567 N. T. S. I DESIGN ,k. i m N X55 CoH �y- C9 PROFILE 9 a ©0 'Edss / a� a I, N GSR / fig VO IPA / J G�©e \ OC /' FN�a\ \1✓ O 'i. ✓ \ \ G 4 yCOT \ v / / C rA n ,� * -yi ✓ i _: to " SITE -PLAN IDESIGN CO S��X 91 ,�p� SLC AG/s GPC c z oy C. • a N D O / •r / N V ~ P i D O N a s \� O V ZO=O0> \ Z Ov O 00 \ A 2mnDX I '� !Mz '• o jAy� >1 or, -;E A 00 ZZO D \ OONON r00. r ��• mmm,ti OCi n // mo O • �r o o� \ rx A D N Ln I N A I N O O r C P.— Z iib r HI �.C..yy l'J d ml N. T. S. DESIGN I.D.S.F. DETAIL 1CAJ r ^zx 1 O�j -4� r� OOON00 ►J'- V, cn 0— � C-) �+ n D Z m O r� �. mrrl C7 m0 0VyD .i v 'a D � VI N ti — m VI A d ePoo r r D > IIoII W -3 QF� r ,� II N II OOOOo CD . 18, y `� ODo^ 6 er n ` x � to E2 Fa �Pn ab �i z. jrrl o z y no no 6 ri � K'n O n(.J' A o 3� sa p r 1 F C" N m C a: N may. 9 S d c c t ~3 h A ^ D o C" O �- fill VI 2 _w. v�•46.«�.. j F ftl O t.� Is �� d.�3p •, '� l AJ9 -3 tl- O cygwnw.ww�'f'" HEALTH AUTHORITY APPROVALS SEWER Q WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION 6 FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURALS MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSAL SYSTEM DESIGN S & Sl Robert A. Shafer, P.E. ;IneCRInG CIVIL ENGINEERING PH: 907.694-2979 FAX: 907-694-1211 IIVTERMITTANT DOSING SAND FILTER SPECIFICATIONS Lot 1; Block 3; Valli Vue Estates #1 SID May 28, 2010 GENERAL STATEMENT OF WORK The work and plans covered by these specifications consist of furnishing all labor, materials, tools, transportation, and equipment necessary to complete an Intermittent Dosing Sand Filter system as described herein and on the attached drawings. All work under this project shall comply with current Municipality of Anchorage (MOA) Regulations. The scope of this project includes the installation of a new I.D.S.F. septic system to serve the existing 4 bedroom residence located on the referenced property. SITE INVESTIGATION The Contractor must carefully examine the project documents, have full knowledge thereof, have investigated the site, and be satisfied with the conditions affecting the work. Conditions include, but are not limited to those bearing upon transportation, disposal, handling and storage of materials, availability of labor, water, electric power, roads, and uncertainties of weather, physical conditions at the site including all underground utilities, the conformation and condition of the ground, the character of equipment and facilities needed preliminary to and during prosecution of the work. The Contractor must be satisfied with the character, quality and quantity of surface and subsurface materials or obstacles to be encountered. Any failure by the Contractor to become acquainted with the available information will not relieve him/her from responsibility of performing the work as stated in these specifications and drawings. of utilities will be the contractor's responsibility. 15861 S. Birchwood Loop Road, Chugiak, Alaska 99567 Page 2 Lot 1; Block 3; Valli Vue Estates 01 SID May 28, 2010 SEPTIC TANK/ LIFT STATION/ AIR COMPRESSOR A. General The work under this section consists of the performance of all operations pertaining to furnishing and installing the septic tank/lift station, air compressor and piping to the sand filter. B. Materials 1. Tank a. Septic tank shall be a two compartment tank of at least the minimum size indicated on the drawings and MOA approved. b. First compartment shall have a separate 4" pump -out riser. The second compartment shall have a separate 4" pump -out riser. c. I IDPE septic tanks are required to have a 4" monitoring pipe installed next to the tank extending to the bottom of the tank, a minimum of 2" direct burial insulation, and a maximum of 4 feet of cover. 2. Manhole Riser or Lift Station Tank •t a. An additional second compartment manhole riser shall be capable of being equipped with the following: 1. A junction (Nema 4x) box or equal, bonded or attached to the pump basin. 2. UL listed electrical cord grips, installed in the J -box. b. An additional tank (M.O.A. approved) may be provided for the effluent pumping assembly and the items in (a.) above. 3. Effluent Pumping Assembly, Controls, Alarm & Piping a. Effluent pumping assembly shall be of approved materials, including the following: I. A 110 volt or equal U.L. Listed effluent pump. Page 3 Lot 1; Block 3; Valli Vue Estates 01 SID May 28, 2010 2. Iligh-density PVC cylinder housing the pump, with level controls and screen, serving as a baffle to prevent the screen from clogging. 3. All piping shall be PVC or other non -corroding material. b. Pump controls and alarm system shall be an approved system with the following options consisting of: 1. Event counter 2. Elapsed time meter 3. Program timer 4. 10 watt heater 5. Remote alarm panel option with a minimum of 80 D13 sound pressure at 24", operating temperature 30AC to 65AC, continuous sound to be located in the home. 6. Oil -tight visual alarm with push -to -silence feature. Automatic audio -alarm reset. 7. 15 amp motor rated toggle switch, double pole, double throw with three positions; manual (man), automatic (auto) and center (off) (Ii.O.A.). 8. Nema 4x -rated, fiberglass, or equal, enclosure with hinged cover. 9. All controls to be installed as per manufacturer's recommendations. 10. Control panel to be installed on outside wall of home within sight of septic tank/lift station. c. Piping from the septic tank to the sand filter is to be 1 1/4" PVC schedule 40 solvent weld piping properly bedded as described in Materials Specifications and sloped to drain back to the lift station. Insulation board 2" thick and 2' wide centered over pipe is to be placed where soil cover is less than 4' depth over pipe. Page 4 Lot 1; Block 0; Valli Vue Estates 91 S!D May 28, 2010 d. The airline from the house to the filter is to be IIDPE insulated pipe 3/4"-2" SDR -I 1. The compressor will have a gauge (0-10 psi), a low pressure alarm, and be extended into the living area or garage for easy monitoring by home occupants. 4. Air Compressor a. Air compressor shall be a THOMAS LINEAR SERIES model number 5060-A or 5070V -A or M.O.A. approved equal. CONSTRUCTION SEQUENCE In order to insure proper installation, the system is recommended to be installed in the following order: I. Sewer line from house to tank II. Septic tank/lift station III. Sand filter IV. Leachfield bed (if required) V. Final grading CONSTRUCTION 1. Construction Instruments Contractor shall provide instruments such as transits, or levels, for establishing proper elevations and levelness of pipe or materials. 2. Pipe Laying All pipe shall be laid with material free of large or sharp rocks and organic matter. Each section of pipe shall be handled carefully and placed accurately. The spigot end shall be fully inserted pointing in the direction of flow and glued in place to make a water tight seal. Page 5 Lot 1; Block 3; Valli Vue Estates 01 SID May 28, 2010 Each section of pipe shall be properly supported to insure true alignment and an invert which is smooth and free from roughness or irregularity. At all times, when work is not in progress, open ends of pipe and fittings shall be closed so that no undesirable substance will enter the end of the pipe or fittings. 3. Bedding of Pipe for Sewer Lines The pipe should be bedded with materials free of large or sharp rocks and organic matter, compacted. Native materials may be used as back fill material above the pipe, provided it is free of large rocks and organic matter. All lift stations shall be installed in accordance with the manufacturer's recommendations and standards. Electrical installation is to be in accordance with the National Electric Code (latest adopted edition) by a licensed electrical contractor, with M.O.A. inspection where required. If MOA inspection is not required, a licensed electrician is to provide a letter to the Engineer stating that the system meets or exceeds all applicable codes. 4. Excavation Excavate to proper depth to allow gravity flow, install tank level, tolerance 0.05 foot, on undisturbed or compacted classified sand fill material. Create a level sand surface over the tank and add 2" burial foam +35 PSI directly over tank. Mound unclassified soil over tank with a minimum of 2 feet of cover and anti -flotation weights that may be required in areas of shallow ground water. 5. Connections All connections to be as per MOA requirements, PVC 3034 piping with Caulder or equivalent couplings for inlet riser pipes. All tank connections are to be completely water tight. Page 8 Lot 1; Block 3; Valli Vus Estates 01 SID May 28, 2010 SAND FILTER The work under this section consists of the performance of all operations pertaining to furnishing and installing the sand filter. A. Materials 1. Sand Filter a. Liner (if required - not required for bottomless sand filter) - OSI Model LI or equivalent. 30 mil PVC cut and fabricated to provide water tight enclosure of filter sand volume. Seams to be permanent as per Manufacturer's recommendations. All connections, such as boot flanges, through sand filter to be permanently bonded to the liner. b. The Contractor shall provide a washed sand to meet ASTM C-33 Concrete Sand Specifications with the additional requirement that all but 1% of the materials passing the #100 sieve be removed. All sand shall be approved for use by the Municipality of Anchorage (M.O.A.). If the sample does not meet specifications, all sand will be removed and replaced. c. The Contractor shall be responsible for providing pea gravel that shall be a washed material containing no fines (0% passing the #100 sieve) and a maximum size of 1/4" diameter. d. The Contractor shall provide the manifold assembly. The manifold assembly shall be of approved materials with orifice shields and flushing assembly. All drilled holes to be cleaned of burrs and pipes flushed, prior to assembly. Flushing valve to include riser to finish grade. Lateral distribution piping is to be laid level (@ ± 0.05'). e. Top of the filter box to be insulated with 2" direct burial polystyrene insulation. f. The Contractor shall be responsible for providing filter fabric. g. Air coil in sand filter to be geoflow WF16-4-24 150 LF placed 6" above bottom ofsand. Page 7 Lot 1; Block 3; Valli Vue Estates •1 SID May 28, 2010 Construction of Sand Filter The sand filter construction is to follow procedures as outlined below, as applicable to this design. Pea gravel and filter sand are to be hand leveled to proper depth (tolerance within 0.05 feet) in filter, taking care not to allow mud or fine soil material into the filter or gravel layer. This would include any soil material picked up by excavation machinery buckets while loading specified material. The Contractor should estimate filter material volumes such that allowance is made for wastage of material in contact with the ground at site. The area over the sand filter to be finish graded with a minimum of 2 feet of cover and to prevent ponding of surface water run off. Side slopes shall not exceed 3:1. The Engineer will reject any sand or pea gravel that does not meet specifications or is contaminated in transit or while handling. If such material is placed in the filter, all soil material may be required to be removed and replaced with new material. CONTRACTOR/ INSTALLER GRPr,_ER ANCHORAGE AREA BOR, JGH T_' NC) 0'1�m Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME (\011 :JUjI Rd'k MAILING ADDRESS ��I��C7 liLl�l2- PHONE •.��-3.3 lvdZ�( LOCATION t6i% Ta.L L''- )YI F:i YI (Lka LEGAL DESCRIPTION x"OT I Rs IC -3 V14,11/ VqF e�SI , `� �t.I SEPTIC TANK: t i�� PiA DISTANCE / � 1�1NUMBER OF •� FROM WELLCcaft Ih1 MANUFACTURER .ti- MATERIALlygCOMPART E INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY1C- GALLONS. T -lid DRAIN FtffL-D - ' Vv-- i 14 + - TOTAL LENGTH, p DISTANCE FROM WELLc-�+.Mill FOUNDATION NEAREST LOT LINE OF LINES 76t NUMBER OF LINES DISTANCE BETWEEN LINES TRENCH WIDTHWk IN. TOTAL EFFECTIVE ABSORPTION AREA (GCs3 k SQ. FT. LENGTH OF EACH LINE y+ DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISH GRADE �J 1� _ MATERIAL BENEATH TILE WELL: TYPE�2LJA CONSTRUCTION BUILDING NEAREST NEAREST SEPTIC FOUNDATION LOT LINE , SEWER LINE , TANK CESSPOOL OTHER SOURCES APPROVED DISAPPROVED REMARKS Ot. ABOVE TILE q� IN. SEEPAGE SYSTEM_ DISTANCES: DIAGRAM OF SYSTEM INSTALLED BY:�-1 U SEWER LINE DEPTH: PI E MATERIAL:L til+vL?c.� ry _k L' pppp zz T I n. C LOT SLOPE: REMARKS: DATE !k+ APPROVED Form EQ -032 DISTANCE FROM: M4_"I r~ I F•F L_ I ir'-O OF= tit -J E:- fliF,:" 1:3E DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION , 2510 E. TUDOR RD.., ANCHORAGE, AK. 99507 276-2221 PERMIT NO. C 76159 ) APPLICANT NEAL SULLIVAN_ 2120 CHANDALAR DR 333-6201 LOCATION LUNE TREE 4 MAIN TREE LEGAL L1 B3 VALLI VUE SUBD LOT SIZE 21024 SQUARE FEET TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATING (SQ FT/BR)= 275 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: CoF=F'-IF H= :IL:--> LENOT'H= UFeF=l VF=L Co FE F= ' -r = THE LENGTH DIMENSION IS THE LENGTH CIN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION CIN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION CIN FEET). F --'"C KF1r_3F= F I F:l .i'T FZE:01U I FZEC31 EITHER A CLASS I OR II MSF APPROVED PLANT MAY BE INSTALLED. A 9ONTINUOUS MAINTENANCE AGREEMENT TS—REQUIRED./ IF A MAINTENANCE AGREEMENT IS NOT KEPT CURRENT YOU MAY BE REQUIRED TO ENLARGE THE SOIL ABSORPTION SYSTEM AND/OR YOU MAY BE SUBJECT TO PROSECUTION. IF A CLASS I SYSTEM IS USED THE LENGTH IS 56.0 FEET. IF A CLASS II SYSTEM IS USED THE LENGTH IS 72.0 FEET. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON—SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 200 FEET FOR A PUBLIC WELL. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F•F=FSM I T tir`FtL I C• F"OF;L:." ONE: YF=F=ew F= F;ZOM I "4JF= I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON—SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: 1 UNDERSTAND THAT THE ON—SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. SIGNED:_ � _" ��-- APPLICANT NEAL SULLIVAN 7_ ISSUED BY_6'2��—___--DATE__`5 _ —� s' Lon1ttuetion ETEzi-fa.�rY,. "One test is worth a thousand opinions" _ 2204 Cleveland Anchorage, Alaska 99503' Date Performed 5/6'&'7/76 Performed For Mr. Neal Sullivan Subdivision Leal oescrit+tion: Lot_Block � Sub W es This Form Reports Soils Lon Perco1 t� Denth Feet 6 i 4— Brown Gravelly Sandy Silt 6— (ML) ^ 35a 8 10- 12 0- 12 14—. Gravelly Silty Sand 16 (SM) ^ cl75 18 _ Bottom of test hole 20— Was Ground Water Encountered? No If Yes, At what Depth? Rem Date Gr( F— 5-6-76 Sat i Per 5-7-76 5-7-76 r— Be ir. ���t M, FS Percolation Rate 1" 40 Minutes Pit Drain Field Yes Prnnosed Installation: Seenaoe Denth T� o Bottom Of Pit Or �Trench Oeoth of Inlet CnMMENTS: 275 Square Feet rainage area required per bedroom. rertified Ry: qm �.4 , 70 • !1 Municipality of Anchor. ::�r,?l-.1 �/ 3 ot // On-Site Water and Wastewater Prog � -i �;v (907) 343-7904 APR 201 a ET � 3 � v c. ti Certificate of On-Site Systems Ap.z 8 L cA"I�' Parcel I.D. 015-322-09 Expiration Date:q^2 5"-- 1. 1. GENERAL INFORMATION Complete legal description Valli Vue Estates #1 B3 Li Location (site address) 10600 Main Tree Dr Current Property owner(s) Lori C. & Dennis D. Wichman Day phone Mailing address 5993 Vanity Fair Rd Milton FL 32570 Real Estate Agent Matthew Lindsay Day phone (907) 257-0174 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual 0 Individual Water Storage ❑ Holding Tank ❑ Community Class A Well 0 Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: .0/t Date: _5/06 COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ 52(x'' Waiver Fee $ Date of Payment zj' 2.BJH U Date of Payment Receipt Number '03181 Receipt Number COSA# ()Sea 11 GJ'1 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 time of installation. Name of Firm Forge Engineering Phone (907) 522-7773 Address PO Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Date 4/19/18 . 49±i 6. DSD SIGNATURE �� e io Y. v :MIC AI<L E. /,-5 ERSON System #1 Approved for bedrooms OA x'4`'61• "C1r 43 - 81 :• o System #2 Approved for bedrooms �'A�f��'°;�'`''t �:•°°��® Disapproved ,f;, ea ...... ,® is '- Conditional approval for bedrooms, with the following stipulations: ON-SITE 13. WATER AND WASTEWATER PROGRAM' ;--c( „- Original Certificate Date: � 70—ig 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 r '- c If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: Valli Vue Estates #1 B3 L1 Parcel ID: 015-322-09 A. WELL DATA Well type A If A, B, or C provide PWSID# 210605 Well Log (Y/N) Date completed Sanitary seal (Y/N) Wires properly protected (Y/N) Total depth ft. Cased to ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test Community well Static water level ft. ft. Well production g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate mg/L Arsenic ug/L Date of sample: Collected by: Forge Eng. B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/HDPE Date installed 7/23/11 Tank size 1300 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 Date of pumping 9/25/17 Pumper A+ Home Services C. ABSORPTION FI,L D AT10 ViiiiiminDate installed Soil rating (g.p.d./ft2 or ft2/bdrm) 2.0 GPD/SF System type IDSF Length 20 ft. Width 18 ft. Gravel below pipe 0.25 ft. Total depth 3.0 ft. Eff. absorption area 360 ft2 Monitoring tube Y Depression over field N Date of adequacy test 4/18-4/19 Results (Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption field before test 0 in. Water added 701 gal. New depth 0 in. Elapsed Time: 1440 min. Final fluid depth 0 in. Absorption rate >= 600 g p d NoneAny rejuvenation treatment (past 12 mo.) (Y/N &type) If yes, give date D. LIFT STATION Date installed 7/23/11 Size in gallons 550 Manhole/Access (Y/N) Y "Pump on" level at Timer in. "Pump off' level at Timer in. High water alarm level at 36 in. Datum Bottom Cycles tested A+Home Sercises Meets alarm&circuit requirements? 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: >5' >5' Building foundation 10 Property line Absorption field Water main X10 Water service line >10' Surface water >100' Wells on adjacent lots N/A ABSORPTION FIELD ON LOT TO: >10' Property line >10 Building foundation >10 Water main >10' Water Service line >1 Surface water �1 00 Driveway, parking/vehicle storage Curtain drain None Noted Wells on adjacent lots N/A F. COMMENTS G. ENGINEER'S CERTIFICATION ��_gOF l�ittiee s I certify that I have determined through field inspections and 42". ''''/V:** • ••'4;5��, review of Municipal records that the above systems are in ,"Ci • ' •;r 'to conformance with MOA COSA guidelines in effect on this date. ® !'z°,;:4. "`� • * r'4 Engineer's Printed Name Michael E. Anderson, P.E. �W C�_sc►' e, A 'V:.MICHAEL E. ANDERSON • Date 4/19/18 of',..7.••• CE-4381 : "® , COSA brown sheet 10-10-12.doc ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT BETWEEN MUNICIPALITY OF ANCHORAGE AND Thomas Parr THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this G-� Day of is r i j of 20_18, by and between Thomas Parr herein the"OWNER,"and the Municipality of Anchorage,herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein,the parties to this Maintenance and Repair Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS),described as ADVANTEX WASTE WATER TREATMENT SYSTEM located at(legal description). Valli Vue Estates#1 LI B3 2. Definitions. Alteration. Any change to the design or function of an AWWTS that includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Certificate of On-Site Systems Approval(COSA). An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with Anchorage Municipal Code(hereinafter, "AMC") 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. Permit.An On-Site Wastewater Disposal Permit as required by AMC 15.65 to construct and operate an AWWTS. 3. Term. The term of this Maintenance and Repair Agreement shall begin on the date of approval by the Municipality to operate the installed system or issuance of a COSA,and shall continue while the AWWTS is in use or is operational or until the property is sold or title is transferred by the owner and a new COSA is issued to the new owner or transferee of the property. 4. Alterations,Installation and Removal of Additional Equipment. Prior to performing any alterations to an AWWTS, the owner agrees to obtain an On-site Wastewater Disposal Permit from the Municipality in accordance with AMC 15.65. 5. Maintenance and Repairs. A. Throughout the term of this Maintenance and Repair Agreement,the Owner shall maintain their AWWTS in a satisfactory condition capable of producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. The owner shall enter into a service agreement with an AWWTS H. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction,maintenance and repair of the Owner's AWWTS. 6. Nonwaiver. The failure of either party at any time to enforce a provision of this Maintenance and Repair Agreement shall in no way constitute a waiver of the provisions,nor in any way affect the validity of the Maintenance and Repair Agreement or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 7. Amendment. A. This Maintenance and Repair Agreement shall only be amended,modified or changed by a writing, executed by authorized representatives of the parties,with the same formality that this Maintenance and Repair Agreement was executed with, and such writing shall be attached to this Maintenance and Repair Agreement as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this agreement,the only authorized representatives of the parties are: a. Owner: Thomas Parr b. Municipality: Director, Community Development or designated authority C. Any attempt to amend,modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. service and maintenance provider approved by the municipality and the manufacturer of the AWWTS for the entire term of the AWWTS. In addition, it shall be the responsibility of the Owner during the term of this Maintenance and Repair Agreement, and any renewals thereof, at the owner's sole expense,to pay for any and all: (1)repair(s), (2)maintenance,(3)adjustment(s),(4)replacement costs, and(5)inspection costs. B. Owner agrees to comply with all applicable ordinance, laws, regulations, rules and orders for the AWWTS. C. Upon request by the Municipality,the owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system. When a record of maintenance is documented and maintained by the system vendor,the owner agrees to allow the Municipality access to this information. D. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60 for improper discharge. E. Owner agrees that only maintenance and repair personnel approved by the Municipality will inspect and make any necessary maintenance,repairs or permitted alterations to the system. F. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. G. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On-Site Systems Approval. 8. Jurisdiction: Choice of Law. Any civil action arising from this Maintenance and Repair Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Maintenance and Repair Agreement. 9. Severability. Any provisions of this Maintenance and Repair Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Maintenance and Repair Agreement. OWNER: By: r 7.49,4' 4-"--- {signature) Date: V/z 7/it "s (R.r^! (print name) STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this ail day of Apr, \ 20 iia, by Thr-ryvxs i�r-err • frTARY PUBLIC FOR AL KA srA rL R ��1_nsCnNor�K}� }�l,li] lc •Commission expires: 4 q tq k '1 JANE HASTINGS 8-'0 74, .b.,,• Commission Ex'Inas April 9,2019 MUNICIPALITY: By: (signature) Date: (print name) Title: Municipality of Anchorage • .�a Development Services Department - Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 A _ Anchorage, AK 99519-6650 �j° www.muni.org/onsitej' (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL lai�3 FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-322-09 COSA# 31 �rl'5 7 1. GENERAL INFORMATION Expiration Date: f �� ✓ ! i s� Complete legal description VALLI VUE ESTATES #1; BLOCK 3, LOT 1 Location (site address) 10600 MAIN TREE DRIVE *ANCHORAGE, AK 99507 Current Property owner(s) Mailing address Lending agency Mailing address DAVID SULLIVAN Day phone 10600 MAIN TREE DRIVE *ANCHORAGE, AK 99507 Day phone Real Estate Agent BOB BAER W/ DYNAMIC PROPERTIES Day phone Mailing address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 346-2313 346-2313 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ individual On-site 0 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. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, l verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. i further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 " ANCHORAGE, AK 99507 Phone Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA 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 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. These conditions are outside the control of the evaluator of the system. Satisfactory test 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 any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE / Approved for _4_1 bedrooms. Disapproved. 337-6179 3 �F CE -7)53 ! �'rofessio�o�� Conditional approval for bedrooms, with the following stipulations: y��, __1 c 1_x7 WRSTEWA AA Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Nitrate Advisory Other By: (Rev. 7 V05) Original Certificate Date: — Municipality of Anchorage • '� Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 3437904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST �dk Legal Description: VALLI VILE ESTATES #1; BLOCK 3 LOT 1 Parcel ID: 015-322-09 A. WELL DATA Well type CLASS 'A" Date completed Total depth ft. Date of test Static water level Well production WATER SAMPLE COMMUNITY WATER If A, B, or C provide PWSID# 210605 Well Log (Y/N) _ Sanitary seal (Y/N)_ Wires properly protected Cased to ft. Casing height (abo n FROM WELL LOG AT IN CTION ft. ft Ulm Coliform �Gcolonies/100 ml. Nitrate mg./L. Collected by: ug./L. Date of sample: B. SEPTIC/HOLDING TANK DATA M. Tank Type/Material SEPTIC/PREMIER PLASTIC Date installed **UNKNOWN Tank size 1300 gal. Number of Compartments E Cleanouts (Y/N) YES Foundation cleanout Y/N YES Depression over tank Y/N NO \ ( ) — p ( ) _ j High water alarm (YIN) Date of pumping bo l)- Pumper C10 'Id lei t 1 C. ABSORPTION FIELD DATA *BELOW EXISTING GRAD Date installed **UNKNOWN Soil rating (g.p.d./ft2or /bdrm 2.0 System type IDSF Length 20 ft. Width 18 in. ft. Gravel below pipe 0.25 ft. Total depth *5.69 ft. Eff. absorption area 360 ft2 Monitoring tube YES Depression over field NO Date of adequacy test 7/5/2012 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 0 in. Water added 700 gal. New depth 0 in. Elapsed Time: 0 min. Final fluid depth 0 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date – **INSTALLED SOMETIME AFTER PERMIT WAS ISSUED ON 6/10/2010. D. LIFT STATION *SEE ATTACHED MAINTENANCE INSPECTION REPORT. Date installed **UNKNOWN Size in gallons 550 Manhole/Access (YM) YES "Pump on" level at TIMER in. "Pump ofr level atTIMER in. High water alarm level at 36 in. Datum BOTTOM OF TANK Cycles tested * Meets alar & circuit requirements?YES E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAift station on lot Absorption field on Public sewer main Sewer /septic service line areas On adjacent On adjacent lots manhole%leanout Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field ***5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ PRIVATE/200'+ PUBLIC SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water service line 100+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ PRIVATE/200'+ PUBLIC F. COMMENTS **INSTALLED SOMETIME AFTER PERMIT WAS ISSUED ON 6/10/2010. ***ASSUMED 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. Engineers Printed Name JEFFREY A. GARNESS Date .x/113 COSA Fee Date of Payment Receipt Number (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number ' SS NpIG Hi F�4 e ®. 5 J FATS A -FALL NO A+ HOME SERVICES , INC. 7501 E. 140th Avenue Anchorage, Alaska 99516 345-1890 CUSTOMER Block Lot INVOICE # DATE DESCRIPTION AMOUNT l^ _ TOTAL REMARKS Gallons Septic Leach Area Holding Tank ❑ PROBLEM AREA — CALL FOR MORE INFORMATION ❑ NEEDS TO BE DONE AGAIN IN 5 MONTHS ❑ Good Shape ❑ Sludge buildup on bottom ❑ Jim cap missing or ❑ Cut standpipe to 1' above ground needs replacing Standpipes Time ❑ Floater on top ❑ Needs Septictrine A+ H,me S,e1 V/Ili..®s 11.. lns%.nP,c tions Tank Type:_ Name: Address: /C E t?G- T'= Phone Number: ----- - - - - -- Inspection # OYJ Timer Setting a.7 11I' Air Flow C�/I Elapsed Time 11i/i Event Counter �✓G Date & Time �7 /Ti -17-- WIMMO Problem:. S �c � � sn�{a°.� /din Lu vsI./s • .�MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES M} 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 Parcell.D.# 3Q,;�-CL HAA# Af--)°I aLL,21QLQ 1. GENERAL INFORMATION Complete legal description L d� 3 l � (AL1 t{� 85 Mme, Location (site address or directions) 10 40 d xje�;? i,,? / �—e- Property owner ����� ( �C� f I%a�yl Day phone k Mailingaddress Po C�C)4'1 C��l Lending agency Mailing address. Agent Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water Day phone Day phone NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site —— Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025(R".1/91) Front MOA#21 .1 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 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 J,3 1v 5� ��o/�J � j phone Address Engineer's signature 6. DHHS'SIGNATURE Approved for Disapproved. Conditional approval for Additional Comments bedrooms. Date _Zo - OF AC James F. Sizemore # 1517 E bedrooms, with the following stipulations: The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA N21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L 183 Ugl (i --Vue G%-� Vrl Parcel I.D. 0� A. WELL DATA Well type Log present(Y/N) -max Clam /f If A, B, or C, attach ADEC letter Date completed Total depth Cased Sanitary seal (Y/N) Date of test Static water level Well flow Pump level SEPARATION DISTANCES Septic/holding tank Absorption Public sewer main FROM WELL LOG ADEC water system number Driller Casing height Wires properly protected (Y/N) M. lot — Public sewer Public sewer service line WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate B. SEPTIC/HOLDING TANK DATA 0 Date installed 2 /)--A--/7& C /7& Tank size AT On adjacent lots n adjacent lots man le/cleanout Petroleum tang, Collected by: 12-5-0 Other bacteria Compartments 41211 Cleanouts (Y/N) 4 Foundation cleanout (YIN) Depression (Y/N) High water alarm (Y/N) rn & Alarm tested (Y/N) Date of pumping SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot / On adjacent lots ! To property line —Absorption field— Surface ield Surface water/drainage .Vi v� Foundation / Z' / Water main/service line SG !C� OF M o /q F 72-026 (Re, 3/91) Front MOA 21 C' CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent(Y/N) "Pump on" High water alarm level Meets MOA elec 'cal codes (Y/N) Z SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Manufacturer (Y/N) "Pump off" level at ra ? �: PU o z Cycles tested o n v m O T p� (p < D Surface water 0 -. N D. ABSORPTION FIELD DATA z " Date installed/a�/ 7Soil rating Z-7 5System type N Length WidthGravelthicknessTotal depth l/ Total absorption area l c T Cleanouts present (Y/N) t �7 c-) Depression over field (Y/N) Date of adequacy test l — — Results (pass/fail) P J for bedrooms Peroxide treatment (past 12 months Y/N �V ��r ����� ( ) If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: C-0 glw Y � - Well on lot On adjacent lots Property line To building foundation To existing or abandoned system on lot /V2% 1-7 C- On adjacent lots Cutbank A 20 Water main/service line- Surface ine Surface water 7� 0 `� e Driveway, parking/vehicle storage area �U CurtAln drain E. ENGINEER'S CERTIFICATION 1 certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on tpe date of this inspection. Signature - ' G' Engineer's e cC�G/ %�-� Nam Date lo G Z, HAA Fee $ 17D, DC7 Date of Payment C?Z, Receipt Number CA30a 72-026 (Rev. 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number James F. $izO 9f 1517 F. ( WALTER J. NICKEL, GOVERNOR DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE DISTRICT OFFICE 800 E. DIMOND BLVD., SUITE 3-470 ANCHORAGE, ALASKA 99515 October 1. 1992 Mr. James Sizemore SUBJECT: Valli Vue Subdivision Class "A" Public Water System, PWSID 210605 Dear Mr. Sizemeore: (907) 349-7755 I have completed a review of this office's files concerning the monitoring status of the above -referenced Class "A" Public Water System and found the following: 1. The last satisfactory Total Coliform Bacteria Sample results was submitted to this Department on September 8, 1992. This does meet the provisions of 18 AAC 80.200(a), of the State Drinking Water Regulations. 2. The last inorganic Chemical Contaminants Sample results were submitted to this Department on August 13, 1992. This does meet the provisions of 18 AAC 80.200(a), of the State Drinking Water Regulations. 3. The last Radioactive Contaminants Sample results were submitted to the Department on September 9, 1992. This does meet the provisions of 18 AAC 80.200(a), State Drinking Water Regulations. 4. The last Organic Chemical Contaminants/Volatile Organic Chemicals were submitted to this Department on November 12, 1991. This does meet the provisions of 18 AAC 80.200(a), State Drinking Water Regulations. Issuance of this letter does not imply that the above -referenced Class "A" Public Water System is in compliance with other provisions of the State Drinking Regulations. If you have any questions on the above information, please do not hesitate to contact this office at 349-7755. Sincerely, Mi hael Lu Environmental Eng. Asst. II printed on recycled paper by Q.fl. ';:1: Time 1. Date MUNICIPALITY OF ANCHORAGE DEPARTMC�—'OF HEALTH AND ENVIRONMED''`, PROTECTION 825 Street, Anchorage, Ala_..' 99501 279•-2511, ext. 224 or 225 Date Received: May 9, 1977 _ 9:30 a.m. #2: Time 43: .Time _ 5-10=77 Tues Date Date Insp Pratt Insp Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES Lending Institution Request: First National Bank of Anchorage Post Office Box 720 99510 276-6300/483 Mailing Address: Phone: 2. Property Owner: Mailing Address: 3 Neal L. Sullivan Post Office Box 10-097 99502 Phone: 349-8547/279-8494 Legal Description: Lot 1 Block 3 Valli Vue Estates 4: Single Family Residence: (x) Number of Bedrooms: - Multiple Family Residence: ( ) Number. of Bedrooms: 5. Well System: Permit # Construction Individual Well ( ) Community/Public System ( A Depth of Well ^_ Well Log on File ( ) Bacterial Analysis 6. Sewage Disposal System: On-site System (x) Permit # Installed Septic Tank Size Absorption Area Public Utility ( ) Installer Manufacturer Soils Rate 7. Distances: Well to Septic Tank to Sewer Line to Nearest Lot Line Nearest Lot line Material to Absorption Area Absorption Area Page Tw,o Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 1 Block'3 Valli Vue Estates Comments: Affadavit Attached: ' ) Letter Attached: ( ) Approved: Date:/ Disapproved: Date: Department Worksheet: n �0,� rnurr r nr;cr(oar, - ` \ DEPT: Or !Lv',GII T MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" Street, Anchorage, Alaska 99503 — 274-4561 HIM 9 �/IOU REQUEST FOR APPROVAL OF JR1-F1 V D INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO VA FHA CONV 2. Property Owner: ��'y / �' �� // /��4 shy -mss u7 Mailing Address: 1!20 z?=n l0 - O i 9 fsroz Day Phone 2 7 % Serif 3. Name of Buyer: vw'?eG-- Mailing Address: Day Phone 4. Name of Lending Institution: , f�ne��O ry vox ?20 yS'io 276 —6300 Mailing Address: p 9 Phone 5. Name of Realtor or Agent: A7 °"-e Mailing Address: Phone 6. Legal Description: Location: _ 7 L1 a O/O � n?a•:h hPe Type of Facility to be inspected: - Water Supply Type of Supply: Public Utility X If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System Type of System: Public Utility If Individual, date of installation EQ -037 (1/74) No. Bdrms. Individual Individual (on-site) X